Now that the Affordable Care Act (ACA) requires physician offices of all sizes to establish health care fraud and abuse compliance programs, it’s time for pediatricians to act. A deadline for this requirement is expected soon.

A compliance program encourages ethical conduct and a commitment to compliance with the law throughout the practice. It establishes a practice-wide strategy to improve the accuracy of billing, coding and documentation by creating checks and balances to review and corroborate billing. This helps the practice identify and correct potential errors and fraudulent activities before the claim is submitted as well as review past billing practices to detect, report and correct prior errors.

The ACA funds the Centers for Medicare & Medicaid Services (CMS) to adopt new tools and resources to better identify fraud and abuse in its programs. Any claim for payment to Medicare, Medicaid or the Children’s Health Insurance Program poses a potential...

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