IntraVires Health

The Critical Path to Refresh the Code of Conduct

Part 1.  The Code of Conduct is arguably an organization’s most public and ubiquitous document. It unites all employees, agents, vendors, and business associates who commit to behave in accordance organizational Standards. The Compliance Officer often oversees the Code of Conduct’s maintenance and distribution and relies on the Code to support them in assessing corporate ethics and risk. So, why does the Code of Conduct too often “sit on the shelf” and adapt only to major events like a merger? Rules and roles in healthcare can change often, so Compliance Officers should occasionally lead an effort to refresh the Code and affirm the organizational expectations. Follow the Critical Path to begin the process:  NOW: Find the current version. Compile an itemized list…

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The Critical Path to Add Compliance to Strategy

The Critical Path to Add Compliance to Strategy Organizations may not recognize that strategic plans should include a compliance component.  Compliance officers frequently look outward to monitor regulatory enforcement initiatives and assess associated risks.  An organization’s compliance program can contribute significant value to key strategic initiatives by recognizing and proactively managing compliance risks associated with those initiatives.  Now:  A thorough compliance risk assessment and the organization’s strategic plan can be harmonized to prioritize and manage compliance risks that can complicate or derail strategic goals.  A good place…

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The Critical Path to Make Your Case for Compliance Resources

The Critical Path to Make Your Case for Compliance Resources To reduce expenses, organizations may limit compliance resources or delegate compliance duties to another role or function, particularly if there have been no recent serious incidents and other control functions are in place (e.g., internal audit, human resources and legal services).  This approach fails to recognize the positive influence of an independent compliance program on the organization’s performance.  Without a compliance program focused on building an ethical culture and avoiding…

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The Critical Path in a Compliance Crisis

The Critical Path in a Compliance Crisis In a compliance crisis, such as a whistleblower case (e.g., qui tam), discovery of systemic non-compliance, privacy violations, or executive misconduct, for example,  it is vital to gather the facts, gain an understanding of the risk, and immediately begin addressing the crisis.  What to do NOW:   After investigating the facts, determine the size and scope of the crisis and forecast which resources are needed to manage through it.  Assess whether confidentiality is important…

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Welcome to “The Critical Path”

Welcome to “The Critical Path” The Critical Path will provide information and action steps to “Get Better Compliance” particularly when validation of a compliance program’s approach is needed, issues become too complex for the team to handle alone, or there’s a sensitive investigation needed that requires findings and insights of an independent expert.  The Critical Path will help to make the case for compliance to Boards, Audit Committees and governmental agencies and to imbed compliance principles into strategic plans and decisions.  The Critical Path will focus on compliance realities and challenges to help readers find a way forward.    What to do NOW:  Put The Critical Path on your list of sites to consult for updates and helpful information about…

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Insight into a Fraud – What Happened at Rock Capital Markets?

January 27, 2019 By: Shelley C. Koltnow, Principal Consultant, IntraVires Health Compliance Consultants Miller Beach, IN INSIGHTS INTO A FRAUD – WHAT HAPPENED AT ROCK CAPITAL MARKETS? On January 15, 2019, Thomas C. Lindstrom woke up, went to court, and under a plea arrangement with the U.S. Attorney’s Office in Chicago, pled guilty to one criminal count of wire fraud, ended a years-long investigation, and received a five-year, federal prison sentence (with a two-year supervised release afterward). The Path to…

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Hallmarks of an Ethical and Compliant Culture

By Shelley C. Koltnow, JD, MBA, FACHE       An organization’s culture is the demonstration of its character and personality.  While the goal of any compliance program is to foster an ethical and compliant culture, influencing the culture may be very difficult.  Here are some signs of an ethical culture and some hacks to improve culture where necessary. An Ethical Culture fosters reporting of concerns and incidents without fear of retaliation.  In an organization that values doing the right…

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Four questions your physician orientation should answer but might not

Dan Fisher Consultant Answering these four questions during physician orientation will guard against business, quality, and compliance hazards. What are some key characteristics of the physicians’ new patient population(s)? The challenge: Population health – the buzzword of the decade. Payers are requiring physicians to demonstrate cultural competency in their medical decision making. Physicians need to know and understand their patient populations to diagnose health outcomes, recognize possible health determinants, and coordinate care with other providers (especially in a patient centered…

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A Note to Legal Counsel – Compliance Crisis Management

    Legal Counsel may benefit from a consultant’s assistance in a compliance crisis.  The following message explains how.  We are writing to you as a healthcare attorney to share how our unique consulting approach can help you represent your healthcare clients, particularly those facing a compliance crisis.  Our assistance in crisis scenarios facilitates fact development, client self-efficacy, corrective action planning and implementation, and optimizes compliance programs, while remaining cost-effective and aligned with your representation.  Notwithstanding rapid cycle changes and…

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Have You Considered Hiring a Compliance Operations Director?

Dan Fisher, MS Consultant In one striking, but less than obvious way, the Chief Compliance Officer (“CCO”) is the most unique member of the C-suite. The CCO is both a person and a named component of a program. [Way back] in the 1990’s, the US Sentencing Commission and the HHS OIGinstructed healthcare organizations to start compliance and ethics programs with seven (7) distinct components, in short: 1) Standards of Conduct, Policies & Procedures; 2) Compliance Hotline; 3) Audit and monitoring systems; 4) Disciplinary…

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