info@riddlecompliance.com

Get In Touch

908.447.0521

Call Us
Riddle Compliance
Riddle Compliance

Healthcare Compliance Program Assessment (CPA)

EMPLOY A MEANINGFUL COMPLIANCE PROGRAM ASSESSMENT “CPA” TO IMPROVE YOUR ORGANIZATION’S COMPLIANCE POSTURE

Improve your organization’s ethics & compliance program by assessing its effectiveness against essential components, regulatory insights and industry trends. Riddle Compliance helps clients identify strategic benchmarks for governance, corporate and regulatory compliance, integrity, and risk mitigation. Regulators across industries scrutinize the comprehensiveness of compliance programs when deciding on reprimands, fines, and during routine federal and state audits. Organizations with growing revenue are most vulnerable due to an organic proclivity to ignore cumbersome or nuanced mandates. Facilitating an external compliance program assessment on a routine basis allows a company to identify gaps in operations before regulators. Contracting with Riddle Compliance is a step in fostering program effectiveness and mitigating risks.

COMPLIANCE PROGRAM ASSESSMENT AND AUDIT DESIGN

Riddle Compliance has expertise on regulatory trends but understands companies’ risk tolerances. Although one entity may have a risk profile mirroring an organization of similar size and complexity, risk tolerances vary. Risk tolerance is more about leadership style and strategic goals. With this understanding, Riddle Compliance devises robust compliance audits to fit a company’s perceived exposure. Our business is to opine on best practices while assisting our clients with mitigating probable risks without frustrating growth and development.

INFORMATION GATHERING AND REVIEW PROCESS TO ENSURE EFFECTIVE AUDITING

Our team of consultants employs a structured evaluation process. Policies and procedures, company standards, and other controls are thoroughly reviewed against each organization’s regulatory environment, opinions from senior staff and front-line works, as well as actual day-to-day conduct. We utilize a number of tools to extract the most pertinent information and accurate representation of a company’s compliance disposition. Each step of information gathering and compliance program review is strategic and deeply rooted in mitigating pertinent risks.

USE RIDDLE COMPLIANCE’S CPA REPORT TO OPERATIONALIZE GAPS AND  REMEDIATE FINDINGS

Our team of consultants analyzes all relevant information then produces a comprehensive compliance program assessment report. This report details pertinent compliance patterns, trends in conduct, recommendations on policies and procedures, evaluation of staff commentary, samplings, and various other details. Once we have completed a compliance audit report, we facilitate a workshop with internal staff, executive leadership, and relevant audit committees to explain findings and possible remediation efforts.

LEVERAGING THE ELEMENTS OF AN EFFECTIVE COMPLIANCE PROGRAM ALONGSIDE THE CPA

The Department of Justice (DOJ) updates the criteria of an effective compliance program on a routine basis. These updates are usually published annually. Riddle Compliance uses these updates along with the standard elements of an effective compliance program and other industry best business practices to measure organizations’ compliance posture. This is a critical part of the procedural audit of the compliance program assessment. Other areas of the CPA include an evaluation of substantive subject matter, related controls, policies, and procedures, and a host of other healthcare systems, downstream entities, business associates, and other partnerships. A list of the elements of an effective compliance program include the following.

  • Designated Chief Compliance Officer and supporting staff
  • Communicate clear standards and procedures
  • Implementation of risk monitoring and mitigation practices
  • Effective training and compliance communications
  • Confidential reporting and investigative procedures
  • Third-party management and due diligence initiatives
  • Comprehensive auditing and monitoring practices
  • Facilitation of enforcement and corrective actions

OTHER QUESTIONS TO CONSIDER BEFORE CONTRACTING WITH US TO FACILITATE A COMPLIANCE PROGRAM ASSESSMENT

  • Has my organization identified key regulatory compliance areas?
  • Is the healthcare compliance program comprehensive and rooted in risk mitigation?
  • Do monitoring and auditing initiatives produce substantive findings?
  • Does the compliance program remediate and address trends of noncompliance?
  • Are corporate trainings aligned with regulatory mandates and company values?
  • Are formal investigation protocols in place?
  • Does the compliance program operate across all business functions?
  • Are policies and procedures impactful?

USING A COMPLIANCE PROGRAM ASSESSMENT AS A REGULATORY MOCK EXAMINATION

Our compliance program assessment is a high-level review of governance, risk, and compliance controls that mirrors a mock regulatory exam. Using a team of professionals, we evaluate pertinent regulatory issues, data protection and cybersecurity, supply chain management and due diligence, incident reports, policies, recurring corporate conduct against written company standards, regulatory frameworks, and a litany of industry best practices.

EVALUATING THE USABILITY AND EFFECTIVENESS OF COMPLIANCE POLICIES AND PROCEDURES

A full-scale review of all company-wide policies and procedures is part of Riddle Compliance’s ethics and compliance program assessments. Policies are assessed for their readability, risk coverage, enforcement metrics, and learning and training modules. Reviewing policies and procedures is a pertinent part of an effective compliance program.

EXTERNAL DOCUMENT REVIEW, TRANSACTION TESTING AND RECORD SAMPLING TO ENHANCE COMPLIANCE CONTROLS

Riddle Compliance has a formal process to collect documentation and conduct sampling during compliance program assessments. This portion of a compliance audit is cumbersome, but it uncovers some of the most important aspects of an organization’s practices and compliance processes.

STAKEHOLDER INTERVIEWS, COMPLIANCE SURVEYS, AND OTHER QUALITATIVE TOOLS

Department supervisors as well as front-line employees offer unique compliance perspectives given their respective roles. We perform comprehensive staff interviews to gather information and trends to measure against regulations, company standards, and best business practices.