Compliance Program Effectiveness Reviews

Compliance program effectiveness continues to be a focal point of compliance programs and governmental investigators. A regular evaluation of compliance program effectiveness is critical to identify gaps and deficiencies. This evaluation can also evidence that the compliance program covers all seven (7) elements of an effective compliance program outlined by the Office of the Inspector General (OIG), and track key metrics that show compliance program effectiveness.

Compliance and Privacy Program Development and Implementation

The OIG’s General Compliance Program Guidance provides detailed guidance for preventing fraud, waste, and abuse, maintaining organization-level compliance programs, and considering infrastructural issues in healthcare compliance. This guidance addresses the seven (7) elements of an effective compliance program supporting quality patient care and operational efficiency by addressing regulatory requirements.

  1. Policy and Procedure Review and Development
  2. Program Authority and Oversight
  3. Workforce Skills Enhancement
  4. Open and Effective Lines of Communication
  5. Establish and Enforce Appropriate Standards, Consequences, and Incentives
  6. Risk Assessments, Monitoring, and Auditing
  7. Issue Investigation, Remediation, and Reporting

Alignment of Priorities and Strategic Initiatives

Effective compliance and privacy programs align the necessary resources with the organizational priorities and strategic initiatives. By exploring possibilities and developing value-add strategies in accordance to your organization’s risk tolerance, an effective approach to compliance and privacy will become a reality.

Band-width Extension

Compliance and privacy programs cannot exist in a vacuum or maintained in a notebook on the shelf. In order to meet the ever-evolving demands involving healthcare rules, laws and regulations, a mutually beneficial working relationship is important. I am at your disposal to serve as your partner to carry out the multiple demands of establishing and implementing your program objectives.

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