How doctors can fight health care fraud

Health care fraud costs the nation billions of dollars every year. If you are a physician involved in health care fraud, even by mistake, your livelihood is at stake.The complexities private, local, state and federal regulations are difficult to understand. As a provider, though, you can take steps to protect your reputation and your way of life.Common mistakes by physiciansIf you think you are immune to committing health care fraud, you are wrong. Fraud can happen when you fail to correct a mistake by a billing clerk. Or when you submit a bill for medication that a patient did not pick up. They may seem like minor oversights, yet they can have major implications.The penalties for health care fraud are serious. Your practice can suffer if by exclusion from government health care programs. On a personal level, you can face large fines, prison time and the loss of your license.Part of the problem, of course, is that you and your office are busy delivering services to patients. Everyone is under pressure to provide the best care possible. Paperwork often takes a back seat to other priorities.Common ways to avoid mistakesWhat every health practitioner needs is a strong compliance program. A system of checks and balances can keep you and your practice out of trouble with regulators. Some aspects of a program:

• Written standards of conduct and policies that address disciplinary measures

• Assigning a chief compliance officer

• Ongoing education and training of staff

• A system of reporting and responding to fraud and complaints

• Audits

Whether facing

state or federal charges,

the legal issues are complex. Following the rules sometimes is not enough. You have to prove your compliance with the law.

Common sense your best defense

Given all the regulations you have to follow, mistakes are easy to make. You may not even be aware you are in violation until you are facing charges.

You have dedicated your life to helping others. While admirable, do not forget to practice enough common sense to protect yourself.