To create a culture of compliance in your healthcare organization, start with an effective compliance program. This crucial step enables your company to identify and remediate potential vulnerabilities, promote quality care and reduce instances of fraud and abuse.
These seven elements are the foundation for a robust compliance program.
Documented policies, procedures and standards of conduct
Promote your organizational commitment to compliance with documentation that addresses specific risk areas. A well-written, easily-understood set of policies, procedures and standards of conduct helps your workforce understand and perform their job functions in a manner consistent with federal health care program requirements while clarifying the organizational mission and objectives.
Designate a compliance officer
The compliance officer manages and oversees the healthcare compliance program. An appointed compliance committee, comprising members from various parts of the organization, supports and advises the compliance officer in preventing, detecting and correcting non-compliance. The compliance officer and committee work together to promote standards of conduct and maintain communications channels for reporting instances of non-compliance.
The organization’s entire workforce must receive training to identify, report and minimize fraud and abuse, as well as a review of regulatory requirements (e.g., HIPAA, CFR 42 Part 2). Offer training often, and make it a job requirement to ensure your staff keeps current on emerging compliance issues.
Effective channels of communication
Communication is essential for reporting potential non-compliance. Make communications channels highly accessible and ensure confidentiality. Further, develop your culture of compliance by communicating your organization’s compliance message regularly and encouraging conversation and feedback.
Conduct internal monitoring and auditing
Develop a consistent, ongoing monitoring and assessment process to ensure the effectiveness of organizational training and corrective action plans. This element includes proactively monitoring for risk areas, scheduled auditing of records and the ongoing review of your compliance program.
Enforce standards of conduct with sanctions
Ensure standards of conduct, which outline proper practices and workforce expectations, are followed consistently and constantly with well-publicized disciplinary guidelines. Standards must apply to all personnel, without regard for position, rank or title.
Respond promptly and take action
Minimize organizational exposure through timely and effective remediation efforts. Develop methods for tracking and responding to compliance issues. Thoroughly document and investigate suspected non-compliance occurrences while enforcing corrective action tracking complaints and resolutions.
Culture of compliance
An effective compliance program isn’t a set-it-and-forget-it proposition. It requires ongoing development of processes to identify issues, educate the workforce, and generally ensure guidelines are applied consistently and effectively. A strong compliance program protects organizations against potential areas of liability while helping to avoid fines, reduce costs and improve healthcare services.