Corporate Compliance

Ensure your entire workforce is wholly committed to your ethical standards, conduct business in compliance with governing laws, regulations and policies.

Office of Inspector General, Centers for Medicare & Medicaid Services

Corporate Compliance

The Office of Inspector General (OIG) has defined an effective compliance program as one that includes the following:
  1. Customizing the written policies & procedures
  2. Designating the compliance officer & committee
  3. Educating the workforce via consistent training
  4. Developing effective lines of communication
  5. Monitoring internal processes & regular audits
  6. Enforcing standards & policies
  7. Executing the corrective action plans
HCP's Corporate Compliance Program addresses all seven required elements, including the tools and support you need to stay on track.

Your Corporate Compliance Program Includes:

code of conduct, policies

Policies & Procedures

Policies pertaining to the Code of Conduct and Corporate Compliance Program will be customized to ensure that workforce members are wholly committed to ethical standards and conducting business in compliance with governing laws, regulations, and policies.

corporate compliance exclusion list monitoring, list of excluded individuals and entities, system for award management

Exclusion List Monitoring

HCP will perform monitoring of all employees, providers, business associates, and vendors on both the OIG's List of Excluded Individuals and Entities (LEIE) and the System Award Management (SAM) exclusion lists.
You will receive a monthly email notifying you of anyone who appears on this list and will be provided instructions on how to handle an exclusion.

fraud waste and abuse, whistleblower statute, compliance training

Fraud Waste & Abuse (FWA)

There are differences between fraud, waste, and abuse. One of the primary differences is intent and knowledge. Fraud requires intent to obtain payment and the knowledge that the actions are wrong. Waste and abuse may involve obtaining an improper payment or creating an unnecessary cost to the Medicare Program but does not require the same intent and knowledge. Organizations that provide health or administrative services for Medicare enrollees, every action you take potentially affects Medicare enrollees, the Medicare Program, or the Medicare Trust Fund, compliance is required and the responsibility of all. Your HCP Compliance team will help you understand your obligations and fulfill your responsibilities according to your contract with CMS.

internal monitoring and auditing, seven elements of an effective compliance program

Internal Monitoring and Reporting

CMS considers monitoring as ongoing, including conducting analyses and tracking trends to correct issues "in real time". Auditing, on the other hand, is a formal review with a methodical approach and sampling of cases, and those performing audits must be independent of, and not employed by, the department being audited.
Your HCP Compliance team will work with you to establish a protocol to address the monitoring and auditing of your program. For more information about coding audits click here.

discipline and corrective action, seven elements of an effective compliance program

Discipline and Corrective Action

Enforcing standards and disciplining the individuals who violate them underscores the organization's commitment to compliance; it's important for the standards to apply to employees at all levels.
Your HCP Compliance Team will provide you with guidance on the investigation of complaints and infractions as well as your grievance procedures, your due diligence will be documented in the software.

compliance hotline, anonymous reporting, whistleblower

Compliance Hotline

Compliance programs operate most effectively in organizations that encourage open lines of communication. Organizations should create and maintain a mechanism to encourage and facilitate candid communication.

You will receive access to an anonymous hotline that will allow your workforce to submit any issues, concerns, or suggestions. You will also be given a toll-free number where anonymous messages can be left. HCP will transcribe these messages and relay them (anonymously) to designated leadership within your organization.

Stark Law, Anti-Kickback, guidelines

Stark Law & Anti-Kickback Statute

Receive guidelines to comply with the Stark Law that prohibits offering, paying, soliciting, or receiving anything of value to induce or reward referrals or generate Federal health care program business, and the Anti-Kickback Statute that prohibits a physician from referring Medicare patients from designated health services to an entity with which the physician has a financial relationship.

Medical Assistant, Credentialing, CPOE

Medical Assistant Credentialing

In the event that you have any non-certified medical assistants that you need to perform the CPOE function in your EMR, you can have them take our approved Medical Assistant Credentialing course which, upon passing, allows non-certified MAs to perform this function.

Remember, you also have access to all features of our Core Compliance solution

"Thanks for your assistance. We greatly appreciate your service and trainings!"

Aislinn H.

The Bone and Joint Clinic of Baton Rouge

"Thank you very much for checking in with me! The staff at HCP has been fantastic in assisting us with anything we need. I really appreciate you reaching out."

Shelby W.

ResolveROI

My favorite thing about Healthcare Compliance Pros is the reporting. We're always all about the reports. I like that at my fingertips, I can pull up who's done the training, who has not, and who's behind. Then, I can shoot that off to the leads and managers. Any direct reports tell leaders who's...

My favorite thing about Healthcare Compliance Pros is the reporting. We're always all about the reports. I like that at my fingertips, I can pull up who's done the training, who has not, and who's behind. Then, I can shoot that off to the leads and managers. Any direct reports tell leaders who's not doing their things. The system can produce reminders for you. Like there's a setup for that specific timing and whatnot. So it can be hands-off for you. But they dig in to find out what's been done, who's in compliance, and who's not. With HCP, you're good to go--you're well protected.


Cinderella Tollefsen

Corporate Compliance FAQs

Q What is corporate compliance?

A

Corporate compliance refers to an organization's adherence to laws, regulations, guidelines, and ethical standards set by governing bodies, industry regulators, and internal policies. It ensures businesses operate within legal boundaries, act ethically, and mitigate risks.

Q Why is corporate compliance important?

A

Industry regulators require corporate compliance for several reasons:

Legal Protection

By complying with laws and regulations, businesses minimize the risk of legal consequences, including fines, penalties, and reputational damage.

Ethical Behavior

Compliance promotes ethical practices, creating a positive brand image and fostering trust among customers, partners, and stakeholders.

Risk Mitigation

Compliance programs help identify and mitigate potential risks associated with legal violations, financial mismanagement, fraud, or data breaches.

Competitive Advantage

Businesses with strong compliance programs tend to attract more investors, clients, and business partners who value transparency and integrity.

Q Do all businesses need corporate compliance programs?

A

Yes, all businesses should have corporate compliance programs regardless of size or industry. Compliance applies to large corporations, startups, small businesses, non-profits, and even sole proprietorships. The level of complexity may vary, but compliance remains essential for any organization to uphold ethical standards, protect against legal risks, and maintain a trustworthy reputation.

Q What are the key factors to know about corporate compliance?

A

Compliance Culture

Establishing a strong compliance culture involves promoting an ethical environment, fostering open communication, and ensuring that employees understand the importance of compliance.

Regulatory Knowledge

Corporations must stay informed about relevant laws, regulations, and industry standards. Regularly review and update compliance policies and procedures to maintain alignment with legal requirements.

Internal Controls

Implementing effective internal controls helps prevent and detect non-compliance. These controls include internal audits, segregation of duties, risk assessments, and whistleblower mechanisms.

Training And Education

Provide comprehensive training programs to educate employees about compliance obligations, internal policies, and ethical behavior. Regularly refresh training materials to reflect any regulatory changes.

Monitoring And Enforcement

Establish mechanisms to monitor compliance activities, identify potential issues, and enforce consequences for non-compliance. Conduct periodic assessments and audits to ensure the effectiveness of compliance programs.

Remember, corporate compliance is an ongoing process that requires commitment and continuous improvement. Seek legal counsel or consult compliance professionals to tailor your program to the specific needs of your organization.