Our Services
Gap Assessments & Licensure Readiness
Assess an organization’s regulatory program as it relates to OIG 7 elements and state/federal privacy requirements
State Medicaid programs
Organization’s legal departments deficiencies
AAAHC accreditation
Conduct state survey and accreditation mock surveys
Draft and review licensure policies and procedures
Gap analysis on state licensure requirements
Fractional General Counsel
Maintain corporate governance
Review and draft documents
Litigation management and avoidance
Manage M&A transactions
Review and draft employment and 1099 agreements
Manage organizations’ intellectual property
Provide guidance on initiatives from a legal/regulatory perspective
Advise on human resource matters
Review and guidance on marketing campaigns
Fractional Compliance Officer
Conduct gap analysis of organizations’ compliance program
Draft and guidance on annual work plans
Create and implement regulatory compliance program
Provide guidance on PSO membership
Establish risk management patient grievance process
Educate on state and federal privacy requirements
Guidance on regulatory requirements per area specialty
Organizational Education
State privacy and federal HIPPA
Corporate practice of medicine requirements
Fraud, waste, and abuse
Anti-kickback/inducement
Stark/self-referral laws
Board of Director healthcare requirements
Independent Board Member
Serve under a Corporate Integrity Agreement program build
Serve during lender restructuring through acquisition
Serve as Secretary for the Board of Directors
Assist with organizational long-term vision and strategic goals
Identifying and mitigating organizational risk
Ensuring the organization adheres to regulatory standards
Oversee corporate governing documents and policies
Preservation of organizational assets and provide financial oversight
What Does Enforcement Look Like?
These recent settlements are from the Office of Inspector General of the U.S. Department of Health and Human services’ public website. Often we find that an Organization is subject to false claims and anti-kickback litigation because they don’t have the proper tools to detect process errors quickly. That is why it is imperative for a healthcare organization to have a robust compliance program that focuses on policy driven processes which monitor and audit behavior, thereby protecting your organization’s leadership team and investors from exposure. At Honor Healthcare Advisors, we provide the expertise and resources to ensure your organization is following all relevant laws and regulations to drive strategic goals and efficiencies in a compliant manner.
Enforcement is Lucrative
The Centers for Medicare & Medicaid Services (CMS) has reported that their return on investment (ROI) for their enforcement efforts through their Fraud Prevention System (FPS) is more than $5 for every $1 spent.
The HHS’ Office of the Inspector General is expected to recover more than $3.44 billion in fiscal year 2023 as a result of investigations into fraud and misspent funds in Medicare, Medicaid and other government health programs, according to the agency’s latest report.
The semiannual report tallied 707 criminal enforcement actions and 746 civil actions including false claims, unjust-enrichment lawsuits and civil monetary penalty settlements from Oct. 1, 2022 through Sept. 30, 2023.
The OIG also banned more than 2,000 people and entities from participating in federal healthcare programs.
