Tips for Building an Effective Healthcare Compliance Program

Follow these tips to ensure you’re implementing an effective healthcare compliance program.

1. Understand the OIG’s Seven Elements
2. Toss your outdated compliance program guidance manual
3. Lean on the healthcare compliance experts
4. Work with a reliable healthcare compliance tracking system

1. Understand the OIG’s Seven Elements

The wealth of information you can find on compliance can be overwhelming. An excellent place to start is with the Office of Inspector General’s (OIG) Seven Elements of an Effective Compliance Program.

According to OIG, healthcare organizations should do the following to meet compliance standards.

• Implementing written policies, procedures, and standards of conduct
• Designating a compliance officer
• Conducting effective training and education
• Developing effective lines of communication
• Conducting internal monitoring and auditing
• Enforcing standards through well-publicized disciplinary guidelines
• Responding promptly to detected offenses and undertaking corrective action

Healthcare Compliance Program Policies and Procedures

Healthcare compliance program policies and procedures serve as a guide for your organization and employees. Policies and procedures are essential for ensuring the privacy and security of protected health information (PHI). They also guide safe work practices to protect employees and patients from workplace hazards.

Designating a Compliance Officer

Designating a Compliance Officer ensures that your organization follows policies, procedures, and the code of conduct. They’re responsible for handling responses to reported breaches or incidents, and implementing corrective actions. This individual ensures your healthcare organization understands regulatory requirements across federal and state laws.

Employee Compliance Training

Healthcare compliance training is vital to compliance and ensures patient and employee safety. Your employee training program must cover several topics, including proper use and disclosure of PHI, cybersecurity best practices, workplace hazards, and how to report incidents.

Effective Lines of Communication

Creating a culture of compliance depends on safe, accessible communication pathways. All employees and stakeholders must have a confidential method of reporting regulatory concerns. Whether it’s an unsafe working environment or a data security concern, compliance hinges on employees being able to report these issues without fear of retaliation.

Internal Monitoring and Auditing

Routine audits to monitor regulatory compliance ensure internal processes are compliant. Audit results allow the compliance officer to refresh and reset compliance goals and practices.

Enforcing Standards and Disciplinary Guidelines 

Responding quickly to any deviation in compliant behavior is critical to protecting an organization and its patients. Disciplinary guidelines should be published in employee handbooks, including the process.

Responding to Offenses and Corrective Action

The ongoing success of an organization is reliant on incident response. Some compliance deviations may require legal involvement, professional board reporting, insurance submission, and board reporting. Regularly reviewing and enhancing regulatory controls are key to staying ahead of regulatory concerns.

2. Toss Your Outdated Compliance Program Guidance Manual

Using a compliance program guidance manual used to be the industry standard for meeting regulatory requirements. However, as technology evolves, your compliance needs change. Whenever there is a change in regulatory requirements or how your business operates, your healthcare compliance program must be adapted to effectively manage your risk. 

For example, Dr. X’s practice has always used pen and paper for medical charts, but has recently adopted an electronic medical records platform. This move makes good business sense, but has the practice’s compliance program accounted for this change? Since Dr. X adopted a new piece of software, the practice needs to update its compliance program to reflect this. 

When using a traditional compliance manual to manage compliance, instances like Dr. X’s are often overlooked. Using comprehensive healthcare compliance software to track and manage compliance makes it easier to adapt your program as necessary.

3. Lean on the Healthcare Compliance Experts

So you found a healthcare compliance program sample online and think, “Great, I can use this sample program to create an effective healthcare compliance program in my business.” Well, that may not be the best course of action. Even seasoned healthcare compliance officers often look for support.

This is because healthcare compliance is exceptionally nuanced. It’s easy to let something slip through the cracks. But when you hire a company to help you manage your compliance, it gives you peace of mind that you haven’t missed a thing. 

4. Work with a Reliable Healthcare Compliance Tracking System

You decided to work with a company to help manage your compliance, but not all compliance systems are created equal. Many offer an out-of-the-box solution that doesn’t allow you to customize your healthcare compliance program for your specific needs. This might work as a stopgap, but you now know this is not good enough.

Having a healthcare compliance program sample built into your healthcare compliance tracking system gives you a framework to start from, but you want to be able to adjust the sample to meet your needs.

Solve healthcare compliance challenges quickly and confidently with Compliancy Group’s simplified software. Whether you need HIPAA, OSHA, SOC 2, or all three, your compliance program is fully customizable. Remove the complexities and stress of compliance, increase patient loyalty and the profitability of your business, and reduce risk. Endorsed by top medical associations, clients can be confident in their compliance program.