Compliance Corner

Compliance Corner

Compliance Corner
By Robin Brown
EHS Chief Compliance Officer

Why do we need a Compliance Program?

Healthcare compliance began emerging as a profession in the 1990s after the U.S. Sentencing Commission released its Guidelines Manual in 1991 that laid out the seven elements of an effective
compliance program that organizations could use to develop their own programs. At this point, it was strictly voluntary for healthcare organizations to implement a compliance program.
The U. S. Department of Health and Human Services Office of Inspector General followed in 1998 with a release of compliance program guidance for hospitals. The Social Security Act and CMS have also provided guidance for compliance programs.

However, the Patient Protection and Affordable Care Act of 2014 mandated that providers put a compliance program in place as a condition of participating in Medicare and Medicaid.
Compliance officers are often seen as “internal police” or the one who always says “no”. In reality, compliance officers are business protectors and enablers:

  • Helping establish and maintain an ethical culture.
  • Maintaining compliance with state and federal laws and regulations
  • Detecting and mitigating issues
  • Solving problems and creating solutions
  • Protecting the organization’s financials
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