Carrie Kusserow, MA, CHC, CHPC, CCEP
Chief Operating OfficerCorporate Headquarters
5911 Kingstowne Village Parkway
Alexandria, VA 22315
Ms. Kusserow is a Certified Compliance and Ethics Professional (CCEP), and is Certified in Healthcare Compliance (CHC) and Certified in Healthcare Privacy Compliance (CHPC). She has over 15 years of experience in health care compliance, with expertise in False Claims, Anti-Kickback regulations, Stark Laws, HIPAA Privacy and Security, Fraud, Waste and Abuse, and Medicare Marketing regulations. She specializes in compliance advisory services including corporate compliance program development and implementation, evaluation of compliance program effectiveness, compliance risk assessments, policy and procedure development, investigations, and hotline operations and issue management.
Ms. Kusserow has experience working with a variety of health care organizations, including hospitals, health systems, physician practices, long-term care organizations, behavioral health providers, home health providers, and managed care organizations. She assists clients with the development, implementation, management, and maintenance of effective compliance programs, as well as conducting compliance program risk assessments and effectiveness reviews. She also assists in the development and implementation of remediation plans to address compliance program deficiencies and promote industry best practices. She works with providers on addressing compliance risks; investigates potential violations of laws, regulations, and Code of Conduct; and develops and assesses compliance-related policies. She is experienced in performing regulatory due diligence in connection with potential physician practice acquisitions. Ms. Kusserow performs risk assessment and management services for clients, both general in scope (e.g., identifying all applicable risks), as well as more tailored towards specific risk areas (e.g., HIPAA, Physician Contracting, etc.). She also provides risk remediation services including policy development, employee education and training, and implementation of proactive and reactive auditing and monitoring practices. She has provided compliance presentations to various health care organizations, and is an experienced compliance trainer at all levels of an organization, including physician and Board training. Her training expertise includes, but is not limited to, Compliance/Code of Conduct, Fraud, Waste and Abuse, HIPAA Privacy and Security, Physician Compliance, Two Midnight Rule, and Drug Diversion.
Ms. Kusserow’s specialized experience includes implementing a regulatory due diligence process and post-acquisition monitoring process for physician practice acquisitions; developing and implementing processes for management of RAC and other audit contractor claims, including policies and procedures, process flows, tracking system and establishment of an oversight committee; assisting a healthcare system in identifying outlier physician payments that could potentially implicate the Stark and/or Anti-Kickback laws; and designing and implementing a system for a large managed care organization to simplify the Medicare Advantage annual mandated member materials creation and review process to ensure compliance with the CMS Medicare Marketing Guidelines.
Ms. Kusserow is also responsible for oversight of Strategic Management’s Compliance Resource Center, which provides policy and procedure development, online training, surveys, sanction screening, and compliance hotline services.
Previous Work Experience
Prior to joining Strategic Management, Ms. Kusserow was a consultant with a “Big Four” public accounting firm, where she focused on providing compliance-related consulting services to healthcare providers and managed care organizations. She also has experience as a Chief Compliance Officer for a health system, where she was recognized for significantly increasing senior-leadership support and engagement in the compliance program. As Chief Compliance Officer, Ms. Kusserow oversaw Compliance for the organization’s multiple hospitals, continuing care retirement community, and physician practices, including the Radiation Oncology, Surgical Oncology, Urology and Cardiology practices. In this capacity she was also responsible for management of the organization’s HIPAA Privacy program. Ms. Kusserow began her career as a partner in a hotline services company that provided compliance hotline services to over a thousand organizations, including two-thirds of the nation’s hospitals. They also administered the Office of Inspector General hotlines for several of the federal government agencies. She has provided training to numerous organizations on hotline operations, investigations, and issue management.