Compliance and ethics program requirement in limbo
Among the many provisions hidden in 2010’s Patient Protection and Affordable Care Act is a new requirement for physicians designed to protect Medicare, Medicaid and the Children’s Health Insurance Program from fraud and abuse.
Physicians must establish a compliance program “to prevent, detect and correct inappropriate behavior and ensure compliance with all applicable laws, regulations and requirements” under Section 6401(a) of the Affordable Care Act. This requirement also applies to other providers of medical services and supplies who participate or plan to participate in Medicare, Medicaid or
the Children’s Health Insurance Program.