The Office of the Inspector General hasmany different resourcesfor healthcare compliance. Along with education materials, the OIG’sCompliance 101 pageoutlines elements of effective healthcare compliance programs.
Based onthose elements, here are some ideas for creating an effective compliance program for your organization:
Develop, distribute, and implement written policies, procedures, and standards of conduct
Policies, procedures, and standards formalize practices within your organization.
Policies and procedures promote consistency and improve the quality of care. They also help protect your organization in the event of an incident of noncompliance.
The OIG suggests that policies and procedures include policies about coding, overpayment, conflict of interest, privacy, non-retaliation, and policies that address regulatory requirements.
Of course, in order for policies to help with compliance, they need to be accessible so employees can read them and understand how to comply with the requirements.
Apolicy management softwarecan help you create and distribute policies and procedures. You can track signatures to make sure that every employee receives and acknowledges each policy.
Policy management software also makes it easy to collaborate on policy updates so you can ensure that your policies keep up with industry standards and regulations.
Designate a chief compliance officer or compliance committee
With all the different aspects of healthcare compliance, it’s best to have a compliance officer or committee that is responsible for coordinating compliance.
This person or committee should be responsible for operating and monitoring the compliance program. They should ensure that the proper controls are in place, evaluate how effective the program is, and keep up-to-date on changing regulations.
The chief compliance officer or committee needs the resources, and tools to properly fulfill the role. They should report directly to the CEO or governing body and have the authority to make suggestions and enforce compliance.
Develop and deliver effective training on written policies, procedures, and standards of conduct
Even when employees have access to policies and guidelines, they sometimes may have a hard time seeing how regulations apply to their work.
Healthcare compliance training helps employees understand the importance of compliance, promote a culture of compliance, and communicate complex regulations in a way employees can comprehend.
Atraining management softwarecan help your organization streamline healthcare compliance training by conducting some of the training online. You can track training all in one place and attach quizzes to test employee comprehension.
Create effective lines of communication, including the ability to anonymously report concerns or complaints
The compliance officer or committee can’t be the only one monitoring compliance. Employees are often better situated to spot compliance violations.
Training will help employees know how to identify a violation. But they also need to know how to report violations. This requires a degree of trust – employees must know their complaint will be taken seriously, and that they won’t be punished for voicing concerns about compliance.
As we wrote in ourarticle about avoiding Qui Tam lawsuits, encouraging transparency andopen communicationcan help your organization address issues internally and avoid litigation.
Actively monitor and measure compliance through internal audits
Healthcare compliance programs require regular upkeep. Regular internal audits can help you identify any potential issues before they become a problem.
Along with audits, you can also regularly send out anonymous surveys to employees asking if they have any compliance concerns.
Enforce standards with well-publicized disciplinary guidelines
Along with clear policies and procedures, your organization’s compliance program should establish the disciplinary actions for noncompliance.
Communicating disciplinary guidelines shows employees how serious compliance really is.
Having employees sign off on these guidelines can also provide an extra measure of protection and enforcement. Use apolicy management softwareto track signatures.
Respond promptly to offenses and develop corrective action plans
If a compliance issue comes up, the chief compliance officer should respond immediately. Whether it’s a potential concern or a compliance violation, following through on discipline and corrective action is probably the most important aspect of the compliance officer’s job.
Proactively responding is always better for your organization. It can prevent future incidents and improve your overall compliance. Learn more about healthcare compliance and compliance across industries by checking out our article here.
Healthcare compliance is an essential part of protecting your organization, providing good patient care, and ensuring operations run smoothly.
As you seek to create a compliance program for your organization, you canuse PowerDMSto promote healthy communication, and update, distribute, and track your policies and training.
