Outsourcing Your Corporate Compliance Program

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For many healthcare organizations, especially smaller hospitals, medical groups, and skilled nursing facilities, the availability of resources is an important issue.

The Benefits of Outsourcing

Our clients have the peace of mind that comes with the knowledge that their compliance program is supported by a team of knowledgeable and experienced experts. This team approach ensures that there will be continuity in the compliance program.

In-house programs are subject to gaps and interruptions due to staff turnover or alternate priorities. Further, in house programs can be challenged by compliance training issues. Unfortunately, tasks are then left to untrained individuals and/or spread over different departments. A lack of trained in-house staff will eventually lead to deficiencies in current regulatory compliance processes.

Outsourcing your compliance program will allow your organization to:

  • Reap the benefits of strategic, skilled expert consultants
  • Build a sustainable Corporate Compliance Program
  • Reduce Organization Risk
  • Train in-house staff in Compliance
  • Develop Regulatory Compliance Processes
  • Increase efficiencies and capabilities
  • Reduce overhead
  • Cut costs

In many cases, an organization tries to combine the duties of Compliance Officer with another position such as Risk Management or Performance Improvement. These arrangements are less than ideal, especially since the individual’s primary qualifications may be in a field other than compliance. In addition, the individual’s current job functions may preclude them from devoting sufficient time and resources to the compliance program. This can lead to the development of an inadequate corporate compliance program and increase the organization’s risk.

Healthcare regulations are subject to constant and frequent changes and compliance regulations are no different. The compliance team of The Fox Group will stay abreast of these changes so our clients do not have to worry about doing so.

The Solution, Outcome, and Sustainability

Building and sustaining a successful compliance program rarely follows the same formula from organization to organization. The final arrangement should include the compliance and privacy officer positions, with an active internal liaison from the client’s healthcare organization. Although technology enables organizations to communicate in many ways, there is still nothing like having an onsite presence of a respected, knowledgeable “compliance coordinator” in-house to closely work under the guidance of the consulting firm to facilitate communications, gather records or other data/reports, and even serve as a local presence for receiving confidential questions or information related to compliance issues.

Hospitals for example, with an organizational culture that values compliance, are more likely to have effective compliance programs and, thus, are better able to prevent, detect, and correct problems.

Such programs generally require:

  1. the commitment of the hospital’s governance and management at the highest levels.
  2. structures and processes that create effective internal controls.
  3. regular self-assessment and enhancement of the existing compliance program.

The Compliance Program

The Officer of Inspector General (OIG) recognizes that implementation of a compliance program may not entirely eliminate improper or unethical conduct from the operations of health care providers. However, an effective compliance program demonstrates a health care entity’s good faith effort to comply with applicable statutes, regulations, and other Federal health care program requirements, and may significantly reduce the risk of unlawful conduct and corresponding sanctions.

According to the OIG, a successful compliance program addresses the public and private sectors’ mutual goals of reducing fraud and abuse; enhancing health care providers’ operations; improving the quality of health care services and reducing the overall cost of healthcare services. Attaining these goals benefits the health care industry, the government, and patients alike. Compliance programs help health care entities fulfill their legal duty to refrain from submitting false or inaccurate claims or cost information to the Federal health care programs or engaging in other illegal practices.

A health care entity may gain important additional benefits by voluntarily implementing a compliance program, including:

  • Demonstrating the entity’s commitment to honest and responsible corporate conduct;
  • Increasing the likelihood of preventing, identifying, and correcting unlawful and unethical behavior at an early stage;
  • Encouraging employees to report potential problems to allow for appropriate internal inquiry and corrective action; and
  • Through early detection and reporting, minimizing any financial loss to government and taxpayers, as well as any corresponding financial loss to the entity.

Corporate Compliance Programs have been around now for more than three decades. Guidance on Corporate Compliance Programs from the Health and Human Services Department Office of Inspector General for healthcare organizations continues to be freely available.

The Fox Group, LLC, has provided personalized, conscientious, and comprehensive Corporate Compliance Programs and other healthcare services to our clients for 30 years. We are one of just a few healthcare consulting firms in the nation that not only provide recommendations and guidance for your Corporate Compliance Program but will also “roll up our sleeves” and work with an organization on implementation of the steps necessary for compliance success.

The Fox Group is well versed in addressing the details needed to help your organization comply with current regulations and to set up a sustainable program that will benefit you for years to come. Our team of experts has assisted numerous healthcare organizations of many types with their Corporate Compliance Program and a variety of other projects.  In each case, our many years of hands-on experience and understanding of the details that go into Corporate Compliance has enabled our clients to make well-informed decisions about their organization’s risk.

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