What this service is:

The Health Care Program Compliance Guide helps to ensure the integrity of your health care compliance program and reduce your legal risks. This all-in-one resource, especially for health care providers seeking reimbursement under Medicare, Medicaid, TRICARE, and other federal health care programs.

What it helps you do:

• Develop appropriate compliance programs.
• Assure that your organization is meeting legal standards.
• Address issues of noncompliance.
• Establish training programs to prevent potential problems.
• Be aware of changes in laws and regulations.
• Understand and stay abreast of nationwide government enforcement priorities, initiatives, and actions.
• Keep up with information regularly provided by the HHS Office of Inspector General, Justice Department, U.S. Attorneys.
• Save hundreds of hours of research and preparation time.
• Receive expert analysis from Bloomberg BNA editors with substantial guidance and review from members of the American Bar Association Health Law Section.
• Analyze specific selected compliance topics, complete with case studies, interviews with experts, and tips, in Monthly Focus.
• Use practical tips, compliance checklists, and other useful documents.
• Search the Library easily for topic-specific news and analysis.
• Access full-text documents through convenient links to public and private Web sites.

Product Structure

Reference: analysis, guidance and primary source material

Formats and Frequency

Print reference material is updated monthly.

Web reference available on the Health Law Resource Center.

For information about the Health Care Program Compliance Guide, please contact the Bloomberg BNA Customer Contact Center at 1.800.372.1033.

• Anti-kickback
• Attribution of financial relationships
• Billing for items or services not rendered
• Billing for medically unnecessary services
• Clinical research/drug trials
• Creation, retention, and destruction of records
• Clinical research/drug trials
• Credit balances/failure to refund
• Clinical research/drug trials
• Data collection and submission
• Discounts and free items
• Duplicate billing
• Enforcement actions and settlement agreements
• Equipment and space rentals
• False cost reports
• Group practices
• Hospice and nursing home relationships
• Hospital admissions and discharges
• Hospital incentives to physicians
• Industry compliance guidelines
• Joint ventures and acquisitions
• Managed care
• Marketing and enrollment
• Marketing practices
• Outpatient services
• Oversight of contractors/subcontractors
• Personal services and management agreements
• Physician financial relationships
• Statutory and regulatory requirements
• Teaching physicians/residents
• Unbundling
• Underutilization and quality of care
• Upcoding
• Waiver or payment of copayments, deductibles, or premiums