Measuring Compliance Program Effectiveness

Measuring Compliance Program Effectiveness: A Resource Guide

On January 17, 2017, a group of compliance professionals and staff from the Department of Health and Human Services, Office of Inspector General (OIG) met to discuss ways to measure the effectiveness of compliance programs. The intent of this exercise was to provide a large number of ideas for measuring the various elements of a compliance program. Measuring compliance program effectiveness is recommended by several authorities. This list will provide measurement options to a wide range of organizations with diverse size, operational complexity, industry sectors, resources, and compliance programs.

Compliance Program Guidance

OIG has developed a series of voluntary compliance program guidance documents directed at various segments of the health care industry, such as hospitals, nursing homes, third-party billers, and durable medical equipment suppliers, to encourage the development and use of internal controls to monitor adherence to statutes, regulations, and program requirements. The documents provide principles to follow when developing a compliance program that best suits your organization’s needs. The documents also identify fraud and abuse risks to watch out for when creating a program.

Provider Compliance Training

Compliance training widgetBelow are links to free training for health care providers, compliance professionals, and attorneys. OIG’s Provider Compliance Training was an outreach initiative developed as part of HHS’s and the U.S. Department of Justice’s Health Care Fraud Prevention and Enforcement Action Team.

Inspector General Discusses the Importance of Health Care Compliance

Dan LevinsonInspector General Daniel Levinson outlines important compliance issues for health care providers before the Health Care Compliance Association.

Compliance Education Materials for Health Care Boards

A meeting tableBecause of their oversight responsibilities, boards of directors have a unique opportunity to influence their health care organizations to promote quality of care and embrace compliance with the law. These resources can help directors, who may not be lawyers or health care providers, create a corporate culture that promotes high-quality care and embraces compliance with the law.

Compliance Education Materials for Physicians

Brochure coverThese educational materials assist in teaching physicians about the Federal laws designed to protect Medicare and Medicaid and program beneficiaries from fraud, waste, and abuse. The materials summarize the five most important Federal fraud and abuse laws that apply to physicians and provide tips on how physicians should comply with these laws in their relationships with payers, vendors, and fellow physicians and other providers.

FDA Compliance Education on Prescription Drug Advertising and Promotion

FDA BadAd Program Brochure

FDA’s Office of Prescription Drug Promotion in the Center for Drug Evaluation and Research have developed a compliance program that focuses on educating healthcare providers about the role they can play in helping the agency make sure that prescription drug advertising and promotion is truthful and not misleading.

The FDA “Bad Ad” program External link includes a CME/CE e-learning course External link and case studies External link to raise healthcare providers and students’ awareness of misleading prescription drug promotion and other common regulatory concerns.

Healthcare providers can also report misleading prescription drug promotion activity via e-mail BadAd@fda.govor call 855-RX-BADAD.

FDA BadAd Program Brochure External link

Visit the original page OIG Compliance Resources

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