Maintaining the relationship between regulatory standards and high-quality care can be a complicated process with many moving parts. Today, providers are required to have a comprehensive compliance plan to mitigate their risks of having to pay significant fines for non-compliance.

In order to protect themselves, healthcare organizations need to ensure that an effective compliance plan is in place that incorporates the seven elements dictated in the federal sentencing guidelines and Office of Inspector General (OIG) Guidance. These elements include, having a designated compliance officer, maintaining written policies and procedures, routinely providing compliance education, implementing a robust monitoring and auditing program, providing a method to report compliance concerns, enforcing the compliance program and responding appropriately when non-compliance is suspected.  While not all practices are large enough to have a full-time compliance officer on site, a compliance expert is very helpful to have on-hand to assess the organization’s plan. Compliance advisors such as Graham can not only serve as interim officers, but also evaluate the plans to give detailed feedback and recommendations.

“There are a lot of moving pieces when it comes to compliance. Depending on the size of an organization, a lot of times the compliance officer will also be the privacy officer. If find myself in that role often.”

In that role, Graham said, she will develop a three-part evaluation including corporate compliance to ensure proper policies exist regarding stark, anti-kickback and conflicts of interest, compliance to ensure that an effective compliance plan is in place that meets requirements and HIPAA compliance to meet the protection of patient health information standards. By having a similarly maintained and routinely assessed compliance plan in place, Graham said, healthcare providers can protect themselves from potential legislative action while maintaining a high standard of care for patients and employees.

For more information on healthcare compliance, visit or get in touch with Katie Graham directly at or 865-862-3020.