Whether you’re working as a litigator or paralegal, clinician or contract specialist, if you're a claim examiner at a hospital or managing a clinical practice, you can solidify your credibility and enhance your organizational integrity by getting certified in health care compliance.
What is Health Care Compliance?
The Association of Corporate Counsel (ACC), an international bar association that promotes the common professional and business interests of in-house counsel, defines a health care compliance program as “a formalized system of policies, procedures, and processes developed and implemented to prevent, detect, and correct conduct that is inconsistent with applicable federal and state laws, rules, and regulations governing a health care organization.”1
Compliance programs help to establish an ethical direction for professional conduct for an organization, field, or type of job but are more than just a set of rules. According to the ACC, compliance programs should include at a minimum: Written policies, procedures, and standards of conduct, a compliance officer, compliance committee and high-level oversight, training and education, open lines of communication, internal reporting systems for monitoring and auditing, consistent enforcement of standards through well-publicized disciplinary guidelines and corrective action and finally, prompt response to compliance issues.1
Overview of Health Care Compliance Certification
If you’re interested in a full-time compliance position or just enhancing your skill set with knowledge of the rigorous standards of health care compliance, consider a health care compliance certificate program to help you prepare for the certification exam and embark on this career path.
Benefits of Health Care Compliance Certification
There are several advantages to becoming certified in Health Care Compliance. First and foremost: it can help give you confidence that you're performing your job to the best of your abilities and helping to protect your organization and its clients.
Certificate programs are great for compliance professionals who already work in the industry and want to expand their skills but can also help career changers looking to increase their credibility in regulated health care spaces, attorneys who need to build knowledge to help certain clients, or health care professionals who routinely find themselves engaging with compliance issues or addressing legal obligations of an organization. Many certificate programs take less than a year to complete and can be taken online or in a flexible hybrid format, making them ideal for working professionals. In fact, when you're working and attending a certificate program at the same time, you’ll likely find yourself applying the compliance knowledge you're building in class to your job, helping lessons hit home.
Steps to Getting Certified in Health Care Compliance
Researching Graduate Certificate Programs
Whatever program you choose, make sure it’s accredited by the Compliance Certification Board (CCB) to ensure that you’re getting a high-quality education that will help you qualify for a certification exam.
Meeting Eligibility Requirements
If you successfully complete a graduate certificate program offered by a CCB-accredited university, you will be qualified to take several certification exams, including Certified in Healthcare Compliance (CHC)®, Certified in Healthcare Privacy Compliance (CHPC)® and Certified in Healthcare Research Compliance (CHRC)®.
You must sit for your certification exam within one year of completing your program.
However, without earning a graduate certificate from an accredited university, in order to become certified you must meet the following requirements: You must submit documentation of 20 CCB-approved continuing education units of which at least 10 must have come from live training events, and have been earned within the 12-month period preceding the exam date. Your CEUs also must meet at least one of the 10 subject areas identified by CCB as relevant to compliance certification.3
Those subject areas include:2
- Application of management practices for the compliance professional
- Application of personal and business ethics in compliance
- Written compliance policies and procedures
- Designation of compliance officers and committees
- Compliance training and education
- Communication and reporting mechanisms in compliance
- Enforcement of compliance standards and discipline
- Auditing and monitoring for compliance
- Response to compliance violations and corrective actions
- HIPAA privacy
Additionally in order to qualify for the exam, you must gain the necessary work experience and be considered a Compliance Professional. You may qualify for this either through a minimum of one year of full-time work in a compliance position or at least 1,500 hours of work experience in a compliance-related position within the last two years. Duties should include those reflected in the exam in the candidate handbook.3
Preparing for CHC Exam
While certificate programs can prepare you with fundamental knowledge for a compliance professional, they are not prep courses. Review study materials and take practice exams to ensure that you are well-prepared for the test. Many resources can be found on the Health Care Compliance Association (HCCA) website including books, training materials and webinars, though you may have to be an HCCA Member in order to access them.
Taking the CHC Exam
Health Care compliance certification exams are developed and maintained by the CCB, which is an independent body made up of compliance and ethics professionals who determine what obligations you need to fulfill prior to and after certification. In order to take the exam you have to submit an exam application along with a fee. The application includes information attesting to your completed continuing education units and professional or student hour requirements. Once it’s approved, you will be able to schedule the date of your exam. Good luck!
Join the HCCA to stay current with updates in the field and to take advantage of educational, networking and professional development opportunities. Like many professional certificates, to maintain your status as a Compliance Professional, you will need to earn and submit 40 CCB CEUs along with a renewal fee every two years.4
The Importance of Health Care Compliance
Effective compliance programs are created to identify, manage and reduce risk and protect both patients and the providers and organizations who care for them. Compliance in health care is also fundamental in areas such as research, quality, and data management.
The healthcare system is a complex and highly regulated area driven by Medicare, Medicaid, the Affordable Care Act, the Anti-Kickback Statute, Stark Law, the False Claims Act, the Food, Drug and Cosmetic Act, the Controlled Substances Act, and more. One rule you might be familiar with is the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules which implement national standards for covered entities (providers, insurers and clearing houses) on the use, storage and protection of patients’ personal health information. All covered entities should be in compliance with the Rules, and should have clear standards of action in the event a breach occurs.
Strengthen your resume as a certified compliance professional
Ready to become a certified Compliance Professional? Check out the University of Pittsburgh online graduate certificate programs in compliance. Pitt offers a CCB accredited university program for health care compliance, as well as certificate programs in human resources law and international business.
Graduates of Pitt Law’s Health Care Compliance Certificate who have fulfilled the applicable requirements are eligible within one year of earning the certificate to sit for industry exams, including:
- Certified in Healthcare Compliance (CHC)®
- Certified in Healthcare Research Compliance (CHRC)®
- Certified in Healthcare Privacy Compliance (CHPC)®
- Retrieved on March 1, 2023, from acc.com/resource-library/health care-compliance-programs-united-states-101
- Retrieved on march 1, 2023, from hcca-info.org/certification/continuing-education-units-ceus
- Retrieved on March 1, 2023, from hcca-info.org/certification/become-certified
- Retrieved on March 1, 2023, from hcca-info.org/certification/renew-certification