The U.S. Department of Justice False Claims Act settlements and judgments exceeded $2 Billion in Fiscal Year 2022 and, in 2020, over 20 percent of all False Claims Recoveries came from the healthcare industry. Unlawful kickbacks were a key area of focus in the 2020 analysis, and according to the most recent report, these transactions continue to receive significant scrutiny because Many hospitals and systems often lack controlled, enterprise-level, audited, and validated mechanisms for capturing Gift data and tracking it throughout the year, instead trying to manage tracking in disparate, uncontrolled spreadsheets with no oversight capability and no controls
Healthcare entities in the United States are required to demonstrate comprehensive compliance programs towards the prevention of violation of the Anti-Kickback Statute (AKS), which seeks to curb these potential impacts of bad faith operators. While intent matters when it comes to actual prosecution, the lack of effective safeguards can prove disastrous for organizations’ public image and severely impact patient trust.
While AKS compliance may seem a significant undertaking, health systems can streamline their processes by integrating non-monetary compensation (“gift”) tracking with contract lifecycle management (CLM), ultimately giving organizations an even greater degree of visibility and control over related policies and procedures. With a single view of gift transactions across all departments, compliance managers can easily identify any potential gift irregularities or violations. This facilitates faster resolution of potential AKS issues, resulting in improved compliance and greater efficiency.
With RLDatix’s CLM-integrated gift tracking management module, healthcare teams can realize multiple benefits. Easy centralized tracking of gift entry and oversight ease the burden placed upon compliance and administrative teams right out of the box, while also eliminating the need for distributed spreadsheets or other workarounds. Reports, dashboards, and email alerts deliver real-time notification when staff approach or exceed preset limits, allowing for immediate response to recoup funds if needed.
With a comprehensive solution, healthcare systems can validate gift details on a periodic basis (e.g., annually or at each contract renewal), track gift details at the recipient or facility level, and configure processes to include a statement of the prior year’s non-monetary compensation to that same recipient to build in formal validation and protections for both the recipient and the entity.
The integration of gift tracking and contract management also offers numerous benefits to organizations, and with RLDatix’s dedicated healthcare-centric solutions, health systems can enjoy cost savings while improving administrative processes in the following ways:
1. Establishing clear rules and procedures around gift acceptance. By having well-defined gift policies and procedures in place, organizations can ensure that gifts acceptance only occurs when the exchange meets certain criteria or advances legitimate business needs.
2. Utilizing automated workflows for gift requests. Automated workflows within a contract lifecycle management system help ensure that all gift requests receive appropriate review and approval. Additionally, as federal regulations and internal policies change, updates to gift tracking workflows can be deployed immediately, ensuring both the system and the recipient are current and compliant.
3. Facilitating gift tracking across all departments. With gift tracking capabilities, gift managers can quickly access gift information at any time to ensure that transactions are accurately tracked and fully compliant. There’s no need to manually exchange information across teams, and key stakeholders will always have the necessary data right at their fingertips.
4. Monitoring gift activities for compliance purposes. By closely monitoring gift activities, organizations can promptly identify any potential irregularities or conflicts of interest and address them within the required resolution windows. Increased data accuracy also helps to ensure that gifts are tracked accurately from start to finish.
As a dedicated healthcare partner, RLDatix’s CLM-integrated gift tracking module meets all of your business requirements, while also levering our team’s expertise to deliver a solution designed to address operations and obligations unique to the industry. This ultimately helps organizations save time and money otherwise lost to cumbersome, manual recordkeeping processes.
Healthcare teams work hard to improve the patient experience and deliver safer care. When someone in your organization receives a gift, it should be an opportunity to celebrate their effort and dedication, rather than create a compliance headache. Integrating a comprehensive gift tracking solution into your contract lifecycle management system is essential for effectively administering the gifting process, while also promoting a culture of transparency and regulatory compliance. Gift Tracking ultimately helps healthcare organizations save time and money, allowing them to reinvest in better outcomes and experiences for patients and staff alike.