October 2, 2022

Volume XII, Number 275


September 30, 2022

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September 29, 2022

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Seven Elements of an Effective Compliance Program

Hospitals, health systems, physician groups and other healthcare industry face an enormous regulatory and compliance burden unlike any other sector. Below, Womble Bond Dickinson Healthcare Consultant Carrie Tuttle gives her Seven Elements of an Effective Compliance Program. These elements can serve as general guideposts to help healthcare providers and employers create a culture of compliance and proactively address compliance shortcomings that may lead to problems down the road.

Also, watch below to see a comprehensive webinar presentation with Tuttle discussing the elements of an effective compliance program in the healthcare industry.

Implementing Policies, Procedures, and Standards of Conduct

Policies, procedures, and standards of conduct should be written in such a way that is easily understood in order to maintain compliance while performing job functions.  Policies and procedures should be clearly written, they should be relevant and current, specific to job functions, reviewed on a regular basis (e.g. monthly or quarterly), and readily available.

Designating a Compliance Officer and Compliance Committee

Designating a Compliance Officer and Compliance Committee will at minimum prevent, detect, and correct non-compliance, supports the organization’s unique structure and compliance program with sufficient resources, promotes standards of conduct, and establishes a clear means of communication for reporting non-compliance.

Training and Education

Effective training and education can be achieved by offering compliance training frequently (at minimum annually), making training and education part of the job requirements, and staying current on compliance issues and trends by attending conferences, reading articles and/or publications, and professional networking.

Effective Communication

Developing effective lines of communication is essential and is a great mechanism for reporting instances of potential non-compliance. Effective communication can be developed by being visible and approachable, ensuring confidentiality, communicating the compliance message, encouraging feedback, and providing methods for anonymous and good-faith reporting (e.g. anonymous hotline, survey, etc.).

Monitoring and Auditing

Conduct internal monitoring and auditing by establishing an annual work plan, determine any areas of risk, proactively audit, and review the compliance program.  This ensures the compliance program addresses any areas of concern while sustaining compliance program effectiveness.

Disciplinary Guidelines

Well-published disciplinary guidelines ensure standards are followed continuously and consistently throughout the organization.  Standards should be followed by all personnel regardless of position, title, or rank.  Never assume the standards are being followed, check in often to inspect for the standards set forth.

Detecting Offenses and Corrective Action

Developing a method for tracking and responding to compliance issues, thoroughly documenting and investigating, enforcing corrective action, and tracking the resolution of complaints are effective ways to address offenses. Acting promptly to detected offenses and undertaking the appropriate corrective action is pertinent to maintaining an effective compliance program.

Copyright © 2022 Womble Bond Dickinson (US) LLP All Rights Reserved.National Law Review, Volume X, Number 8

About this Author

Healthcare is a highly complex and regulated industry, and at Womble Bond Dickinson we have lawyers with in-depth local experience working with both the UK and US systems. We offer advice, strategy and representation to a broad range of public and private clients including major health and social care providers, financial institutions and other key stakeholders.

Across both jurisdictions, we advise all stakeholders on the full spectrum of corporate transactions from corporate M&A to distressed and insolvent care providers. Overlaying this...