Due Diligence, Accreditation ?and Consistent Vision

One key strategy to get senior management to commit to a culture of compliance in your company is to educate and advocate for the many benefits which effective compliance programs offer to home care companies. An effective compliance program can improve bottom line reimbursement and can enhance relationships with personnel and with outside partners as well. And there are even more ways an effective compliance program can benefit a home care company. These benefits focus on your relationships with business colleagues, financiers and customers in order to obtain better funding, better contracts, better growth opportunities and more successful consumer and patient relationships. An effective compliance program helps a home care company achieve or maintain accreditation status. Your company’s ability to demonstrate compliance knowledge now weighs heavily in accreditation efforts. Compliance is no longer just a governmental concern. It is now considered essential by all of the DMEPOS accrediting agencies. HIPAA compliance, fraud compliance, reimbursement compliance and accreditation compliance all fit together as an integrated system. Benefits are synergistic. Because there are substantial overlaps among the compliance efforts, substantial efficiencies and economies of scale are possible. I realize many home care companies just show compliance with specific rules when seeking or renewing accreditation. But a fully realized compliance program can make accreditation easier to pursue or renew, by demonstrating both legal compliance and effective operational oversight. Plus, when you can show that your compliance program educates, audits and monitors proactively, the accrediting agency should be satisfied more quickly and easily. An effective compliance program is a valuable part of due diligence activities with acquisitions and sales. A home care company which purchases or sells assets, or which acquires or merges with another company, must undertake a due diligence process to assure the other parties that the supplier has the capacity to consummate the transaction, and that the transaction will not create any undisclosed or unexpected problems for the other parties. The presence of an effective compliance program demonstrates that the home care company is less likely to have any lurking problems stemming from violations of fraud or reimbursement rules. Further, because an effective compliance program demonstrates a home care company’s capacity for effective self-assessment and self-policing, this can give comfort to the other parties that the company has the ability to carry out its promises in general, and may also have the ability to identify and resolve internal problems which do not involve compliance issues. This often results in a less burdensome due diligence process, thereby reducing the company’s scope of due diligence and thus its costs (in both money and time). A home care company can use its compliance program to help focus on its objectives and to assist and enable growth, interaction with third parties, etc. In order to create the specific standards, policies and protocols which constitute a compliance program, a home care company must identify which issues are important to it and how it wishes to resolve them. Does a policy against conflicts of interest mean that the home care company will not do business with other businesses owned by employees, owners or board members? Or, does it simply mean that such transactions must be approved by disinterested parties? Does it apply to all transactions, or only those above a certain dollar amount? There are no correct answers to these sorts of questions. However, the way that a home care company answers should reflect the company’s philosophy, vision and mission, as well as its corporate culture. The process of creating and using documents for a compliance program can help you identify where your company’s values and corporate culture truly lie, so that it can strive for consistency of vision in day-to-day operations.