Blog Post

Checklist for Evaluating Compliance Consultants

Richard P. Kusserow | January 2024

Check credentials, qualifications, experience, cost, references & responsiveness to RFP.

The OIG and DOJ stress that compliance programs are always works in progress that must evolve and respond to the ever-changing legal, regulatory, and business environment. One difficulty in successfully running a compliance program is not having the appropriate staffing to venture into other areas warranting attention. Most organizations will find it necessary from time to time to acquire the services of a compliance expert consultant to provide advice and guidance in assessing and advancing the Compliance Program.  Choosing the right firm is a challenge. Before you launch an in-depth search for a quality management consultant, ensure you fully understand your organization’s needs and goals. For example, for financial audits, one should use a Public Accounting Firm. For legal analysis and opinion, use a Law Firm. For compliance regulatory reviews and advisory services, one should use a Compliance Consulting Firm. With a multitude of compliance consultant vendors in the marketplace, it is important to narrow down the list to select the most competent healthcare regulatory compliance consultants. The following is a checklist that may help in making the right decision:

  • Expertise. Does the firm possess relevant expertise and knowledge? Check for journal articles, blogs, and presentations consultants have made and the credentials they possess.   
  • Healthcare Compliance Experience. Has the firm focused on healthcare sector compliance, and are they generalized across other industries (e.g., financial, energy, environment, etc.)? 
  • Compliance Knowledge.  Do the available consultants evidence the needed experience and knowledge regarding the work to be performed?
  • Responsiveness. How quickly and completely did the firm respond with a proposal (prompt responses to emails, calls, and messages can indicate how they will perform their work)?
  • Availability. How soon would the consultants be available to begin work?
  • Experience. How many years of experience do the firm and its consultants possess (indicators of reliability and stability)?   
  • Depth and Breadth. What is the depth of the firm’s capabilities with who will lead the engagement, along with others with varied credentials in support?
  • Cost. What would the contractors charge for services (fixed or hourly fee)? Note, that the contractor bears the cost for any overhead (FICA, leave and health benefits, etc.).
  • Reference. Does the contractor have references for the quality of previous client services?
  • Interview Proposed Consultant. Are you able to interview the consultant for the proposed work to ensure there is good working chemistry?
  • Independence and Objectivity. Will the firm attest to following the GAO Generally Accepted Government Audit Standards for operational reviews and assessments? 
  • Accessibility. Will the firm be available for immediate service and response to ongoing needs?
  • Credentials. What is the range of the consulting firm’s credentials relevant to current needs (e.g., JD, PhD, CPA, CPC, CCEP, CHC, CHPC, CHPS, MBA, PMP, HIM, RN, COC, CCNA, CDIP, etc.)?
  • Professional indemnity insurance. Does the firm possess multimillion-dollar professional liability insurance for the services being offered?
  • Quality Management. Will the firm certify results follow generally accepted review and consulting guidelines, and if so, who would sign it?

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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