Kusserow on Compliance: Compliance Officers Being Effective

Richard P. Kusserow | March 2017

By Richard Kusserow, former HHS Inspector General and CEO of Compliance Resource Center.  Reprinted from Wolters Kluwer‘s Kusserow on Compliance Blog

Today, organization leadership wants to feel confident that its compliance officer is effective in guarding against government intervention, litigation, and other unwanted events that give rise to liabilities. The challenge is how to convince everyone they are effective in what they do. Experts with years of experience as both compliance officers and advisory compliance consultants to organizations were asked to provide some insights and suggestions for compliance officers.

Al Bassett, J.D., is a retired Deputy Inspector General and nationally recognized expert on health care compliance programs who has worked on evaluating effectiveness of dozens of compliance programs. He believes that to be effective, the compliance officers must always be selling the benefits of a successful program, as well as the consequences for not having one, to the Board and executive leadership. Once they are on board, then the selling must continue with managers and first line supervisors, and finally with the rank and file employees, physicians, and medical staff.

Carrie Kusserow has 15 years’ experience as a compliance officer, interim compliance officer, and compliance consultant to many organizations. She agrees and says, without question, the biggest sales target has to the Board, in that once it is sold, executive leadership will follow suit. It needs to know and understand what is required of it by enforcement and regulatory agencies, as well as the personal risks for ignoring its fiduciary compliance oversight responsibilities.  The HHS Office of Inspector General (OIG), along with the American Health Lawyers Association, has been issuing ‘White Papers” on Board obligations.  The most recent was Practical Guidance for Health Care Governing Boards on Compliance Oversight. The OIG is now incorporating this guidance into mandates for the CIAs.

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Tom Herrmann, J.D., retired from the HHS OIG Office of Counsel to the Inspector General (IG) and then became a compliance officer and consultant to many organizations. He states that once there is “buy-in” from leadership, it is important to cultivate sound working relationships with other functions that overlap with compliance, including human resources (HR), Health Information Portability and Accountability Act (HIPAA) (P.L. 104-191) privacy and security officers, legal counsel, and internal audit.  In far too many organizations, these functions operate at cross purposes with one another and engage in turf battles, so as to have a serious negative impact on compliance officer effectiveness. There is a need to focus on developing cooperation and coordination of effort, along with developing protocols (policy documents) that establish working relationships and methods of cooperative effort.

Steve Forman, CPA, is another veteran of the HHS OIG, where he served as Director of Operations; he followed this with more than twenty years’ experience as a compliance officer and consultant. He sees the most successful and effective compliance officers as having been able to convince first-line managers to carry the compliance message to their subordinates by word and example.  The words they say and the attitudes they project to their staff are powerful, more so than pronouncements from the compliance officer or even the executive leadership.  Compliance officers selling themselves as being effective can be quickly enhanced by personally meeting with and talking to first-line supervisors and managers about the compliance program.

Jillian Bower has worked with dozens of compliance officers in advancing their programs. She points out that it is important to maintain ongoing metrics to benchmark progress of the compliance program to reassure executive leadership and the Board that the compliance officer is being effective in protecting the organization from unwanted events or acts that could give rise to liabilities.   She has found that one of the most useful means of doing this has been employing a professionally developed and independent administered compliance knowledge survey that evidences employee understanding of the program. The best surveys are anchored in a large database to permit comparison to other health care entities; and used periodically they also can measure benchmarks and progress in the program and further evidence compliance officer effectiveness.

Kashish Chopra, J.D., has worked with a number of clients with their compliance programs, in addition to have served as an interim compliance officer. She believes effective compliance officers are successful in promoting employee compliance communication channels, particularly hotlines, that ensure complaints and allegations are promptly investigated and resolved professionally. If the workforce does not believe the organization is receptive to its concerns and nothing happens to its input, the compliance officer and program will never be fully effective. In addition, the compliance officer needs to be visible and available to hear employee concerns.  Chopra believes in walking around and being available to talk with people about their jobs, thoughts, and concerns.

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.