Scenario

Physician’s Family Clinic is a mid-sized clinic that employs five physicians that specialize in family medicine. You were recently hired by the office manager as the billing specialist for the clinic. You were excited to get started on your new job. However, after a few weeks, you notice violations of compliance regulations that govern healthcare. 

You overheard a patient telling the receptionist that her primary care physician received a $100 Amazon gift card for referring her to a physician at Physician’s Family Clinic.

A nurse left documents with patient information in the lobby.

A physician referred a patient to an imaging center owned by his wife. 

1. Not wanting to see the physicians or the clinic get into trouble, you bring up the compliance issues to the office manager. The office manager does not have much experience with compliance and has asked you to develop a proposal to fix the issues.Identify the compliance issues and describe in detail which regulations were violated. 

Describe the different components of the Office of Inspector General (OIG) and provide an evaluation of how each component helps to monitor regulations and compliance.

Discuss how the OIG impacts the operations of the clinic. 

Explain which methods the clinic could use for monitoring compliance with regulations and include routine preparedness activities to help keep the clinic in compliance.