Corporate Compliance

Tip: Areas to audit

Compliance Monitor, March 5, 2008

The OIG recommends hospitals conduct regular audits. Either internal or external auditors with expertise in government healthcare requirements can conduct these audits.

The audits should review external relationships with third-party contractors, specifically those with substantive exposure to government enforcement actions. At a minimum, audits should address the hospital's compliance with laws governing:

  • Kickback arrangements
  • Physician self-referrals
  • Current procedural terminology
  • Claim development and submission
  • Reimbursement
  • Cost reporting
  • Marketing

This tip was adapted from the Compliance Program Effectiveness Handbook. For more information about the book or to order your copy, click here.

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