Contract Compliance. Getting Full Value from Your Business Arrangements Healthcare Contract Compliance April 2014 Sue Ulrey
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1 2014 CliftonLarsonAllen LLP Contract Compliance Getting Full Value from Your Business Arrangements Healthcare Contract Compliance April 2014 Sue Ulrey CLAconnect.com Objectives of Today s Session and Agenda Why is Contract Compliance Important? Current Market Dynamics Techniques of Contract Compliance Reviews and Monitoring The Benefits of Establishing a Healthcare Contract Compliance Program Considerations in Reviewing Healthcare Contracts Your Questions Answered 2 1
2 Why is Contract Compliance Important? An increasing number of companies are engaging in commercial relationships with third parties in which payments and receipts are based upon self declarations or self reporting. Any company that has portions of its business, (especially Information Technology, healthcare and pharmacy benefit management), conducted by another party inherently faces control, revenue, and expense risks. Problems arise when risks associated with these relationships are not properly monitored and evaluated. For example, changing market conditions may trigger changes to key contract terms, such as: Utilization Triggers Service Level Agreements/Performance Guarantees Pricing Tiers/Margins Volume Discounts Changes in Market Conditions Changes in Regulatory Requirements 3 Current Market Dynamics Driving Factors Increasing competition Disclosure and transparency of pricing Broker involvement and increased focus on performance guarantees Drivers from regulatory changes Increased efficiency and timeliness Impacts to Organizations Health care claim audits (for self insured companies) Rights to audit Performance guarantees Pricing tiers Vendor relationships and rebates/pricing All lead to increased focus on efficiency and effectiveness of business relationships 4 2
3 Current Market Dynamics The Causes of Undetected Reporting Errors are Typically Unintentional, yet the Consequences are Significant Most Common Causes of Reporting Errors Results Failure to devote sufficient resources to managing the contractual relationship System weaknesses result in failure to support compliance with contractual obligations Misunderstood, complex, and ambiguous agreements Failure to review self report information provided by a business partner Less frequently, fraud (or upcoding/overutilization) SLAs operating levels not attained Most favored customer pricing is not passed on Unauthorized purchase expenditures are bundled and billed to contract invoices Use of inaccurate contract billing rates Inappropriate use of sublicensing of intellectual property, processes, or equipment Inappropriate discounts or deductions Sub licensed products without vendor authorization Contract non compliance leading to breach in contract and vendor liability 5 Techniques of Contract Compliance Reviews and Monitoring Evaluate performance based on deliverables within the contract Process needs to be: Conducted Regularly Deliverables are Measurable Measures are Verifiable Proactive Address Themes and Emerging Trends Address Training/Education Needs Clarity Policies and Procedures Contingency Plans Dispute Resolution and Communication Protocols Exit Strategies Access to Records/Audit Rights On Site/Off Site Expectations Renew/Refresh Contracts Post Contract Review and Knowledge Sharing 6 3
4 Benefits of Establishing a Healthcare Contract Compliance Program Financial Recoveries can be/should be passed through to the organization Pricing errors Business Process Improvement Do you incorporate contractual provisions for operational and business opportunities? Improved decision making on structure, costs, etc. Performance reporting Enhanced Contract Language Reduced ambiguity Measurement of terms Inclusion of audit rights and other performance requirements Compliance with Qualitative Contract Terms Performance guarantees Enhanced insight into operational and QA Processes Rebates and pricing structures 7 Benefits of Establishing a Healthcare Contract Compliance Program Return on Investment Recovered cash Self reporting of operational/claim units is often different than internal audit, corporate performance, or other audit units Contracts must stipulate audit requirements Pass through of Rebate volume discounts Business Process Improvement Improved quality of information Improved internal control and governance environment regarding costs Enhance Contract Language and SLAs Enhance and refine SLAs Improved measurement terms and metrics 8 4
5 Considerations in Reviewing Healthcare Contracts Ownership of data. Often times, vendors will not allow direct access to audit claim information/files but will include provisions for third parties to perform audits. Services Covered Settlement Authority Performance Guarantees/Penalties Exclusions Right to Audit Clauses Access to Data Record Retention Requirements Record Retention Regulatory HIPAA, BAA 9 Considerations in Reviewing Healthcare Contracts Governance Does your organization have effective controls for timely and accurate reporting of key regulatory requirements? If organization does have access to claim files and related data are appropriate compliance and access controls implemented: Disclosure monitoring and reporting? HIPAA? Others (hotlines, etc.) 10 5
6 Your Questions Answered 11 6
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