Blog Post

Affordable Compliance Programs for Physician Practices

Richard P. Kusserow | December 2019

Use Designated Compliance Officers to build and manage compliance programs

The use of Designated Compliance Officers (DCO) has been recognized as an alternative by the Department of Health and Human Services (HHS) Office of Inspector General (OIG). The OIG notes in their Compliance Program Guidance that, “for those that have limited resources, the compliance function could be outsourced to an expert in compliance.”  As such, an outside expert can be a part time but permanent alternative to a W-2 employee compliance officer. Organizations may consider many reasons for using a DCO, instead of a full time W-2 employee, to build and manage corporate and HIPAA compliance, including the following:

  • Experts can build and manage the programs more efficiently;
  • Using a DCO avoids adding staff overhead with benefits;
  • DCOs can manage data breaches and other compliance events effectively;
  • DCOs are able to keep current with regulatory changes;
  • The compliance function can be performed primarily offsite;
  • Using a DCO ensures that a proven expert is managing compliance needs; and
  • DCOs are less costly than a full-time employee.

The contract should define not only the work of managing the compliance program but offering added value by providing the following:

  • Establishing/updating the Code of Conduct, compliance program-related policies, charters, forms, etc.;
  • Keeping the practice up to date on regulatory changes;
  • Handling data breaches or other compliance events efficiently;
  • Providing experience and knowledge in working with a variety of practices;
  • Serving as an authority in building confidence in enhancing the compliance program and culture;
  • Providing experience and detailed knowledge of federal and state laws and regulations; and
  • Establishing metrics to evidence compliance program effectiveness.

Kashish Parikh-Chopra, JD, CHC, CHPC, has assisted many organizations with finding individuals to act as a DCO, noting that the OIG recognizes that keeping up with the wide range of compliance responsibilities can be a serious problem for smaller organizations that may not be able to afford a full-time compliance officer. The OIG notes that an outsourced party can provide services on a part-time basis. Using experts with a proven record can potentially lower fixed costs, reduce staff loads, and avoid having to use someone who is less qualified. It also reduces costs of recruiting and providing full-time compliance staff and benefits. Using an outside expert part time can accomplish more than a lesser experienced full-time employee. Ms. Parikh-Chopra notes that it is extremely important to confirm that the DCO is properly qualified with multiple levels of experience that the practice can draw upon. Serving as a compliance officer in another organization, where it may or may not have been a model program, is not sufficient.  She also advises comparing the cost of hiring a full-time compliance officer against that of a part-time expert acting as the DCO.

For more information on this subject, Kashish Parikh-Chopra can be reached at or via telephone at (703) 535-1413.

About the Author

Richard P. Kusserow established Strategic Management Services, LLC, after retiring from being the DHHS Inspector General, and has assisted over 2,000 health care organizations and entities in developing, implementing and assessing compliance programs.

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