How to educate staff on Stark law compliance
How to educate staff on Stark law compliance
Most of the advice offered about the current "self-referral" laws is how to carry out a post-mortem analysis of problems already uncovered. But the key to successfully dealing with the so-called "Stark laws" is to incorporate education about these laws into a compliance program before that post-mortem becomes necessary. "If you prevent one problem with Stark that you will not have to untangle later, it will have been well worth the effort," says Roy Snell, senior manager with Deloitte & Touche in New York.
"Incorporating Stark into a compliance program involves the basic concept of all compliance programs — to prevent problems — and I can’t think of a better place to do it than Stark," he adds. There are no simple solutions that will make or break an effort to accomplish this. But there is also no shortage of tools that can help providers in that effort such as the code of conduct, education, hotlines, auditing and monitoring procedures, disciplinary actions and investigations, he says.
"It really requires a series of actions in order to make a difference," says Snell, who was the founding president of the Philadelphia-based Health Care Compliance Association. That series can begin with a sentence in a provider’s compliance program about the importance of understanding self-referral laws and the importance of bringing any concerns about referral patterns to the attention of the General Counsel or compliance officer.
When it comes to education, Snell says providers are sometimes resistant because of the complexity of these laws. "The point is not to teach them about the Stark law itself but to make them aware about the general principles behind Stark and the issues that surround these laws," he explains. "If you raise their awareness enough just to come ask questions you have succeeded."
Education about Stark can come in many forms but Snell says "a lot of little doses" work better than single all encompassing training initiatives. Numerous tools can be used to reinforce employee awareness including memos, newsletters, e-mails, individual discussion, department meeting, as well as the compliance plan itself. Another worthwhile tool rarely used is the education of hotline operators, he says.
"You lose the listener if you try to teach them things they know they will never need," Snell warns. "But it is just as important to give them enough information to know they need to include self-referral’ in their decision-making process."
It is also important to determine the range of potential education items such as the definition of self-referral and designated health services, advisory opinions, financial arrangements, safe harbors, and even sanctions for violations.
According to Snell, the ultimate goal in all of this is to make sure that self-referral laws are understood throughout the organization and integrated in all components of its activities, including audit and monitoring procedures, disciplinary processes, and investigations.
Snell also urges providers not to overlook due diligence. He says providers are sometimes in a hurry to complete a merger or acquisition and rush past compliance due diligence, including Stark. "It just boggles my mind that we can’t get organizations to do this," he says. "I would never complete that process without having a professional take a look at it for Stark and other issues."
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