Corporate Compliance

Tip: Avoid the consequences of substandard care

Compliance Monitor, March 24, 2010

The Supplemental Compliance Program Guidance for Hospitals states that the OIG will exclude individuals and entities that provide substandard or unnecessary items or services from Medicare, regardless of the party’s knowledge or intent. The OIG’s exclusion authority covers unnecessary or substandard items or services provided to all patients, including non-Medicare and non-Medicaid beneficiaries.

To avoid these pitfalls, make sure your hospital adheres to the following recommendations:

  • Continually measure your performance against comprehensive standards such as the Medicare Conditions of Participation
  • Develop your own quality-of-care protocols and adopt mechanisms for evaluating protocol compliance
  • Expand reviews of nursing and other ancillary services to include the credentialing and peer reviews of medical staff

This week’s tip was adapted from The Compliance Program Effectiveness Handbook. For more information about the book or to order your copy, visit the HCMarketplace.

Most Popular