The Deficit Reduction Act of 2005: Raising the Bar for Health Care Compliance

Compliance officers, in-house counsel, and other senior management for health care providers across the US must take action to update their compliance programs. Compliance officers, in-house counsel, and other members of senior management for health care entities also should be aware that the Deficit Reduction Act of 2005 (DRA) will have a significant impact on state health care enforcement actions. The DRA imposes detailed requirements for health care providers that participate in Medicaid to adopt policies and procedures, as well as educating their employees, contractors, and agents on health care fraud enforcement. However these responsibilities may be delegated, it is critical that these written policies are not only created but also effectively implemented. An entity should be prepared to demonstrate effectively implemented policies and procedures by: 1. retaining schedules of training sessions on the policies, 2. requiring each trained person to certify in writing that he or she has received and understood the training, and 3. keeping logs of all reports of potential violations of law and documentation.