Compliance Perspectives

By Adam Turteltaub

When Garth Jordan learned about the opportunity to lead the SCCE & HCCA, he was excited about the idea of helping to build trustworthy organizations.  And, the more he spoke with the board and talked to his peers, the more convinced he was that this was the role for him.

Unlike our previous CEOs he came to the association not from compliance, but from the field of association management.  He has served in leadership roles for the American Animal Hospital Association, Healthcare Financial Management Association and Medical Group Management Association.  As he looked at SCCE & HCCA he saw a great opportunity for growth and greater impact.

He tell us in this podcast that he will be focusing on the complete range of things that we do, from publishing to creating events to providing certifications to facilitating networking.

Listen in to learn more about him and how he plans on using design thinking to help create a robust future for the SCCE & HCCA.

By Adam Turteltaub

What do cupcakes, cookies and compliance training have in common?  More than you might think, reports Barbara-Ann Boehler, Senior Director of the Program on Corporate Compliance and Ethics at Fordham University  School of Law.  She successfully used the act of frosting the treats a part of a compliance learning exercise.

It’s a great, if unusual, example of experiential learning, which seeks to teach people by getting the learner to do the thing that they are learning rather than just sitting and listening.

A more common example of experiential learning is to create a case study in which the participants play different roles and see how the situation plays out.

This interactive approach to learning can be much stickier, figuratively and literally (if you use frosting) with lessons sinking in deeper and discussions lasting long after the session is over.

Listen in to learn more but, maybe, eat something healthy first.

By Adam Turteltaub

Being a leader is hard.  Being a compliance leader is harder.  Being a compliance leader in fast-changing times takes it up yet another level, but it’s not impossible.

Kim Jablonski, Chief Compliance & Ethics Officer at Bristol Myers Squibb shares that with these challenges it’s important for leaders not to think in static terms but to recognize that the landscape is constantly changing.  The transformations include not just new laws and regulations but also new expectations for compliance programs, such as when it comes to taking a more data-driven approach.

At the same time, though, some things don’t change.  For example, you need to communicate with the workforce the importance of acting with integrity, even when there is business pressure to deliver.  That same message should come from leadership as well so that employees see integrity as a part of the culture and behavioral expectations.

For their part, compliance leaders, and their teams, need to have a deep understanding of the business and how it works.  They must also be flexible with more than one solution to a problem.

She also advocates for a collaborative approach.  Working together with a wide range of internal teams leads to better outcomes, both from a compliance and business perspective.

Most notably of all, she shares an insight that is relatable and very eye opening:  We all have obstructed view seats.  As she explains, we all only see a part of the picture and need to be mindful that we benefit from the views of others and that bad decisions are often the product of not being able to see the whole panorama before us.

Listen in for more eye-opening insights.

By Adam Turteltaub

There’s a car pulling up to your facility loaded up with a patient and a trunk full of risk.

Non-emergency medical transportation (NEMT) plays an important role in getting elderly and poor patients to their medical appointments and pharmacies.  But, explains Colin May, Professor of Forensic Studies and Criminal Justice at Stevenson University, the amount of fraud is exploding.  There are cases of billing when service was not provided, trips to facilities that are closed, overbilling, upcoding, overcharging for tolls, and more.

Enforcement authorities have been doing more to crackdown on this fraud, but providers need to be on the lookout for a host of schemes, including kickbacks.

Frontline employees, he argues, should be trained to look out for questionable, unusual situations that may be the sign that something improper is happening.  Technology can also be deployed in areas such as pre-trip screening.

Listen in to learn more about this growing problem and what your organization could and should be doing about it.

By Adam Turteltaub

Things are a bit out of balance when it comes to Business Associates (BAs) in healthcare.  Organizations invest a great deal of time and resources in vetting these third parties to make sure that they will safely handle data from the covered entity.  But, when the relationship ends, those same organizations may overlook the risks to their data post-separation.

The problem is complex because different BAs will fall under different regulations and use data differently.  Some may process but not retain data.  Others may have terabytes of your data to return or destroy immediately.  For others, there may be a law or regulation requiring them to hold onto that data for several years.

The compliance team, explains Marti Arvin (LinkedIn), Vice President, Chief Compliance and privacy Officer at Erlanger Health System, needs to ensure it is part of the process whenever a BA relationship is coming to an end.    At that point, it’s time to reach out to the BA to ensure there is a plan in place for how data will be handled, and to begin documenting the process.  This helps in case there is an incident later.

Listen in to learn more about what you can and should be doing to ensure that the close-out process is as healthy as it should be.

By Adam Turteltaub

Ahmed Salim wants you to change how you approach change.  An active consultant to the compliance community and Healthcare Compliance & Regulations Adjunct Professor at DePaul University, he is passionate about following a disciplined approach to change management.  Not surprisingly then, he’s the author of a new book from the SCCE & HCCA:  Mastering Compliance Through Change Management.

