Health Care Compliance

The health care regulatory environment continues to change and become more complicated. Health care organizations are struggling to keep up with the continuous flow of new laws, regulations, and government guidance documents. To make matters worse, federal and state enforcement agencies, such as the U.S. Department of Justice, the U.S. Department of Health and Human Services’ Office of the Inspector General, and the Centers for Medicare & Medicaid Services (CMS), are pursuing an aggressive enforcement agenda, which is putting health care  and life sciences organizations on the defensive.

EBG Advisors assists providers, payors, and life sciences organizations in implementing effective compliance programs that can help them avoid or mitigate enforcement risk. Clients depend on our roster of former chief compliance officers from large organizations who know how things work “on the inside” and have designed and overseen many health care compliance programs. We have a deep understanding of the complex issues that give rise to investigations and settlements and provide our clients with proactive measures to prevent fraud and other wrongdoing. Organizations that are pursued by government agencies seek support from our former prosecutors, who enjoy positive relationships with those agencies. We also have data experts and investigators who understand how to protect organizations against government scrutiny.

The U.S. Sentencing Guidelines and various regulatory oversight bodies expect organizations to conduct risk assessments in order to design their compliance programs to address identified risk and to continue to monitor risk controls. Health care providers benefit from EBG Advisors’ experience conducting risk assessments as well as advising, designing, and executing on compliance auditing plans.

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We provide the following services:

• Compliance program development, enhancement, and implementation:
  • Develop compliance policies and procedures
  • Create audit and monitoring plans
  • Provide education and training
  • Develop reports and metrics
• Compliance program effectiveness and due diligence:
  • Evaluate program design and implementation as a benchmark against industry standards and best practices
  • Assess qualities of policies and procedures
  • Evaluate contents of compliance training
  • Develop enhancements to policies, procedures, standards, and training
• Risk assessments and compliance audits:
  • Perform operational and regulatory risk assessments
  • Conduct risk assessments across the heath practice
  • Provide actionable and readable results to mitigate risk
  • Conduct documentation, coding, and billing audits
• Investigations, audits, and corrective action plans:
  • Respond to external inquiries, reviews, audits, and investigations
• Leadership support and augmentation:
  • Act as interim Chief Compliance Officer 
  • Provide executive team coaching 
  • Align compliance strategy
  • Offer program and project management 

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Past Events

EBG Advisors is prepared to assist you with undertakings ranging from launching products to obtaining regulatory approval and legal representation. Please provide us with an overview of how we may be of service, or, if you have any questions, let us know and we’ll direct them to the right consultant.

Joanna Pashos
Assistant Director EBGA
EBG Advisors, Inc.
JPashos@ebgadvisors.com
T: 202.861.1822