Why Compliance Officers Are Crucial for Healthcare Compliance

​A compliance committee, led by the chief compliance officer (CCO), is one of the seven required parts of a healthcare compliance program. According to PwC's "State of Compliance" survey, 86% of healthcare providers have a designated compliance officer. However, more than half of these officers handle other responsibilities too.

This role is challenging but essential. No healthcare organization—no matter its size, type, or specialty—can function without it, especially as compliance issues and costs continue to grow.

What Do Compliance Officers Do?

• Lead the compliance committee to create and manage the organization’s compliance program, starting with organizing and maintaining policies and procedures.
• Make sure hospital staff are trained and up-to-date on policies, procedures, and processes, which are regularly updated to match changing healthcare laws.
• Understand the balance between compliance and risk, including where issues might happen, how to avoid or reduce them, and how to manage costs while minimizing risks.

​Why Is Compliance Important for Your Organization?

Compliance acts as the first line of defense for your organization. It helps ensure decisions are made independently and in the best interest of the organization. Compliance officers must stick to these decisions, even if they are unpopular, and ensure actions are carried out correctly and on time.

To stay unbiased, compliance officers should work separately from the legal team, human resources, and the board. A 2013 study by the Society of Corporate Compliance and Ethics found that:

• 80% of compliance professionals believe compliance officers (CCOs) shouldn’t report to the general counsel.
• 88% said the general counsel shouldn’t take on the role of CCO.

The HHS Office of Inspector General suggests that compliance officers should report directly to the CEO or executive board. This ensures their observations aren’t influenced or filtered by the legal team.

Building a Strong Compliance Program

Creating a strong compliance program requires being proactive and forward-thinking. To keep the program effective and up-to-date:

• Stay informed about new issues and regulations and how they impact your organization.
• Understand the law and how to apply it.
• Promote a culture of compliance within the company and ensure staff are properly trained.
• Make sure policies and procedures align with both the law and the organization’s core values.

Lead by Example

Compliance officers should set a good example. Employees should feel comfortable suggesting improvements to policies and procedures. Officers must also act professionally so their decisions are respected. They should be ready to investigate issues, conduct audits, and take disciplinary action when necessary.

Keep Records Organized

If the organization faces an audit or investigation, a compliance officer needs to provide clear documentation. This includes:

• Written policies and procedures with dates and updates.
• Employee training records.
• Audit reports.

Organized records show the program is well-managed and effective.