Difficult situations that require immediate and certain response arise in healthcare. We work with you and your legal counsel to comprehend and resolve the situation. Some examples include: Civil Investigative Demand (CID); 340B Program audit (HRSA); Stark self-disclosure and repayment; Physician compensation issue; Revenue cycle or reimbursement issue; Corporate Integrity Agreement (CIA); Privacy violation or security breach (OCR); Investigation of a kickback or conflict of interest; Drug diversion; Tax-exemption; Compliance hotline investigation.
Consultants with Custom Compliance Resources are prepared to serve in open compliance, audit, and risk positions during recruitment for permanent staff is underway. Suggested interim positions include, but are not limited to: Chief Compliance Officer; Chief Risk Officer; Internal Audit Executive; Compliance Program Management; Project Development. Custom Compliance Resources also assists in recruiting healthcare compliance executives.
Compliance is a control department. Boards and audit committees need assurance that effective compliance oversight is in place and the culture of the organization supports the compliance program. Our Consultants provide: Education to Board and Audit Committees Education and training for executive leadership Compliance committee formation and administration Assistance with policies and procedures Assistance with Standards of Conduct (Code of Conduct) Compliance as a component of enterprise risk
Our Consultants assure your compliance program is aligned with your organizational goals and strategic plans, with a high degree of effectiveness. Examples of services that optimize the compliance program are: Gap analysis to ensure that the compliance program reaches the “four corners” of the organization; Compliance Plan development; Compliance program structure and hiring plan; talent assessment; Compliance program marketing and awareness; Department operating plan development; Team building; Analytic support for program administration and audit; Risk assessment and audit plan development;…
Value-based care and modern payment models can carry high risk without a strong compliance component. Medicare Accountable Care Organization ACO Medicaid Managed Care Organization (MCO) Medicare Advantage Organization (Plan Sponsor) Medical First Tier, Downstream, and Related Entity (FDR) Patient-centered Medical Home Federally Qualified Health Center (FQHC) Provider-owned payer Health Information Exchange (HIE) Clinically Integrated Network (CIN) Contracting