Healthcare Regulatory Compliance Services

Today’s health care compliance and regulatory environment is among the most complex in our nation. Health care organizations need to have the right information and tools to assess and manage the impact of the government’s ever-changing regulatory compliance and enforcement initiatives. Compliance Officers and health care executives, managers, and workforces must also have an awareness and clear understanding of health care compliance requirements in order to maintain an effective compliance program. One way health care organizations can ensure that their compliance programs are effective and are appropriately addressing health care regulatory compliance initiatives is by receiving health care compliance and regulatory services. These professional services take a deeper look at compliance program operations and overall federal and state health care requirements to assess whether the compliance program has the necessary practices, policies, and procedures in place to sufficiently address such requirements.

Health Care Compliance Services and Regulatory Solutions

• Compliance Program Services
  • Compliance Program Design and Implementation
    Compliance program design, implementation, and advancement tailored to meet the unique needs of the organization
  • Compliance Program Effectiveness Evaluations
    In-depth assessment of compliance program operations to determine the program’s strengths, gaps, and overall effectiveness
  • Sarbanes-Oxley (SOX) and Corporate Governance
    Incorporation of standard elements of SOX and additional corrective action measures and tools
  • Health Care Compliance Training
    Training for a wide range of compliance and regulatory topics delivered through customized sessions
• Interim and Outsourced Compliance Officer and Support Services
  Interim and outsourced compliance staffing provided by highly-experienced consultants
• Corporate Integrity Agreement (CIA) and Independent Review Organization (IRO) Services
  CIA implementation, Independent Review Organization, and Independent Compliance Expert to the Board of Directors services
• Internal Investigation Services
  Compliance investigations and inquiries to help mitigate compliance issues and provide recommended practices to prevent similar issues from recurring
• Compliance Risk Assessment and Management
  Identification and analysis of compliance high-risk areas and best practice solutions for risk remediation, auditing and monitoring and reporting procedures
• Compliance and Regulatory Advisory Services
  Advisory services to ensure understanding of health care regulations and necessary updates to compliance programs based on the latest requirements and industry guidance
• HIPAA Privacy and Security Compliance Services
  Interim and outsourced privacy and security staffing, HIPAA advisory services, training, and risk assessments and remediation to meet HIPAA compliance obligations
• Claims Audits, Appeals, and Revenue Integrity Support
  Claims reviews, appeals support, assessment of statistical overpayment extrapolations in disclosure or internal reviews, and assessment of billing monitoring programs for revenue integrity
• Claims Data Analysis
  Analysis, summary assessments of statistics and data integrity, including data extraction and assembly support, pattern analysis and data preparation for sampling and estimation
• Anti-Kickback and Physician Arrangement Reviews
  Evaluation of proposed and existing physician arrangements to determine their appropriateness under the Anti-Kickback Statute, Stark Law and other relevant regulations
• Litigation Support
  Relevant health care litigation support services to address sensitive compliance issues
• Due Diligence Reviews
  Evaluation of compliance program operations and compliance risks during mergers and acquisitions
• Responding to Government Auditors
  Expert Witness services for organizations that are in litigation because of an audit
• Compliance Resource Center Solutions
  Complete suite of solutions for improving compliance program operations and ensuring organizations meet federal and state law requirements

To learn more about Strategic Management’s health care compliance services and regulatory compliance solutions, please contact us at (703) 683-9600 or fill out our online contact form.

View our Library of Health Care Compliance Resources

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