Healthcare Compliance in the New Normal: Part 2

September 1, 2020 Marcy Utley

A recent panel discussion I moderated with two compliance officers shed light on how they are meeting the challenges of healthcare compliance through the COVID-19 pandemic and how it’s shaping future plans for their organizations.

Our speakers were Tina Tolliver, Chief Compliance, Ethics & Risk Officer/Privacy Officer at Millennium Healthcare and Mark Nue, Compliance & Privacy Officer at Alta Hospitals Systems. Part 1 covered questions about current challenges and staffing changes. Here is part 2 of our 3-part series showcasing excerpts from the webinar discussion.

 


Our third audience polling question: What are the top priorities for our compliance team right now?

What are the top priorities for our compliance team right now?

 


Fourth polling question: Which of the following have impacted your compliance department due to COVID-19?

Which of the following have impacted your compliance department due to COVID-19?

 


Marcy: Tina and Mark have touched on the need to spread additional duties across roles, so that means the compliance team is wearing multiple hats in order to get all the work completed. One of the great things about compliance teams is when times get tough everybody jumps in and helps out. Does that line up with some of your thoughts, Mark?

Mark: Yes, very much. So, documenting for the Cares Act – this has been a standard mantra that I share in the compliance committee when I'm in leadership meetings: Whatever you do, document why you're doing it because that's really the best guidance I think I've heard generally speaking from experts. You're getting this funding and any money from the government will always be audited. They'll look for the low-hanging fruit of you took the money, did you spend it the right way or did you go buy a boat?

So, documentation is key for sure. The compliance inquiries have always been very interesting that I've been dealing with because a lot of times it's the very basic question wrapped up in a COVID-19 exterior. It's the fundamental privacy question, can we do this? Can we share this? But there's a sense that because it's COVID, that there may be an exception. There've been more and more inquiries to compliance but about the same type of thing. So, it's been reinforcing the basics and the fundamentals.

Furloughing definitely has occurred. You know, when you would normally reach out to call your colleague in another department, and they're off that day, or supposed to be off but they always answer, or they tell me that they're furloughed. That's been a challenge.

The elimination of worktime items has been more of a recalibration of timelines and milestones. Not losing focus completely but hoping that what was going to be done in April may be more August. What was going to get done in August may be closer to October and spreading the work around. I have found myself doing things outside of my compliance world, because something needs to get done in that department. It's for the collective greater good, I'll jump in.

I think a complication for everybody is the elimination of the workforce, and then there's the furloughing of workforce and workforce that has tested positive or been exposed so they’re in quarantine for a chunk of time. The staffing challenges run the gamut.

Every day is a new kind of day. Re-evaluate, reshuffle, reprioritize.

Tina: We know that the government doesn't give you anything for nothing. So, with the Cares Act we know they will be coming back at some point in time saying, “how did you spend that money?” There's already been a lot of news out there as far as them prioritizing investigations, finding fraud schemes, and things like that. So, they're going to be checking and double-checking, and we've got to make sure that we are able to show the documentation, to substantiate where those funds were used, just like Mark said. One of the things that we did, too, is we out and we put it in our newsletter that our compliance door was open, remember to call, to remind everyone we're here as a resource. Because out of sight is out of mind. We had already experienced issues being reported, retaliation in that people were saying, “You know, I didn't get this for my department. My hours are being cut. My schedule is changed. But nobody else is.” 

I think it's very valuable for all of us as good compliance officers to know – and to make sure that we're communicating that on a consistent basis – that we are that resource. We want to make sure that people can rely on us, no matter what. And so, even though we have this hotline that's mandated, I know that the majority of the calls and the issues that are brought to us is because people trust us. 

It is about sharing that workload, but also, being that resource and having that persona and that perception that compliance is there, we’re your team member. We're not here to be policing. We've got to lock arms and be there for each other.

Mark: I want to really reiterate who compliance is to the organization. If nothing else, we're the voice of reason in the organization, the ethical compass. We're going to get through this. We're doing the right things. It helps provide some level of assurance and security during these are tough times.

So, you become a little bit of the counselor, and layer in the ethical hats that you wear as a compliance officer, not just the rules and policies and being the HIPAA guy or gal. It's really a matter of being there as a resource and as a go-to problem solver.

 

 


Replay the full webinar on-demand to hear the rest of the conversationRoundtable: Return to Office, Healthcare Compliance Edition

 


See additional resources and insights from SAI Global for managing healthcare compliance during the pandemic.

Learn more about our risk and compliance solutions for healthcare and health insurance organizations

Or, contact us to see how SAI Global has helped organizations like yours.

About the Author

Marcy Utley

Marcy Utley is Senior Product Manager at SAI Global. She is responsible for the company's compliance and risk management solutions for the healthcare market. Marcy ensures SAI Global’s Compliance risk product line meets the needs of healthcare compliance and revenue cycle professionals. Before joining SAI Global, Marcy worked in the healthcare industry for 15 years. She held various positions, including key roles in Physician Services, Revenue Cycle, and the Compliance Department.Marcy holds a Bachelors degree in Business Management and is a member of HCCA, AAPC, and NAHRI.

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