Evaluate Your Organization's Current Compliance Program
Whether your organization needs a top to bottom compliance program or just an assessment of the effectiveness of your current program, we can work with your organization towards an effective model that is specific to your needs. All corporate compliance programs are required to have particular elements. While the basic elements remain the same for all compliance programs, we do not believe in a one size fits all compliance program. We tailor our programs to fit each client’s business model, corporate culture, and financial resources. As an example, rather than simply providing potentially unnecessary, duplicative, and potentially conflicting corporate compliance policies, we recommend a review of current facility policies to determine which, if any, new policies are necessary, if current policies need to be revised, or if current policies will work in developing an effective compliance program. We have found that this saves our clients time and money as well as eases the transition of a facility and its employees to a culture of compliance by taking advantage of known systems already in place.
On Call to Answer Compliance Concerns
The attorneys at the Kitch Firm understand the unique nature of health care, most importantly, that compliance concerns arise 24 hours a day. We provide our clients with after-hours numbers so there is assistance available with emergencies at any time.
Attorney-Client Protected Audits
An effective compliance program requires ongoing audits and monitoring of identified risk areas. There are, however, instances where it would be prudent to conduct audits under the attorney-client privilege. Some examples of instances where the attorney-client privilege would be beneficial include audits of high risk areas, new risk areas, areas that may not be covered by the quality assurance or peer review privileges, or audits responding to compliance concerns or complaints. Depending on the particular compliance concern, the Kitch Firm is able to conduct the audit or we partner with experts or even the facility itself to evaluate the validity or extent of a compliance issue.
Once a compliance concern is suspected or identified, the Kitch Firm is able to direct or conduct an investigation of that concern. Under the attorney-client privilege, we are able to analyze the outcome of the investigation and provide legal guidance on a response if necessary.
Response to Government Investigations
It is never pleasant when a facility is served with a subpoena or is subject to a search warrant. The initial response of the facility and its employees to a government investigation may be crucial in establishing the tone and course of the investigation. The Kitch Firm has extensive experience in representing facilities in investigations and allegations by both state and federal agencies.
Voluntary Refunds and Disclosures
An effective compliance program with more likely than not uncover instances of errors in billing or otherwise, which require the refunding of payments to CMS or other sources. It may also reveal noncompliance (intentional or not) which requires disclosure to the OIG. If necessary, Kitch firm has the experience to be able to guide your organization through these processes, to work towards limiting the likelihood or scope of government intervention, minimizing the financial impact on your organization and building a foundation to defend against criminal implications if necessary.
Compliance as an Element of Employee PerformanceAn effective compliance program should have policies for evaluating employee performance which utilizes the promotion of, and adherence to, the elements of the compliance program as a factor in the evaluation. Managers and supervisors should be disciplined for failing to adequately instruct their subordinates or for failing to detect noncompliance with applicable policies and legal requirements, where reasonable diligence would have led to the discovery of any problems or violations and given the nursing facility the opportunity to correct them earlier. Conversely, those supervisors who have demonstrated leadership in the advancement of the company’s code of conduct and compliance objectives should be singled out for recognition. To measure the effectiveness of this element of the program, the OIG suggests evaluating several areas. Do employees experience recurring pitfalls because the guidance on certain issues is not adequately covered in company policies? Do employees flagrantly disobey an organization’s standards of conduct because they observe no sincere buy-in from senior management? Do employees have trouble understanding policies and procedures because they are written in legalese or at difficult reading levels? Does an organization routinely experience systematic billing failures because of poor instructions to employees on how to implement written policies and practices?