ATLANTA — The van Halem Group announced April 25 that Amarillo, Texas-based HC Comply will become a new division of the company focused specifically on compliance. Effective May 16, the move follows the departure of HC Comply founder Clay Stribling, who leaves to become president and CEO of the Amarillo Area Foundation, a regional charitable organization.
"Clay has been a tireless advocate and compliance pioneer within the HME industry. I've been proud to work alongside him as we've both sought to help companies navigate through new and often complicated federal requirements and rigorous enforcement," said van Halem Group founder and President Wayne van Halem.
Begun in 2006, the company has helped clients navigate Medicare and Medicaid issues related to audits, investigations, medical review, appeals, enrollment, coding, education and training. The new HC Comply division adds compliance program design and training, compliance audit services, monitoring, risk assessment and privacy services.
Having a suite of compliance offerings "will help ensure our clients have the best counsel before, during and following any potential oversight action by the federal government," said van Halem, a former Medicare fraud investigator.
According to van Halem, simply having a compliance handbook sitting on a file cabinet will no longer cut it in the industry's current environment.
"First," he said, "health reform is going to make it mandatory that companies have a valid compliance program." While no deadline has yet been set, van Halem said, "I'm guessing that by the end of 2013 it will be mandatory for DME. Not only that, but much like accreditation, there will be certain requirements that have to be met in order for a compliance program to be considered a 'valid' program.
"The second piece is," he continued, "the government and audit contractors have never been more aggressive with their auditing techniques than they are now. Funding has been increased for audits, and they are not going to go away."
An effective compliance program, van Halem contends, can point up an HME company's vulnerabilities so any issues can be identified and corrected in advance of an audit, which, at some point, is certain to come.
"Having an effective compliance program in place is just a good business decision," van Halem said. "It protects the Medicare trust fund and protects providers as well by keeping little issues from turning into big issues in case of an audit."
Stribling, a health care attorney with Brown & Fortunato before founding HC Comply, agreed. "At this point, compliance programs are vital for HME providers because they are the best defense a company has against the new onslaught of government audits, from the ZPICs and the RACs to other audit sources. An effective internal compliance program can significantly decrease the error rate you have when facing these external audits," he said.
With compliance requirements under the Affordable Care Act in play, Stribling said, if HME providers wait too long to begin adopting and implementing compliance programs, "a lot of companies are going to suffer the same growing pains they did when they waited too long to get accredited."
Advised Stribling, "The companies that are going to be the most successful will be the ones that get out ahead of this and get a compliance program in place that makes them a better company today."