Kusserow on Compliance: Extending and economizing compliance programs—tools, services and tips

Compliance officers are confronted with a host of ever increasing external regulatory and internal demands with most having inadequate resources to meet all the challenges.  Furthermore, it is becoming increasingly common to add responsibility for HIPAA Privacy to the portfolio of compliance officers’ duties. All of this results in ongoing efforts to find ways to extend capabilities, while being sensitive to limited available resources. There are finite options available. Of course, the preference is to handle all this with internal staff. However, unfortunately for most compliance officers, limitations on increased office staffing limits this option. In some cases, organizations turn to Out-Sourcing their compliance program. This is most often done as a measure to temporarily fill gaps with an Interim Compliance Officer (ICO) when an incumbent leaves, or smaller organizations contracting the function out to an individual or firm to assume responsibility by providing a Designated Compliance Officer (DCO). Co-Sourcing is a third option and “middle ground” between hiring new staff (In-Sourcing) and Out-Sourcing and may prove to be the best strategy available for compliance officers to take huge pressures away, if implemented correctly. It involves using limited vendor services and tools to address key elements in the compliance program.

Co-Sourcing Compliance Services/Tools

The key factor that separates Out-Sourcing from Co-Sourcing is the maintaining control and direction under the compliance officer. It involves using a third-party on an ongoing basis to supplement limited staff resources by carrying part of the workload. It can help bridge the gap without compromising the ability to easily return to a structure where the compliance officer reassumes full operation when staffing issues are resolved. This approach is also recognized by the OIG as a useful solution to where an organization is limited in-house compliance expertise and resources. Compliance Officers are increasingly employing this as a means as a practical solution when confronted with a staffing shortage and offers the advantage of using limited, rather than full time services. It also may permit gaining access to a range of specialist without having them full time on payroll.

Common Types of Co-Sourcing Tools/Services

Co-Sourcing Expert Services

There are a number of advantages of engaging outside experts for limited scope of work, especially to address staff shortage or obtaining technical skills that do not exist in-house. Careful use of vendors to supplement the Compliance Office can not only gain access to experts not available in-house, but can save time, money, and effort; while maintaining flexibility to end an arrangement at anytime, when no longer needed. The following are common examples of Co-Sourced services:

Co-Sourcing Tips

  1. Clearly define duties, tasks, responsibilities, and methodology for vendor to follow.
  2. Ensure the agreement is flexible to expand or contract levels of service as needed.
  3. Look for providers that have industry specific expertise.
  4. Check experience and seek references of the firm.
  5. Ensure individuals provided have the needed skills, experience, and expertise.
  6. Bigger is not always better, as smaller niche firms are more likely to provide better, less expensive services.
  7. If planning to Co-Source for multiple tools and services, consider seeking discounts for a “bundling” arrangement.

Richard P. Kusserow served as DHHS Inspector General for 11 years. He currently is CEO of Strategic Management Services, LLC (SM), a firm that has assisted more than 3,000 organizations and entities with compliance related matters. The SM sister company, CRC, provides a wide range of compliance tools including sanction-screening.

Connect with Richard Kusserow on Google+ or LinkedIn.

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Copyright © 2017 Strategic Management Services, LLC. Published with permission.

Kusserow on Compliance: Engaging experts to supplement and assist compliance offices

Most compliance offices are swamped with work. Sometimes it is a periodic rush to meet some urgency, while at other times there is just too much to be done with too little to meet all challenges in the ever-changing regulatory and enforcement environment. There are three broad ways to handle the load: (1) insource, so that all compliance office work is handled in-house, using consultants only occasionally for advisory services or evaluation of the compliance program; (2) outsource the compliance program to designated or interim compliance officers as a temporary solution for maintaining continuity, using an expert to be the interim compliance officer; or (3) cosource by using on-call experts to supplement the compliance office with specific duties or assignments.

Suzanne Castaldo, J.D., an expert on the subject, notes that many smaller organizations cannot justify the cost and burdens of supporting the program in-house and outsource it entirely to a designated compliance officer, who most often is a part-time engaged expert. The HHS Office of the Inspector General (OIG) recognized the use of designated compliance officers who may serve in that capacity for several organizations. Taking this approach should entail engaging experts on a part-time basis. If a full-time person can be afforded, then using this approach doesn’t make sense. The benefits include bringing the experience of many organizations to the entity that could ill afford to develop in-house.

Kashish Chopra, J.D., MBA, CHC, has served as an interim compliance officer and makes the point that in this day and age, with such a rapidly evolving regulatory and enforcement environment, health care organizations cannot afford to take the chance on having a gap in the compliance office. Having an expert on a short-term engagement can take over the reins of the program while a permanent replacement is found.

Jillian Bower, a highly experienced consultant has been instrumental in providing supplemental support to compliance officers. She noted that cosourcing has evolved as a “middle ground” between insourcing and outsourcing and has also been recognized by the OIG as a useful solution when expertise and resources are limited. It involves using experts on an ongoing basis to supplement limited staff resources to carry out part of their workload. It offers the advantage of the compliance officer maintaining control and direction of the program. Cosourcing can help bridge the gap in a manner that does not compromise the flexibility to easily return to a position where the Compliance Office can reassume full operation and end cosourcing at any time, when staffing issues are resolved. It is hiring piecemeal as needed. Common cosourcing may be using a consultant as a HIPAA privacy and/or security officer, conducting ongoing monitoring/auditing, performing enterprise risk management/analysis, engaging a statistical data claims analyst expert to determine error rates, hotline operations management, compliance investigations/training, reviewing arrangements with referral sources, and managing the sanction screening operations.

The fact is that there are options for consideration when a compliance program is being stretched beyond its capability to meet challenges or where a gap takes place among key compliance staff.

Richard P. Kusserow served as DHHS Inspector General for 11 years. He currently is CEO of Strategic Management Services, LLC (SM), a firm that has assisted more than 3,000 organizations and entities with compliance related matters. The SM sister company, CRC, provides a wide range of compliance tools including sanction-screening.

Connect with Richard Kusserow on Google+ or LinkedIn.

Subscribe to the Kusserow on Compliance Newsletter

Copyright © 2017 Strategic Management Services, LLC. Published with permission.