An Ode to Healthcare Compliance

Introduction to the Seven Elements of an Effective Compliance Program via rhyme.

An Ode to Healthcare Compliance

By Lindsey Hennings, MAM, CHC

 

 

Healthcare Compliance. What does that mean?

Rules, regulations, best practices… and all in between!

 

We strive to remain compliant with laws

To provide the best service and care, without pause.

 

Why do we do this? Why do we stress?

Well someone has to sift through this mess!

 

Administrative rules, executive orders,

Proposed legislation within our borders.

 

Plan types and states and federal reign -

Of course the requirements cannot be plain!

 

In order to travel the (over)complicated fray,

We need compliance to show us the way.

 

Compliance is here to guide and to show us,

To partner and support, to train and to grow us.

 

Tools and resources and training abound

To help compliance bring businesses round.

 

The Sentencing Guidelines, following a scam,

Created the Seven Elements of an Effective Compliance Program.

 

What are these elements? You wonder with glee.

Sit down and relax; I will explain them to thee.

 

First recommendation is easy as you please;

Policies and Procedures, also known as P&P’s.

 

These policies document the ways that we work

And prove to regulators we are not just jerks

 

Who do things without thinking or without design.

We use these procedures so our processes align

 

With regs, laws, and rules, while keeping in mind

Business functions, abilities and decisions in kind.

 

Number two comes next and deals with oversight -

Compliance Officers and Committees, you got that right!

 

The Compliance Officer, in charge of all things compliance

To that office we pledge our alliance.

 

Compliance Committees, a stalwart group,

Help make decisions and keep folks in the loop.

 

The next element consists of training.

Effective knowledge is what we’re gaining.

 

Presenting compliance rules and recommendations

While working to ebb trainees’ frustrations.

 

An effective program empowers employees to communicate

In order to drive compliance concerns through the gate.

 

Whistleblower protections and anti-retaliation protocol

Helps employees feel safe while revealing it all.

 

Next comes monitoring and folks’ favorite: the audit.

Routine checking; regulators applaud it.

 

Business departments may not be pleased with your presence

But finding issues before CMS does is certainly a pleasance!

 

Should a claims examiner be punished greater than a CEO?

For similar compliance issues �" the answer is NO!

 

Effective compliance programs have standard rules

For disciplining those noncompliant fools.

 

What do we do when hearing an issue of noncompliance?

Respond, investigate, and correct �" it ain’t rocket science.

 

When hearing of allegations of offenses,

Compliance professionals must take to the fences

 

To review in due diligence the accusations presented

And respond in kind and ensure they’re documented.

 

Regulators, clients, employers, consumers.

Millennials, Gen-X’ers, and Baby-boomers.

 

We all know the importance of remaining compliant.

To these Seven Elements we remain alliant.

 

~THE END~

Author's Note

This is intended for specific audiences interested in healthcare compliance.