Claims Processing Quality Assurance Programs
Key Points: Enforcement actions related to healthcare claims, especially those involving hospitals, are not only common but on the rise.…
Departing Compliance Officers: A Problem or an Opportunity?
Key Points: It has been nearly thirty years since the OIG began issuing the compliance program guidance, which resulted in…
The Difference Between a Compliance Gap Analysis and an Effectiveness Evaluation
Key Points: The Department of Justice and the Department of Health and Human Services Office of Inspector General both call…
Compliance Policy Management: A Comprehensive Guide for Healthcare Leaders
The average U.S. healthcare company is subject to 629 regulatory requirements across nine distinct domains.1 But how can you ensure…
Small Entity Compliance Programs
Most enforcement efforts involve small entities that lack compliance programs Both the Office of Inspector General (OIG) and the Department…
10 Steps to Becoming a Healthcare Compliance Consultant
Over the last thirty years, I have been frequently asked the question; “How can I move from being a compliance…
Corporate Compliance Root Cause Analysis
Guidance on conducting Root Cause Analysis The Department of Justice (DOJ), in its “Evaluation of Corporate Compliance Program Effectiveness”, emphasizes…
Compliance Survey Best Practices
Tips to reduce survey fatigue and improve results In its Compliance Program Guidance documents, the HHS OIG recommends surveying employees…
Preparing Internal Staff to Take Over as Compliance Officers
Education, training, credentialling, gaining experience, and tutoring It has been nearly 30 years since the OIG Compliance Program Guidance helped…
The Best Risk Management Tools in the Healthcare Industry
Healthcare organizations face an increasingly complex landscape of risks—ranging from patient safety issues and regulatory noncompliance to operational failures and…
Increasing Compliance Officer Retirements Creating Recruitment Problems
Key Points: Increasing retirement and an already limited pool of trained healthcare compliance professionals has caused a noticeable shortage of…
Risk Assessment for Skilled Nursing Facilities: Understanding Compliance Requirements
Nursing facilities are the backbone of American healthcare, with 15,000 facilities caring for 1.2 million residents. 1But from ongoing staffing…