Healthcare Compliance 101: What you need to know as a Compliance Officer

Healthcare compliance extends far beyond HIPAA, and for new or developing compliance officers, understanding what must be addressed can feel overwhelming. This practical webinar is designed for healthcare professionals, administrators, and workforce members who have taken on compliance responsibilities—whether by choice, delegation, or organizational need—and need a clear foundation for building and maintaining an effective compliance program.

Participants will explore the essential areas of healthcare compliance, including HIPAA, OSHA, corporate compliance, Medicare requirements, fraud, waste and abuse, and other key regulatory responsibilities. The session will focus on the practical steps compliance officers can take to identify risks, establish appropriate policies and procedures, provide effective training, monitor compliance, and respond to issues before they become costly problems.

A central focus of the webinar will be the Office of Inspector General’s (OIG) Seven Elements of an Effective Compliance Program. Using these elements as a framework, attendees will learn how to develop a structured and sustainable compliance program that supports regulatory requirements while fitting the operational realities of their organization.

The webinar will also address compliance oversight, communication and reporting, auditing and risk assessments, corrective actions, exclusion monitoring, and documentation. Attendees will gain practical tips, tools, and resources that can help them manage compliance responsibilities more effectively, even when resources and budgets are limited.

By the end of the session, participants will have a clearer understanding of what they need to know as a healthcare compliance officer and practical guidance for turning compliance requirements into actionable processes that help protect their organization, workforce, and patients.

• Understand the OIG’s Seven Elements of an Effective Compliance Program.
• Identify key HIPAA compliance requirements and responsibilities.
• Review essential OSHA compliance requirements for healthcare organizations.
• Understand corporate compliance requirements, including fraud, waste, and abuse.
• Identify essential compliance policies, procedures, and documentation.
• Develop effective compliance training and education programs.
• Understand compliance monitoring, auditing, and risk assessment practices.
• Identify appropriate processes for reporting, investigating, and correcting compliance issues.
• Learn practical strategies for building and maintaining an effective compliance program.
• Identify useful tools and resources to support ongoing compliance efforts.

• Policies & Procedures
• Developing clear and effective compliance policies
• Reviewing and updating policies regularly
• Maintaining proper documentation
• Compliance Oversight & Leadership
• Compliance officer responsibilities
• Leadership and management involvement
• Compliance committee oversight
• Training & Education
• Compliance training requirements
• Workforce education and awareness
• Role-specific training
• Effective Communication & Reporting
• Internal reporting processes
• Compliance communication channels
• Confidentiality and non-retaliation
• Enforcing Policies, Procedures, and Standards
• Consistent policy enforcement
• Addressing policy violations
• Accountability across the organization
• Monitoring, Auditing & Assessing Risks
• Compliance monitoring activities
• Internal audits
• Risk assessments
• Identifying high-risk areas
• Corrective Actions
• Investigating compliance concerns
• Developing corrective action plans
• Preventing recurrence
• HIPAA Compliance Requirements
• Privacy and Security requirements
• Security risk analysis
• Breach reporting and Right of Access
• OSHA Compliance Requirements
• Bloodborne Pathogens requirements
• Workplace safety
• Safety Data Sheets and inspections
• Corporate Compliance Requirements
• Fraud, waste, and abuse
• Stark Law considerations
• Exclusion monitoring
• The OIG’s Seven Elements of an Effective Compliance Program
• Applying the seven elements as a compliance framework
• Building a sustainable compliance program
• Compliance Audits & Documentation
• Coding and billing audits
• Audit documentation
• Tracking and addressing findings
• Compliance Program Effectiveness
• Measuring compliance performance
• Identifying program gaps
• Strengthening compliance processes
• Tips & Tricks for an Effective Compliance Program Resources for Compliance Officers
• OIG compliance resources
• Practical compliance tools
• Low-cost resources and references
• Interactive Q&A Session with Jake Yates
  

• Compliance Officers
• Compliance Managers
• Compliance Advisors
• Practice Administrators
• Practice Managers
• Healthcare Administrators
• Compliance Committee Members
• Privacy Officers
• Security Officers
• Healthcare Risk Managers
• Internal Audit Professionals
• Healthcare Quality Managers
• Revenue Cycle Managers
• Billing & Coding Managers
• Human Resources Managers
• Healthcare Operations Managers
• Medical Practice Owners
• Healthcare Providers
• Clinical Staff Members
• Healthcare Administrative Staff

Jake Yates, MBA, CHC, AIP-HC

Jake Yates, MBA, CHC, AIP-HC is a seasoned healthcare professional with over 15 years of experience in mental health, risk adjustment, healthcare audits, and compliance. As a Compliance Consultant and Virtual Compliance Officer, he works closely with billing companies, Managed Service Organizations, private physician practices, medical groups, medical centers, and hospitals to help them navigate the complex landscape of HIPAA, OSHA, and corporate regulatory compliance. Having previously worked in Medicare audits for nearly a decade, Jake has seen firsthand the importance of a thorough compliance and auditing program and its impact on the well-being of healthcare organizations.

Prior to joining Healthcare Compliance Pros, Jake worked as a National Account Manager at Ciox Health and a Client Services Manager at Cotiviti. During this time, he assisted with hundreds of Medicare audits for several of the top 10 largest U.S. health insurance companies. In 2019, he led a team that validated over $130 million in Medicare overpayments to a Medicare Advantage health plan. Since then, he has focused his efforts on regulatory compliance to help organizations ensure they are meeting their requirements and safeguarding their businesses.

Jake’s expertise spans a wide range of compliance areas, including CMS audits, RAPS and EDS claims submissions, healthcare risk management, and regulatory healthcare compliance. His extensive experience working with top U.S. payors has equipped him with a deep understanding of healthcare compliance, Medicare Advantage, HEDIS, and RADV audits.

Jake holds a Bachelor’s Degree in Social Work from the University of Utah and a Master of Business Administration and Healthcare Management degree from Western Governors University. He has also earned several professional certifications, including Certified in Healthcare Compliance (CHC), Certified Artificial Intelligence Professional in Healthcare Compliance (AIP-HC), Certified Healthcare Compliance Professional (CHCP), Project Management, and Lean Six Sigma. He is an active member of the Health Care Compliance Association (HCCA) and regularly presents on compliance topics through webinars, speaking engagements, and professional social media content.