The OIG ensures that HHS programs comply with federal laws and regulations. The OIG’s compliance guidance for new physicians is designed to help them understand their roles and responsibilities in complying with federal laws and regulations governing HHS programs.
The guidance addresses various topics, including the federal Anti-Kickback Statute, the Stark Law, the Physician Self-Referral Law, the Civil Monetary Penalties Law, and the False Claims Act. The guidance also includes information on the OIG’s voluntary disclosure program, allowing physicians to self-disclose potential federal laws and regulations violations and receive reduced penalties. If you are unaware of the healthcare compliance guide, you should contact a los angeles healthcare attorney.
Healthcare compliance guide for new physicians
- Physician Relationships with Payers
EHRs and other health information technology (HIT) have increased the demand for accurate coding and billing. Physicians and providers often have to appeal denials or other problems with coding and billing.
Appealing denials and other problems with coding and billing can be time-consuming. Physicians and other providers can use several strategies to improve the accuracy of their coding and billing. One strategy is to develop and maintain good relationships with payers. Good relationships with payers can help ensure that claims are paid correctly and on time.
Another strategy is to use coding and billing software designed to improve coding and billing accuracy. Coding and billing software can help physicians and other providers avoid coding and billing errors.
- Physician Documentation
For the patient to qualify for home health care services, the physician must document the patient’s need for skilled nursing care, physical therapy, occupational therapy, and/or speech therapy.
- The physician must also document the frequency and duration of services required. The physician must treat the patient and sign the physician certification statement at least once every 60 days.
- The physician may also be required to perform a face-to-face encounter and sign face-to-face encounter documentation. The face-to-face encounter is a meeting between the physician and the patient, which may be conducted using electronic communications.
- Enrolling as a Medicaid provider and medicare
Most physicians and other healthcare providers who serve Medicare and Medicaid enrollees are enrolled in the Medicare program and are automatically enrolled in the Medicaid program. If they are not already enrolled in the Medicaid program, they can enroll in both programs—Medicare and Medicaid—by completing a single application.
- Prescription authority
The Prescription Authority of physicians is the power of a licensed physician to prescribe medication and is usually regulated by the government or the medical board.
It is a common misconception that licensed physicians can only prescribe prescription drugs. The truth is that many healthcare providers can prescribe medication, including nurse practitioners, physician assistants, and pharmacists. However, each state has its own laws governing who can prescribe medication and under what circumstances.
