5 Key Takeaways from the HCCA 2016 Compliance Institute

5 Key Takeaways from the HCCA 2016 Compliance Institute
Senior Director of Marketing

Last week, the 20th anniversary Health Care Compliance Association (HCCA) Compliance Institute was held in the beautiful Aria resort in Las Vegas, Nevada. While this city is usually associated with bad decisions, copious amounts of alcohol consumption, non-stop gambling (until your wallet permits, that is), it has some good parts, too. It’s a great place to celebrate the 20th anniversary of the Compliance Institute, for one. And despite its fast-paced environment, Vegas can also be a great place for healthcare compliance officers to share ideas, relax and unwind.

Despite the city’s many attractions, compliance is the real reason why over 3,000 healthcare professionals gathered from across the country. As the healthcare environment continues to evolve and as HCCA looks ahead to another 20 years of promoting compliance through best practices, here are my top 5 takeaways from the 2016 Compliance Institute.

1. Compliance is Interdisciplinary, the OIG Says

On Monday, April 18, Inspector General Daniel Levinson from the Office of Inspector General (OIG) stepped on stage, declaring the HCCA Compliance Institute has become more of an institution after two decades of permanence. Levinson invited attendees to view healthcare compliance as the classic parthenon, a historical piece of architecture held by several majestic columns. “These columns [represent] the different disciplines required to create a culture of compliance with one column being compliance but another column being coding and another the clinical expertise, the technology people, the administrative staff—each discipline creating that structure of purpose and solidity that is required for a healthcare institution,” he said during Monday’s opening keynote address.

In order to succeed in today’s environment, healthcare compliance professionals need to move away from silos and recognize there are many moving parts of an organization that affect compliance. Therefore, it’s important to ensure that each ‘column,’ as Levinson explained, is working effectively.

2. The Department of Justice’s Turns to Data for Strategic Focus

Leslie Caldwell, Assistant Attorney General of the Criminal Division at the Department of Justice (DOJ), explained how the division has started a strategic effort against healthcare fraud. DOJ has established Medicaid strike forces in cities where healthcare fraud is acute according to their data analysis. According to Caldwell, they have developed successful partnerships with law enforcement and are always reevaluating whether they are focusing on the right cities. “It’s a very live program that will evolve as the needs evolve,” she says.

In 2016, however, DOJ will also focus on address compliance failures in areas such as drug distribution and drug diversion. Caldwell referenced the recent $8 million settlement with CVS for unlawful distribution of controlled substances. Retail pharmacy chains “are exacerbating the opioids problem we have in the U.S.,” she said.

3. Achieving Compliance Through Resilience and Engagement

Healthcare compliance officers should focus on corrective and preventive actions, says James Sheehan, Chief of the Charities Bureau at the New York Attorney General’s office. “If you’ve never identified an overpayment… that tells the government [that] the compliance program may not be working well,” he said.

Identifying problems is key because errors can be used as information to aid in fixing issues. As Sheehan mentioned, an effective compliance program will not only uncover issues but also seek to resolve them. Achieving compliance, however, is not a solo effort. In order to succeed in the long-term, people at your organization have to know what is considered acceptable behavior. Sheehan recommends recognizing people for doing the right thing and following the right process.

“How do you make sure people do the right thing moving forward?” he asked. “Celebrate the discovery of the problem and the resolution.”

4. Collaboration + Communication + Culture = Solid Compliance

As a marketing professional, I know the value of great communication for any initiative, including compliance programs like yours. “You can have the best vision but if you don’t share it with anyone, they are not going to head in that direction,” Jennifer Kennedy, Manager Corporate Compliance at Barber National Institute, said during her presentation.

Not only does your team need to know the vision, but it’s equally critical that they understand the “why,” too. “People will work harder if they understand why they are doing something,” Kennedy says. “If you don’t explain the why, they are never going to do it.”

When communicating with your team members, factors such as age, experience, gender, and culture should affect your approach. Changing your organization’s culture won’t happen overnight, but you start establishing a culture of integrity and accountability by being present. “You need to be out there reaching [people] so that they know that you are committed to knowing what you are doing,” Kennedy says.

5. Exclusion Screening Best Practices

Healthcare exclusions and civil monetary penalties are nothing new for compliance, but they can become an issue for your organization if you don’t have a diligent screening program. The OIG’s Special Advisory Bulletin on the Effect of Exclusion was updated in May 2013 and establishes monthly screening of the List of Excluded Individuals and Entities (LEIE) as the standard recommendation in the industry.

Exclusions is an area where compliance professionals need to collaborate with other departments. Human Resources (HR) departments should conduct exclusion checks on new hires. “HR should ask [about exclusions] in the applications and individuals are responsible for telling their employer if they become excluded,” Robert Penezic, Deputy Branch Chief at the OIG recommends.

As you can infer from these takeaways, compliance is something that is achieved by collaborating with other departments. Is your compliance program supported by various departments like the columns in Inspector Levinson’s classic parthenon example? I’d love to hear your thoughts in the comments section below.