The Dangers of Ignoring Compliance in Your Private Practice

MEG Business Management had the pleasure of sitting down once again with Daniel Hirsch, a nationally recognized Compliance expert and DPT, to discuss an often ignored aspect of the modern private practice: Compliance. Based on that conversation, we’ve captured Hirsch’s notes here to help you keep your Physical Therapy practice compliant. 

The way we see it, you can approach Compliance for your Physical Therapy practice one of two ways. 

You can look at Compliance from the defensive, flight perspective of “oh no!” or take the offensive, fight approach where you confront the challenge head on. 

Remember: Just because you don’t want to think about Compliance, doesn’t mean it isn’t there as a real threat to your practice.

Here are the Top 3 Problems that we hear from practice owners in terms of Compliance:

1) They are too busy to handle Compliance while juggling everything else

2) Their Physical Therapy schools did not cover this material 

3) They don’t already have a Policy & Procedure Manual for patient and staff safety 

To combat these out-points, you need a checklist to establish your Physical Therapy Compliance program. Don’t rely on memory to keep all the necessary guidelines in mind – have it clearly laid out in writing. As mentioned above, you should already have an all-encompassing, working Policies & Procedures Manual in your practice that you regularly update. 

Your program must be customizable and uniquely developed for your practice to capture the individual patient volume, treatments, equipment and company culture. There is opportunity for Compliance violations in absolutely every corner of your practice – no division is exempt. For a comprehensive and detailed policy template for your clinic, check out our Compliance Program

Your Physical Therapy Compliance Program must also be ongoing and routinely updated – it cannot just be addressed once a year. The reason for this is because the rules are constantly changing, so we highly recommend that you have a stable resource (Compliance Officer/Consultant) available to you to get the answers you need. This can be internal or outsourced as needed.

Keep in mind: The laws can also vary state to state, so do your research and stay on top of the nuances. What works for a practice in California may not fly in Florida.

Violations in Physical Therapy Compliance are something that can absolutely shut down your business.

Many folks don’t even realize that they have committed an act of non-Compliance. The occurrence might be completely innocent and accidental. 

You have to ask yourself, where are my exposures? Physical therapists are often so dialed in to: how am I supposed to be a skilled therapist? A good owner? A valued staff member? 

But there are non-Compliance pot holes all over the road that you must become aware of. For example, one that really surprises people is in terms of Referral programs – Did you know that you can’t offer or solicit anything of value to induce or reward referrals?

Practices often want to use this as a Marketing tactic, with discounts and money off, but according to the Compliance laws, you actually can’t give incentives for these kinds of programs. If there is an opportunity for a financial relationship, you can’t funnel all the business to yourself or to your friends, as this opens the door to favoritism. This is not tolerated.

These are seemingly innocent things that are actually problematic and can get you in big trouble with anti-fraud laws. The penalties for this can be up to $25,000 and you could be jailed for 5 years!

Our Compliance expert, Daniel Hirsch, sees cases like these all the time. 

Instead, the way to perform the Marketing strategy for a referral program is through a “game of chance/skill,” where there are fair opportunities and barriers. This is where prizes are won purely based on luck and randomization. There is also a dollar threshold for this that changes every year that you must keep track of. 

As with everything, you want to consult your resource and write the policy, as people cannot play the game correctly if the rules are not defined. 

Again, Compliance touches every area and division of your practice. As the physical therapy owner, you must think of this from a top-down approach. And please (PLEASE) consult a professional – there is no excuse for you to be “winging it” on your own. You don’t want to gamble with the security of your practice, physical therapy license and freedom – as this is what’s at stake here. 

The bottom line: Stay organized. 

You need a playbook with policies that have rules outlined step-by-step so that nothing falls by the wayside. The penalties are steep and on a federal level (and no one wants that)! The truth is that these fines add up incredibly fast. 

Here’s the solution: Don’t be scared; be prepared. Be competent by consulting your professional Physical Therapy Compliance Officer, whether you use us at MEG’s PT Compliance Program or someone else. It all starts with developing your Learning Management System (LMS) Compliance Program to avoid these issues from the very start. You simply cannot be in practice safely without it. 

The work has already been done. Put the emphasis back on the education of it, as we tend to avoid that which we don’t understand. Don’t be “the effect” of what you don’t know and don’t let the next tragic Compliance violation in PT be you.  
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