Physicians are required to develop and maintain a compliance program in their practice under the Affordable Care Act (ACA), a burden some health policy experts say could be a heavy one for some practices.
However, the federal government has yet to release guidelines on what these compliance programs should look like under the 2010 health reform law, creating conflict for doctors on what to do next.
Section 6401 of the ACA -- an often-forgotten provision -- requires that all providers and suppliers, regardless of their size, institute formal compliance programs. New practices will no longer be able to enroll in Medicare or Medicaid without a compliance program in place, and already existing practices also will be expected to institute them.
The mandate shifts part of the burden of preventing waste, fraud, and abuse from the federal government -- which has traditionally been in a "pay and chase" mode -- to physicians.
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Source: MedPage Today