Recent Industry News
One of the Compliance Officer’s greatest challenges is to obtain the necessary empowerment for their role. Compliance Officers should be duly empowered to carry out the compliance program’s duties and responsibilities. For Compliance Officers who seek such empowerment, there are two guiding principles worth considering. First, Compliance Officers should create dependencies among other leaders in the organization. The more program managers and executives are dependent on the Compliance Officer, the greater the empowerment for their office. Second, Compliance Officers should recognize that the currency of power is information. The more valuable information the Compliance Officer maintains, the more dependence they will gain in return, yielding the Compliance Officer greater empowerment. With these principles in mind, Compliance Officers can identify the types of valuable information that they can offer to the organization’s leaders.
Providing Value to Your Organization’s Leaders
Compliance Officers have valuable channels of information that are not as readily available to program managers and executives. Such channels include the following:
- Regulatory and Enforcement News – The Compliance Officer should keep abreast of regulatory and enforcement news in the ever-changing compliance environment. This includes monitoring the enforcement initiatives of the Department of Health and Human Services (HHS) Office of Inspector General (OIG), Department of Justice (DOJ), the Office for Civil Rights (OCR), and the Centers for Medicare and Medicaid Services (CMS) and their administrative contractors. It also includes keeping up with sources such as the OIG’s Fraud Alerts, compliance guidance pronouncements, White Papers, regulations, work plans, findings from audits and reviews, congressional testimony, and relevant podcasts. Similarly, enforcement actions taken by the DOJ, both in the civil and criminal divisions, warrant monitoring. The more the Compliance Officer knows about the regulatory enforcement environment, the better they can translate that information for affected managers and executives. Digesting this information and presenting “lessons learned” to the executive and board-level compliance committees also allows these leaders to realize the value and need for this particular channel of information. When it comes to compliance, the Compliance Officer should be the primary resource that others look to for guidance.
- The Hotline – The hotline is a source of information and intelligence that is generally managed by the compliance office. Human Resources (HR) depends on the information channeled through the hotline. It can also help to identify weaknesses in the system and potential wrongdoers that can create liability issues. Leadership is well aware that allegations may negatively impact the organization, and may implicate them personally. The hotline should be viewed as a serious and credible channel of communication. As such, it should be answered 24/7 and be externally operated. The hotline should be monitored on an ongoing basis and undergo periodic evaluation for effectiveness. The Compliance Officer should act promptly and efficiently on complaints received through the ethics hotline. Failure to address these complaints risks the scenario where employees become external qui tam “whistleblowers” to the DOJ. This message should be conveyed to executive leadership and the board.
- Compliance Culture and Knowledge Surveys – Professionally developed and conducted compliance culture and knowledge surveys result in a great deal of information for the organization. Additionally, the OIG specifically recommends the use of surveys in their compliance guidance documents. The survey results can instruct the Compliance Officer about employee understanding and attitude towards compliance and organizational leadership. The most useful surveys are those that are exclusive to the healthcare sector and have results anchored to a large universe of other organizations using the same instrument. Professional surveys are validated and the results are reliable in their reflection of the universe of employees. This should nullify any negative comments about survey validity from management.
- Ongoing Auditing – The Compliance Officer can gain solid intelligence about operations and systems through ongoing auditing. This requires the Compliance Officer to review and verify program managers’ monitoring of their operations. Compliance Officers should review and monitor audit reports, as they will often identify system weaknesses that must be addressed. In turn, this creates an opportunity for the Compliance Officer to provide assistance to address those weaknesses.
- Compliance Education and Training Programs – Another valuable source of information and intelligence is through compliance education and training programs. The Compliance Officer’s personal participation in new employee orientation and subsequent compliance education programs creates an opportunity to learn about current issues of concern to employees. It also widens the “open door” for employees to directly contact the Compliance Officer to discuss issues and concerns.
- Compliance Conferences and Networking – Conferences and networking activities provide other means to gather information that is not generally available to executives and management. Presentations from representatives of various government oversight agencies can be invaluable. These presentations can speak to their concerns, initiatives, and priorities. Returning to the organization with authoritative knowledge from these people can help guide internal action and work plans. Additionally, interactions with colleagues are useful in garnering new perspectives and ideas.
- Engagement of Experts – Compliance Officers can engage national experts to assist in presenting evidence and addressing organizational compliance needs, as another way to import information. Often, managers, executives, and board members will accept advice and warnings from outside parties over their own Compliance Officers.
Gathering useful knowledge is only part of the equation. Compliance Officers must put that knowledge to work to achieve true empowerment. They should put significant thought into how to best communicate what they learn. If Compliance Officers use such information to play the “gotcha” game, it will have the opposite effect, actually diminishing support for the compliance office. For the Compliance Officer to truly achieve empowerment, their information must be helpful and useful to managers, executives, and board members. These leaders should ultimately look towards the compliance office as an ally to help them identify and rectify program weaknesses.