In this podcast he explains that the concepts behind change management are simple.  It contains 8 critical steps:

So what are the keys to success along the way?  First, have a vision and strategy you want.  Second, get leadership and senior management buy in.  Third, effective communication because if people don’t know about the change, what’s the point.  Fourth, continuous monitoring to ensure that you are making the progress you want, and if you aren’t why.

To all that I would add two more keys:  listen in to learn more about how to make change management a part of your compliance program.  Then, get your copy of Mastering Compliance Through Change Management.

By Adam Turteltaub

As with so many other areas, communication, or a lack of it, can be a big problem when it comes to eDiscovery.  Legal doesn’t always adequately communicate what it needs.  The business unit doesn’t share information about all the technologies its teams are using to communicate, and compliance may be giving the wrong message as a result.

The cure, as Joey Seeber, CEO of Level Legal lays out in this podcast, is making sure that everyone is aware of the issues, the technology and what proper practices look like. That means understanding what platforms are being used for collaboration, and deletion schedules need to be understood and consistent, wherever possible.

To understand more about navigating around these problems, and how to find a vendor that will help your efforts, listen in to discover more about eDiscovery.

By Adam Turteltaub

On July 10, 2025 the European Commission posted The General-Purpose AI Code of Practice.  Unlike the EU AI Act, this new Code of Practice is not compulsory, at least not yet.

Still, it seems prudent to start understanding what it says and what expectations are being laid, as well as what the definition of general-purpose AI (GPAI) is.  To that end, we spoke with  London-based Jonathan Armstrong, Partner at Punter Southall.

Jonathan explains that GPAI systems perform generally applicable functions such as image and speech recognition, audio and video generation, pattern recognition, question answering and translation.  It is similar to generative AI but is not the same.

He then shares that the Code of Practice contains three sections:  transparency, copyright, and safety and security.

Transparency is a hugely important issues for AI.  Organizations need to keep their technical documents related to their AI use current and address topics such as how the AI was designed, the technical means by which it performs functions and energy consumption.

Copyright is a significant source of litigation at present.  Authors and other content creators see the use of their work by AI engines as a violation.  AI developers see the use of those works as furthering a greater good.  The Code of Practice sets out measures designed to help navigate these difficult waters.

Safety & Security guidance is targeted predominantly at the most impactful GPAI operations.  The Code calls for extra efforts to examine cybersecurity and the impact of the technology.  This chapter of the document also includes 10 commitments for organizations to make.

Listen in to the podcast and then spend some time reviewing The General-Purpose AI Code of Practice.   It’s worth seeing where regulations, and perhaps your AI efforts, are going.

By Adam Turteltaub

Managing whistleblowers is always a hot topic, and you’ll find it on the agenda at the 2025 SCCE Annual Compliance & Ethics Institute.   To provide a preview of what you will see if you join us in Nashville, we sat down with the speakers for the session “Someone Blew The Whistle: Perspectives from Former Whistleblowers, In-House Compliance, and External Investigators”.

The speakers in Nashville, and guests of this podcast, are:

In our conversation they share the work Xylem has done to encourage internal whistleblowing.  The compliance team’s efforts include not just having a policy but ensuring that it is clearly accessible as well as explaining confidentiality, anonymity, and even investigative standards and processes.

The company offers their employees multiple avenues to speak up, including HR, internal audit, the hotline, compliance, and even the audit committee of the board.

These efforts are important, the speakers explain, because when whistleblowers go outside and bring a matter to the qui tame bar, typically it’s because they felt that their concerns weren’t taken seriously.

To help keep employees from going outside, they offer several recommendations.  First, show employees that their concerns are appreciated and will be looked into.  Second, explain the investigative process.  Third, to the extent possible, provide regular updates.  Fourth, clearly communicate what the next steps are.

Listen in to learn more, and then be sure to join their session at the  Compliance & Ethics Institute in Nashville.

By Adam Turteltaub

There’s a lot new going on in healthcare enforcement, and, at the same, there’s a lot that hasn’t changed, reports Greg Demske (LinkedIn), partner at Goodwin Proctor and, formerly, Chief Counsel to the Inspector General at HHS.

While the US Department of Justice has changed its priorities in areas such as anticorruption, if you look at what they and the Office of Inspector General (OIG) at Health and Human Services have been doing, he observes, the long-time bipartisan effort to stop fraud in healthcare is continuing.

Yet, there are some significant changes.  At CMS a major shift has occurred when it comes to Medicare Advantage.  In the past there were audits of fifty plans a year, but now the goal is to audit all six hundred or so annually.  Backing that up is an expansion in the number of coders from 40 to 2000.  This has huge implications both for the plans and providers.

Meantime the Department of Justice and HHS have created a False Claims Act Working group to further their efforts.

Then, of course, there are qui tam claims, which hit a record high in 2024, and we have dispositions in the courts as well.

So what should compliance teams do?  He recommends keeping a close eye on what the government is saying to ensure your program is staying ahead of the curve.

And, of course, you should listen to this podcast to gain more of his insights from private practice and over 16 years at HHS.