Compliance is a term that many of us hear through out our professional lives, however, was does it really mean? What is your role? Who does it apply to? When does it apply? The key to a successful Compliance Plan is for everyone to understand these questions.

Compliance is a very broad term and simply means to be in accordance with established guidelines. Lassen County Mental Health further defines compliance as “each employee is expected to conduct his or her work in compliance with all applicable laws, regulations, policies, and with the highest standards of ethics and integrity. (Lassen County Mental Health Compliance Plan 2007, pg 1)”

In order for employees to be fully compliant several things must be in place. First, the awareness of they are part of the Compliance Program. Second, a Compliance Committee and Officer need to be selected; they will ensure the draft of a Compliance Plan and provide essential training. Third, constant vigilance to possible Compliance Violations and proper disciplinary follow through.          

Most often it is easy to understand Compliance in terms of what you should NOT do, rather than what you should do. There are many ways to violate Compliance and I will provide a few examples that could occur in any Medi-Cal billing entity. Improper or False claims are violations of Compliance and occur when services were not provided as claimed. This includes presenting a claim for an item that was not performed or presenting services in a way that will result in a greater payment. Double billing happens when a bill is submitted more than once for the same service, the same client, for the same time period. Another risk area falls under inadequate or no documentation of billed services.

When a violation of Compliance occurs employees are expected to report to the Compliance Officer. The Compliance officer’s role is to monitor the Compliance Program, receive reports of wrongdoing, investigate allegations of improper conduct, and monitor corrective actions.

Please report any Lassen County Mental Health Compliance concerns to Hayley Jensen. Shortly, a compliance hotline will be up and running. Until then please contact Hayley Jensen at hjensen@co.lassen.ca or call (530) 251-8100. If you wish to remain anonymous simply type a letter with the following information: Date of Potential Problem, Alleged or Fraudulent Behavior, and Persons Involved. Please mail to