Healthicity Blog

$8.18 Billion is a lot of money. It’s not the amount recovered by the government from healthcare fraud and abuse. It’s not the amount of money provided in charity care by hospitals.

When compliance officers hear of healthcare organization settlements associated with compliance problems, they’re typically hearing of settlements engineered by a government agency such as the U.S. Department of Justice or the HHS Office for Civil Rights.

In this episode of Compliance Conversations, I sat down with Senior Consultant, Brenden O’Neil, who works in Intermountain’s professional coding and reimbursement department. O’Neil and I had a fascinating discussion on CPT codes and the complicated gray area of coding a laminectomy.

In 2009, the HITECH Act was passed as a part of the American Recovery and Reinvestment Act. It provided the authority for the government to establish the Medicare and Medicaid Electronic Health Record (HER) incentive programs to promote the adoption of EHRs.

Compliance and coding are complicated.

We all “report up” to somebody at some point and that goes for the OIG, too, in their regular reports to Congress. Recently, the OIG submitted its Semiannual Report to Congress for the period of Oct. 1, 2016 to March 31, 2017.

Opinions aren’t always the most effective way to make a case. I’ve found that it’s always easier to find an existing citation or reference instead of using your opinion. Opinions simply sound too subjective and there are too many gray areas in compliance for subjectivity.

“What are the first steps I should take to improve my compliance program right now?”

To put it simply: The more you know, the better off you’ll be. A great compliance program starts with knowledge of compliance, rules and regulations, and best practices.