Outsourced Compliance Officers & Co-sourcing Support for Compliance Programs

Commonly, Compliance Officers are overloaded with duties, responsibilities and obligations yet unable to add staff. This problem can grow larger as a result of the ever-changing regulatory and enforcement environment. Additionally, the trend for health care organizations to have the chief compliance officer assume responsibility as the Privacy Officer also adds to this problem. Strategic Management provides support to Compliance Officers in many forms including:

• Advisory services for the internal management of the compliance program;
• Serve as the Designated Compliance Officer or short term Interim Compliance Officer to fill gaps in the management and operation of the compliance program until a new hire is made; or
• Provide Co-sourcing as the supplemental support of tasks or operations under direction and management by the Healthcare Compliance Officer.

If you would like to discuss getting direct support for your compliance program, please contact the experts at Strategic Management today. You can call us at (703) 683-9600 or fill out our online contact form.

Compliance Office Only (In-Sourcing)

Relatively few Compliance Officers would candidly state they have adequate resources to meet all their responsibilities in the ever-changing legal and regulatory environment. The burdens of the job have also increased as result of executive leadership and Board oversight committees are making new demands for evidence of compliance program effectiveness. If all this was not enough, many organizations in recent years have assigned the Compliance Office responsibility for HIPAA Privacy compliance that brings a whole range of new responsibilities. However, all the work is handled in-house, using consultants only occasionally for advisory services or evaluation of the compliance program.

Outsourcing the Compliance Program

Some organizations decide that hiring an outsourced compliance officer (e.g. Chief Compliance Officer, Director of Compliance, etc.) to assist directly in the operation and management of their compliance program is the best approach. There are three variations on this; (a) employing a consultant as an Interim Compliance Officer (ICO) for a temporary period, (b) engaging a consultant to be the External or Designated Compliance Officer (DCO) to manage the compliance program, and (c) Outsourcing all facets of the Compliance Program to a consulting firm.

It is increasingly common for healthcare organizations to outsource their compliance program to Interim Compliance Officers to temporarily fill gaps when an incumbent leaves, or smaller organizations outsourcing the compliance function to an individual or firm to assume responsibility by providing a Designated Compliance Officer. In an Outsourcing scenario, ownership of the Compliance Office is transferred to an expert firm that provides needed expertise.

Choosing to hire an outsourced compliance officer (OCO) is often driven by the challenge of finding the right resources to support compliance programs. This has driven demand for compliance experts, and in turn, is driving available supply of quality candidates down, causing costs of qualified, experienced talent to go up. This is especially challenging for organizations that have tight budgets, while at the same time face high regulatory scrutiny and risk. However, many small organizations find that with a highly experienced expert, it may not be necessary to have someone on site full time. In fact, the OIG recognized this, when they suggested using outside experts as an option, however: “if this role is outsourced, it is beneficial for the (contracted) compliance officer to have sufficient interactions… to be able to effectively understand the inner workings” of the organization. They also recognized that an outsourced chief compliance officer may serve multiple organizations.

Interim Compliance Officer (ICO)

In today’s challenging environment health care providers need to rely upon continuity in their leadership, including that of the Compliance Officer. Losing a key leader from a sudden departure often creates a near crisis, leading to ad hoc decisions rather than relying upon a well-thought-out plan.

Many turn to expert consultants to fill the gaps in the key leadership positions, including the Chief Compliance Officer, by hiring an expert to provide temporary servicing or possibly outsourcing the compliance function to a consulting firm. Strategic Management provides such services and can provide the right person with all the necessary experience, technical skills, proven leadership and personality to properly fit into the senior management team. Using a properly qualified Interim Compliance Officer (ICO) permits provider organizations to have their compliance program continue operations without loss of momentum or acting upon compliance issues that may arise. It also provides a fresh set of professional eyes examining and testing their compliance program for any potential deficiencies. Additionally, the ICO can assist in identifying the education, skills, leadership experience and personality needed in the permanent replacement. There are many other advantages of using an ICO such as:

• Independence/objectivity with no preconceptions about personnel or current processes
• Added value to the program during the transition period
• Offering a fresh and knowledgeable perspective to the compliance program
• Assistance in identifying qualified candidates for the permanent position
• Evidencing a serious commitment to the compliance process
• Assistance in building a firmer foundation for an effective compliance program
• Giving the incoming compliance officer a road map to follow
• Providing senior management and Board with an independent assessment of the status of the compliance program

Strategic Management has provided Interim Compliance Officers to health care organizations large and small, from physician practices to large hospital systems.

