Why Bother?

Welcome to Compliance University! This month we continue to challenge common compliance-related wisdom by acknowledging and demanding an answer to The Question They Dare Not Ask: “Why should I bother with a compliance program?”

Our premise is this: Any home care provider that does not have a working, effective regulatory compliance program has, in effect, decided not to bother with compliance initiatives. In other words, the provider has decided that the benefits of an effective compliance program are not worth the costs and hassles of implementing the program.

All types of providers engage in this sort of denial. Medical groups, ancillary service providers, long-term care organizations and even hospitals join many home care providers in electing to operate without a real compliance program in place. Why? There are many misinformed reasons why providers fail to implement effective compliance programs. But those reasons don't hold up in the face of one basic truth: An effective compliance program improves reimbursement, prevents trouble with government agencies and produces ongoing benefits for home care providers.

During past sessions of Compliance University, we explored six ways an effective compliance program helps providers stay out of trouble with the government, improve the accuracy of their claims and increase reimbursement (see “Compliance University,” December 2002.) Then, we explored six ways an effective compliance program can improve efficiency and employee morale within a company, so that providers may nurture a more loyal, efficient and savvy workforce (see “Compliance University,” February 2003).

This month, we'll look at six more benefits of an effective compliance program, focusing on business colleagues, financiers and customers.

13

An effective compliance program reassures third parties.

A compliance program demonstrates that you are committed to policing your internal and external activities, and that you are able to create and operate an effective system for ongoing problem solving. Consequently, compliance programs assure outside parties that you are unlikely to have substantial fraud or reimbursement problems. If your compliance program satisfies federal guidelines, this further convinces third parties that you have minimized the potential for sanctions due to inadvertent violations of fraud or reimbursement rules.