Health Care Compliance, Buyer Beware

It should be no secret to health care providers of the government's recommendation that ALL health care professionals implement compliance programs to self-police their practices. With these recommendations numbers of health care professionals have implemented formal compliance programs.

Also with these recommendations a cottage industry was born for compliance companies to assist the health care professional, when needed, on implementing and administering compliance programs. The question for many health care professionals, when assistance is needed, is who to use...

Unfortuantely, numbers of so-called compliance companies have been created that appear to have minimal expertise and experience to provide the full-range (audit to administration) of appropriate guidance and have jumped on compliance as a means for some quick bucks.

For more than ten years I have been working with health care professionals to assist them on the implementation and administration of compliance programs, and, during this time I have heard some dandy stories and claims from health care professionals about compliance consultants - here are just a few recent ones:

A doctor called and asked if it were true that providers would get in trouble for not purchasing services from a speaker at a compliance seminar should federal investigators look at them, adding that the speaker told the seminar audience that he provides his list of seminar attendees to the FBI and that if one of the attendees were to be investigated by the Fed's their attendance would be used against them if they did not purchase his services.

In the more than 10 years of providing training for health care professionals I have never given or been asked by law enforcers for a list of attendees. But this speaker could in fact be giving his attendee list to the FBI - I don't know. With my investigator hat on, I can see how law enforcers could use this info for intelligence purposes but the info, in of itself, would be of minimal value unless there were suspicions that the health care professional was engaged in misconduct, and then it (attending the seminar) might be used in developed fraud cases with established evidence to support that the professional's violations of law were done purposefully - where the list might be of use to show the provider knew what they were doing was wrong and that they purposefully engaged in criminal conduct.

Another doctor, presently a compliance client, indicated that their previous compliance consultant used reported that by placing the (consultant's) compliance certificate on the wall in plain view for those coming into the clinic that if an investigator comes in and sees the certificate they will immediately turn around a leave because they will know the clinic is in compliance once they see his certificate.

Over the years I have heard of and seen people who wield a lot of power, but I have never heard of anyone in the compliance arena having that much power! And, I thought I had it going on.

Daniel J. Osborne, M.S., is a renowned expert on health care fraud issues and recognized authority on health care compliance. He can be contacted at Chiropractic Compliance Consultants, Inc., 18065 238th Street, Tonganoxie, Kansas 66086, 913-369-9000, http://www.cccpfc.com

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