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Corporate Integrity Agreement (CIA)

Take Steps to Headline-Proof Your Compliance Controls

Health care is one of the most highly regulated industries in the United States. Thousands of health care entities have been excluded from participating in federal programs, such as Medicare and Medicaid, for violating laws. The Office of Inspector General (OIG), Department of Justice (DOJ), Centers for Medicare & Medicaid Services (CMS) and other governmental agencies target health care fraud and abuse as high-priority areas for inquiries and investigations.

BKD National Health Care Group has been assisting health care organizations with corporate compliance services since health care fraud and abuse became a major concern. Our consultants teach compliance at conferences and seminars, write articles published in national journals and consult with organizations across the nation. We've also developed innovative compliance tools and approaches to help organizations stay out of hot water. Each service can be customized to meet your specific needs.

Compliance Program Effectiveness Reviews

We can measure the effectiveness of your health care organization’s corporate compliance program, conduct risk assessments, facilitate an organizational SWOT analysis and provide your organization with recommendations to improve your compliance program. BKD has developed specific tools to help organizations evaluate the effectiveness of their programs. These tools include questionnaires, checklists, surveys and other forms designed to identify compliance gaps and flaws.

Program Review & Design

BKD consultants have developed tools to help health care providers create an effective, customized compliance program. Our approach incorporates the OIG’s model compliance program guidance and regulatory developments. We can review your compliance plan document, recommend enhancements and draft the revised compliance plan to incorporate the OIG’s model compliance guidance and other recommended provisions.

Risk Assessments

We facilitate the process of identifying potential compliance risks to your health care organization and quantifying the level of various risks. We also can assist in developing a work plan to define the scope of compliance work your organization will perform.

Corporate Integrity Agreements

If your organization has committed a compliance violation and is required to enter into a corporate integrity agreement (CIA), we can assist by designing compliance organizational structures and compliance processes to reduce the risk of recurring violations and to meet the CIA requirements.

Independent Review Organization

If your health care organization enters into a CIA with the DOJ, it typically must contract with an independent review organization (IRO) to provide independent verification your organization is complying with CIA terms. BKD serves as an IRO to organizations by combining knowledge and expertise of corporate integrity agreements, compliance program operations and coding and billing audits to provide cost-effective, proven results that meet CIA requirements.

Training & Education

BKD can help train your compliance committee, employees, management, board members and physicians on compliance issues. Examples of training include fraud and abuse, current industry developments, compliance program effectiveness, board governance and corporate responsibility and coding and billing issues.

Coding & Billing Audits

BKD’s team of credentialed and certified coding consultants perform independent and objective reviews in many risk areas, including inpatient and outpatient hospital services, skilled nursing services, rehabilitation and psychiatric services, home health and hospice services, community health centers and physician services. Our reviews can be performed using a randomly selected or statistically valid sample.

How can we help you?

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Locations

We have 40 offices in 18 states, with trusted advisors who offer solutions for clients across the country.

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