Compliance Program Effectiveness Assessments

Healthcare organizations, senior executives, and governing body members are under increasing scrutiny to ensure they have an effective compliance program. In 2017, the Department of Justice (DOJ) provided healthcare organizations with an outline of questions and considerations that it reviews when investigating a criminal fraud issue. The guidance provided insight into how the DOJ evaluates the effectiveness of a compliance program.

In 2018, the Office of Inspector General (OIG) unveiled its “Fraud Risk Indicator” that it will use to ascertain the degree of risk an organization that declines to enter into a Corporate Integrity Agreement (CIA) poses to the federal healthcare programs. Although the existence of a compliance program does not affect the level of risk assigned, the failure to have in place an effective compliance program designates the organization as “higher risk.”

Coker’s compliance team will perform a comprehensive evaluation of your organization’s existing compliance program against the seven fundamental elements and offer recommendations to improve the effectiveness of your program. Coker has the tools and resources to assist you in implementing improvements in your program and is available for ongoing execution, support, and advisory services.