Page 36 - Mobility Management, January 2018

3Strengthen and Enforce Compliance Standards
It is no secret that fraud and abuse have historically been a challenge in the healthcare industry. We cannot think that we are immune from this in CRT just because of the tremendous impact of the work we do. It is imperative that we hold ourselves to the highest standards to avoid institutional abuse or, perhaps more likely, individuals skirting laws or regulations. As leaders in CRT, we must educate our collective employees and deliver the proper communications and training on laws, policies and best practices in the areas of fraud, inducement and overall compliance.
We can learn from the past. For example, think about how the concerns of overutilization resulted in devastating financial cuts and many companies going out of business. While the most damaging of these situations was not directly in the CRT space, the residual effects impacted us all. We can avoid repeating history by adhering to best practices with respect to medical necessity. It is our obligation to ensure the best possible clinical solution, and it is also our duty to ensure products are not over- prescribed — the two go hand-in-hand. In the vast majority of cases, overutilization and overprescribing is not happening, but we cannot assume these behaviors are entirely relegated to history. We must continue to audit ourselves, foster cultures centered on compliance and, when we discover improper behaviors and practices, demonstrate that we will not tolerate such misdeeds.
Likewise, we must continue to promote zero tolerance for inducement and similar behaviors. There is no place for providing monetary rewards or gifts intended to encourage specific actions or “quid pro quo” arrangements. Our products and services should stand on their own merits. Relationships should be developed on historical performance and trust built from fulfilling commitments and delivering results that benefit those we serve, not from lavish dinners or tickets to a ballgame.
Clarity, consistency, transparency and rigor ought to lie at the foundation of all that we do in this industry. We are partners in this fight. Those we serve deserve nothing less.
What you can do to help:
• Educate your employees and deliver the proper
communications and training on laws, policies and best practices
• Set an example with your own actions and hold one another accountable
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