A compliance officer recently asked me: How much do healthcare providers typically budget for compliance?
I’m sharing my answer on the blog, because it’s a common question – and while there are multiple answers and no “right answer” – there are guidelines that apply to most organizations.
The size of your compliance budget is based on a consideration of two variables: 1) your resources (personnel time and expertise); and 2) the level of compliance risk that is acceptable to the leadership of the organization.
Here are some items we like to see in a compliance budget:
- Compliance Officer salary (or, contract amount for an outside consultant. For example, MPA provides outsourced compliance support to providers who cannot dedicate sufficient staff hours in-house)
- Education and training for the Compliance Officer. This could include HCCA membership, attendance at the annual HCCA meeting, and webinars/CEUs.
- Staff time and expertise to draft policies and audit tools, and continually update them. OR a budget for purchasing policies and audit tools.
- Compliance training for employees
- Compliance training for the Board
- Compliance Week. This is optional! And I have seen successful compliance weeks with a small budget ($300 (for prizes, treats, and printing flyers)
- Any other compliance-related training that is not otherwise included in the budget. For example, HIPAA training, QAPI training, etc.
- Third party audits if used. For example, a third party vendor comes in to conduct therapy documentation audits.
- Exclusion screening vendor (if not included in HR budget)
- Compliance program annual review (if not done internally)
- HIPAA Security Risk Analysis (if not done internally)
- Any other compliance-related audits that are not otherwise included in the budget
- Compliance survey (if a third party is used or if there is a cost with a survey software program)
- Legal review of compliance issues (if not included in legal expenses line item of budget)
- Anonymous compliance hotline (if outsourced to a vendor)
It can also be helpful to consider how much is spent on compliance versus other departments. Did Compliance Week get a “no” in the budgeting process – but a ski retreat for the Board got a “yes”? That raises an eyebrow about the organization’s commitment to compliance. On the other hand, if the compliance department asked for $4,000 for stress balls with the hotline number on them, and there simply isn’t money for that – but $300 for printing flyers and buying candy was approved, that could be seen as reasonable.