Compliance in Interventional Pain Practices

Abstract

Background: Compliance is a fact of life for interventional pain physicians (IPPs). The health care industry is highly regulated by federal and state governments. IPPs must understand and comply with a broad regulatory landscape that ranges from health care fraud to the prescribing of oral narcotics. Complying with all of these laws requires a proactive approach by an IPP in both the practice and business of medicine. Objectives: This article provides: 1) a brief discussion of the health care laws that IPPs must navigate in their practices; and, 2) practical steps that IPPs can take to ensure that they comply with the relevant laws. Discussion: IPPs should familiarize themselves with the major federal and state fraud and abuse laws that apply to all interventional pain practices. IPPs should also implement effective compliance programs that include tools such as auditing, education, and employee reporting designed to uncover and correct fraud and abuse. Conclusion: Once in place, a compliance program can easily become part of a practice’s culture and pay for itself many times over in problems avoided. IPPs that implement appropriate compliance programs can focus on the most important part of their practice: taking care of patients. Key words: Interventional pain practices, compliance, health care laws, federal, state, fraud, abuse, auditing, education, compliance program, health care industry, False Claims Act, Anti-Kickback Statute, Physician Self-Referral Proscription, Health Insurance Portability and Accountability Act