Other Concerns
Other compliance issues to pay attention to include:
Legibility of the Record
“It has to be something that everybody can read. Handwriting,
abbreviated symbols and the hieroglyphics we all use [aren’t
sufficient.] Make sure you’re documenting appropriately and
legibly, and make it a permanent part of the record,”
Huben-Kearney said. Records travel with the patient and they’re
useless if they can’t be read by the next physician.
Informed Consent
“[N]ot being able to present informed consent – that a
patient was fully aware and making a rational, personal decision to
consent to a particular procedure” – can get offices into
trouble, DiCianni said. When physicians give an “English form to a
Spanish-speaking person, are you really getting informed consent? That
can be crucial, particularly with surgeons and practices dealing with
certain kinds of treatments.”
Boundary Violations
“Improper touching or not explaining you’re going to be
touching or when a doctor starts revealing his or her personal life,
that crosses a line of professional conduct,” DiCianni said. While
it’s rare for a physician to be sent to jail for noncompliance,
there are financial and reputation-related consequences. “Medicare
not only wants the money back for the incorrect billing, but they can
[calculate] that you’ve been doing this for, say, the last seven
years and they can fine you back,” Henderson said. One of her
clients once faced a fine of $1 million calculated this way.
Another typical consequence is the loss or suspension of a
physician’s license to practice. That can happen even if the
regulatory violation is a staff person’s fault. The fact that
staff members practice under the physician’s license underscores
the importance of properly training them. Physicians also want to avoid
negative attention in the press related to noncompliance. “I tell
my clients not to worry about the fine,” Manere said.
“It’s your name in the paper, and the litigation
that’s going to follow if you didn’t follow federal or state
law.”
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