Train to Follow the Rules

Let's talk about training and teaching. Your compliance program is not worth the paper it's printed on (or the electronic type it generates) if your people don't know what it says, what it requires of them, and how they can monitor whether it's working. You must teach the program to your people, and to be effective, it must make sense to them and be remembered by them. Here are a couple of suggestions for effective training. The smart way to train personnel to behave compliantly is not to focus on teaching the laws, regulations, and reimbursement policies — the "Rules." Rather, you should teach staff how to comply with your company's day-to-day operational policies and procedures. You should make sure that those policies and procedures already address the rules. While the government requires that you have compliant policies and procedures, you are not required to teach (or learn) hundreds of pages of regulatory rules. To engender trust in your systems' ability to operate compliantly, one of the secrets of effective compliance training is to avoid leading by memo. Leadership by memo occurs when management sends out memos crafted as orders or ultimatums that warn of severe personal consequences for noncompliance. Employees might even be required to sign a statement confirming that they have read such a memo. Leadership by memo can be worse than ineffective; it can become downright destructive by breeding suspicion and contempt between management and staff, posing substantial barriers to communication and understanding. An effective compliance program does require some training, as well as documentation of the training conducted. But it is for more valuable to teach your staff how HIPAA or the antifraud rules, as examples, reflect everyone's ongoing desire to do the right thing than it is to conduct training because the rules say you must. This is an important point. Compliance builds on already existing policies and procedures that address concerns about invasions of privacy, compromises of care due to conflicts of interest or general unfairness. Long before HIPAA was enacted, your employees already had some idea of what their moral and ethical, if not legal, obligations were regarding patient confidentiality. A good training approach will build on that attitude to foster compliance through cooperation. Of course, I do not suggest that your managers and officers never send out another memo. On the contrary, occasional alerts and memos, properly crafted, can build teamwork by keeping staff and employees informed. But memos cannot replace good training programs professionally conducted by organizational leaders. Good leaders lead from the front, not the rear, and they lead by example. Compliance training should reflect this. When your training sessions do not include organizational leaders who are engaging in the process of learning, you fail to convey fully that your company is serious about compliance and in helping personnel to do the right thing. The leader who joins in training sessions gives the message that proper coding, anti-fraud concerns and privacy and security compliance require a unified effort, and that everyone will work together. Good compliance training embraces the good work and good attitudes already present in your organization. Leadership by memo tells employees that they are being watched and controlled and that, without coercion, they won't do what's right.