Designated Compliance Officer (DCO)

The HHS Office of Inspector General (OIG) notes in its Compliance Program Guidance that, “For those companies that have limited resources, the compliance function could be outsourced to an expert in compliance.” Strategic Management has the experience and expertise to administer Compliance Program on behalf of clients using highly trained and experienced compliance professionals.

The Strategic Management Designated Compliance Officers or Designated Compliance Officials are able to build, implement, manage, and maintain the compliance program. The Firm has extensive experience in the implementation of compliance programs that meet the expectations of the Sentencing Commission Guidelines and the OIG guidelines. The external compliance officers assigned to this work are able to develop and integrate all the elements of the compliance program, including: providing overall direction, overseeing auditing and monitoring activities, providing changes and updates on the regulatory environment to executives and compliance personnel, coordinating training, and reporting on program progress to corporate officials including the board. This has the dual benefits of using recognized experts to bring a compliance program up to standard quickly and ensure it operates consistent with regulatory and program standards.

If you would like to discuss employing an Interim Compliance Officer or a Designated Compliance Officer, please get in touch with us today. You can call us at (703) 683-9600 or fill out our online contact form.

Co-sourcing the Compliance Program

Co-sourcing is a third option and “middle ground” between In-sourcing and Out-sourcing. It is the practice of collaborating with Compliance Officers to assist in meeting Compliance Office responsibilities. This approach is also recognized by the OIG as a useful solution to where an organization is limited in its compliance expertise and resources. It is rare to find any Compliance Office able to have all of the technical and expert resources it requires on hand, at all times. Therefore, attempting to have full-time staff available to meet every internal audit need is not a practical approach. For those Compliance Officer lacking the capacity to carry out all the needed tasks and maintaining the full range of specialists on payroll to meet every compliance need at all times; Co-sourcing may be the practical solution to meeting all the requirements of the office, especially given the complexities of the health care regulatory environment. Co-sourcing has been used to achieve the compliance program objectives by filling gaps in internal expertise and save time, money, and effort in recruiting additional staff. Through this method, knowledge is both retained and leveraged within the organization. In short, it can help bridge the gap in a manner that does not compromise the flexibility to easily return to a position where the Compliance Office can reassume full operation and end Co-sourcing at anytime, when staffing issues are resolved.

Strategic Management’s breadth of industry expertise, technology and operational risk resources provide a highly qualified solution on an ongoing basis to supplement an organization’s limited staff resources and carry out part of their workload, under direction of the Healthcare Compliance Officer. The Firm can address compliance officer staffing shortfalls or provide specialized expertise. Strategic Management has the talent and expertise to provide you with a wide variety of co-sourcing options that permits the Compliance Officer to maintain control of the compliance program, while utilizing our experts to augment staff or to perform specific projects. The Firm has the depth and breadth of experience to assist with specific issues, risk assessments or special projects. By co-sourcing with Strategic Management, it enables the Compliance Officer to effectively manage costs while addressing staffing and technical needs, ultimately increasing the effectiveness of the compliance program.

Strategic Management Provides Experts for Many Co-Sourced Services

• Deputy or Assistant Compliance Officer
• HIPAA Privacy and/or Security Officer
• HIPAA Baseline Security Auditor
• Compliance Auditor
• Compliance Liaison (outlying facilities)
• Compliance Claims Analyst/Reviewer
• Statistical Data Claims Analyst Expert
• Hotline Management
• Compliance Investigations and Training
• Arrangements Reviewer
• Compliance Trainer and Programs
• Compliance Risk Assessor
• Sanction Screening Operations
• Compliance Related Policy Development/Management

Related Resources for Healthcare Compliance Officers and Privacy Officers

The following articles provide additional information about outsourcing the healthcare compliance officer function:

• Meeting the Privacy Officer Challenge: Outsourcing Might Be the Answer
• Outsourcing Compliance in Light of Health Care Reform
• Understanding the Role of an Interim Compliance Officer

View all Health Care Compliance Services

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