eBook, Featured Resource

Back to Basics: Eight Essentials of Healthcare Contract Compliance

Posted By: Sara Low and Bret S. Bissey, MBA, FACHE, CHC, CMPE / April 23, 2015

Healthcare Contract ComplianceThe primary goals of an effective compliance program are to prevent and detect noncompliance and enhance business processes and decision-making. The core elements of an accepted compliance program include:

  • Compliance officer and program oversight.
  • Policies and procedures.
  • Education.
  • Audit.
  • Corrective actions to identified problems.
  • Open communications.
  • Enforce violations.

Both these goals and the elements of your compliance program may span many different areas of responsibility depending upon the type and size of your organization. However, something that does not differ is the high regulatory risk associated with certain functions, such as coding or billing and contracting.
MediTract recommends that your organization’s contracting best practices become an integral component of your compliance efforts. These core elements listed above are applicable to all the recommended best practices for managing this high-risk area.

Many of our clients (more than one of out every four hospitals in the country) learn that by applying best practices to their contracting efforts they not only proactively manage a high-risk area, but also achieve operational efficiencies, which are critical to the core missions of their organizations.

In this e-book, we will outline the eight essentials to healthcare contract compliance, including:

  1. Who is responsible for compliance.
  2. What are they saying.
  3. How are contract compliance requirements being enforced.
  4. What are the specific elements of contract compliance.
  5. What are industry best practices to emulate for contract compliance.
  6. What are compliance areas to focus on for contracting.
  7. What are the risks of noncompliance.
  8. How can my organization gain access to contract compliance guidance.

About the Author: Sara Low

Sara Low

As the senior director of business services for MediTract, Sara Low leads the account management team and works to ensure the successful delivery and mediation of our products and services. She is an active participant in client advisory services and is also instrumental to product development, bringing the needs and interests of clients to the technology team. Prior to joining MediTract to head business services, Ms. Low worked with Erlanger Health System to revitalize and oversee its contract management processes. She has 12 years of legal experience and eight years of healthcare compliance experience. Ms. Low holds a Bachelor of Science in legal studies from the University of Tennessee at Chattanooga.

Bret S. Bissey, MBA, FACHE, CHC, CMPE

Prior to joining MediTract, Mr. Bissey was the SVP, chief ethics and compliance officer at UMDNJ, where he successfully led the compliance program to adherence with a rigorous five-year Corporate Integrity Agreement with the DHHS/OIG that occurred following a Deferred Prosecution Agreement. Prior to UMDNJ, Bissey served as the director of the Regulatory Compliance Practice at IMA Consulting, the chief compliance and privacy officer at Deborah Heart and Lung Center (operating under a CIA) and the VP of compliance at Cabot Marsh/QuadraMed. Mr. Bissey earned a Bachelor of Science in business administration and marketing from Shippensburg University of Pennsylvania and an MBA in marketing and healthcare administration from Wilkes University. Mr. Bissey is a frequent national speaker on healthcare compliance and is the author of The Compliance Officer’s Handbook. He is a Fellow of the American College of Healthcare Executives and a member of the Health Care Compliance Association (CHC), American College of Medical Practice Executives and the Healthcare Financial Management Association.