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Christi Grimm, the Inspector General of HHS, gave a recent keynote address to compliance professionals. In it, she said, “Simply put, the financial incentives created by risk adjustment may be driving upcoding in the severity of diagnoses to garner additional payments.”
If we want to improve our organizations’ compliance culture, then we need to interact with our healthcare leaders in a way that sells compliance without “selling” compliance.
A “reframe, regroup, refocus” approach enables compliance teams to work with other departments to provide excellent patient-centered care.
“By being aware of how your leaders think, you will uncover social determinants of compliance and understand their potential impact on the organization. You can then respond and assist accordingly, or remove barriers to successful compliance deliverables.”
“It behooves all healthcare compliance professionals to be aware of the fraud, waste and abuse risks associated with telehealth services. This mode of delivery holds great promise. For it to fulfill that promise, non-compliance needs to be rooted out and corrected.”
“The secret to my success in reinforcing the value of Compliance’s work comes from partnering with HR. Developing standard interview questions, building leadership competencies, and sticking your neck out to establish strong relationships across the organization are crucial to demonstrating how Compliance delivers value.” – Lisa Herota