Online Training Course

Prod ID: 122
Certified Medical Compliance Officer (CMCO)®

Earn the premier compliance certification for medical office professionals. CMCOs are highly trained compliance professionals who understand the role, responsibilities, and tactical skills needed to control risk and lead practice compliance efforts.

UPDATED FOR 2020

CEUs

25

Length

1500 min

Price

$2095

The Certified Medical Compliance Officer addresses the unique compliance concerns in non-hospital health care provider offices. This updated course is for current and aspiring Compliance Officers working in small- to mid-sized outpatient medical office settings, home health, hospice, DME, PT clinics, and 3rd party billing companies.

The Certified Medical Compliance Officer addresses the unique compliance concerns in non-hospital health care provider offices. This updated course is for current and aspiring Compliance Officers working in Physician Practices, Home Health Agencies, Hospice Companies, Durable Medical Equipment Companies, Physical Therapy Clinics, Third-Party Billing Companies and other small to mid-sized health care provider entities.

CMCOs are proficient in the development, implementation, and management of an ongoing compliance program. They have advanced compliance knowledge that few medical office professionals have obtained.

This curriculum has been widely lauded by participants and it is believed to be the most comprehensive, targeted compliance certification program currently available to small and mid-sized health care provider organizations and was recently approved for physician Continuing Medical Education credit.

Robert W. Liles

JD, MBA, MS


Washington D.C. attorney, Robert Liles, leads the legal team that developed and maintains the curriculum and examination protocols for PMI's Certified Medical Compliance Officer (CMCO) credential. His background and education provide a real-life perspective and approach towards compliance. As Managing Member of Liles Parker, PLLC, Robert heads one of the nation's leading law firms focused on healthcare fraud defense and regulatory matters representing healthcare providers in civil, criminal, and administrative proceedings. He also serves as outside compliance counsel to a number of national health care organizations and a third-party billing association.

PMI has worked closely for many years with Robert as an expert faculty and lead legal counsel on matters of compliance. His qualifications are second to none. He was the first National Health Care Fraud Coordinator and subsequently worked as Deputy Director of the U.S. Department of Justice, Executive Office for United States Attorneys. In addition to his law degree, Robert holds a Master's in Business Administration. He has been awarded an "AV" rating by Martindale-Hubbell, the highest rating that may be awarded to an attorney. He has also been rated "10.0" (out of a possible 10.0) by AVVO, a nationwide attorney rating service.

The CMCO curriculum provides candidates with advanced knowledge that very few practice management professionals have attained. This specialized training guides the development, implementation, and management of a complete compliance program and serves as an ideal platform for professional growth.

Compliance expertise is among the most valuable and versatile attributes in healthcare. Your compliance program extends beyond the maintenance of policies and PHI. It represents an ongoing effort to operate a medical practice or clinic in an ethical manner within the four corners of the law.

A cookie-cutter compliance plan won't do.

A template downloaded from the Internet won't meet federal compliance expectations.

Lack of knowledge won't hold up in a federal audit.

Medicare and Medicaid have expanded audit contractor programs tasked with identifying fraud, waste, and abuse. UPICs, ZPICs, RACs, and other contractors are authorized by CMS to come into your office and request the documentation that supports the claims for reimbursement that you have submitted to the Medicare program. These onsite audits can occur with little or no notice and penalties can add up quickly.

The CMCO Certification training covers every aspect of compliance in an outpatient medical office or facility. The training manual is packed with reference materials and resources, and tactical skills needed to develop and maintain a custom program that complies with federal guidelines and fits your unique requirements. Equally important, if you are audited, the training provides proof that your organization has taken steps to comply with applicable billing and coding rules.

An effective compliance program can benefit a physician's practice by speeding up and optimizing the proper payment of claims, minimizing billing mistakes and may reduce the likelihood of an audit. This includes meeting regulatory obligations and minimizing threats to the organization.

The CMCO is created for non-hospital healthcare professionals. Experience working in a medical office is recommended for this course.

The material covered in this program represents a tremendous amount of information and real-world experience, systematically presented during each session. Don't be intimidated. This program was carefully developed by well-tenured healthcare compliance experts, nationally known Healthcare Compliance Attorney Robert W. Liles, and longtime Compliance Officer D.K. Everitt. They know the subject matter inside and out.

The curriculum is taught with the medical office professional in mind with real-world compliance examples relevant to your office. You'll learn to handle tough situations with ease. The instructors, Robert Liles and Paul Weidenfeld, are healthcare attorneys with significant expertise who are intimately involved in the business of healthcare compliance and management.

Compliance structure and enforcements

  • The seven elements of the compliance plan
  • Health care fraud enforcement and sentencing guidelines
  • False Claims Act, Stark, and the Federal Anti-Kickback Statute
  • Calculation of civil monetary penalties
  • Whistleblower complaints
  • Legal provisions of compliance with a review of actual case examples
  • Impact of Health Care Reform on enforcement statutes and practices
  • Performing a gap analysis and other means of identifying practice-specific risks Billing/coding/coverage and reimbursement

 

Billing/coding/coverage and reimbursement

  • Coding, billing and documentation considerations
  • LCDs/NCDs and their applicability to coverage decisions
  • Drafting and incorporating the office compliance plan
  • Mission statement, codes of conduct, and organizational goals
  • The growing threat of electronic security and identity theft Compliance, risks, actions and issues

 

Compliance, risks, actions, and issues

  • Role of the Compliance Officer in the organizational hierarchy
  • UPICs, ZPICs, RACs, SMERCs, and other Medicare/Medicaid contractors
  • Correct handling of an audit request
  • Organizational risks, peer review actions, state licensure issues
  • Employee screening, staff, and patient relations
  • Employee notification of obligations and consequences for failure to comply
  • Drafting enforcement and discipline provisions
  • Ongoing monitoring and auditing
  • Overview of law enforcement organizations Medicare exclusion and its impact on an organization

 

Medicare exclusion and its impact on an organization

  • Permissive vs. mandatory exclusion
  • Co-payments, waivers, deductibles, and write-offs
  • Overpayments, federal Anti-Kickback, False Claims Act, and Stark implications
  • Gratuities, kickbacks, and payments to physicians
  • Types of referrals that may violate one or more federal statutes
  • Business relationships between your practice/clinic and other providers
  • Setting up mechanisms for employees to file anonymous complaints
  • Avoiding allegations of reprisal and responding to identified deficiencies
  • Voluntary repayments - advantages and disadvantages of making repayment Law enforcement investigation tools

 

Law enforcement invesigation tools

  • Subpoenas and search warrants and how to respond to compulsory process
  • Employment of consultants, lawyers, and other third-party advisors
  • Federal and non-federal administrative appeals of denied claims
  • HIPAA/HITECH and the relationship between privacy and compliance
  • Business associate pitfalls to consider
  • Future risks to your organization

 

Five hours are allotted for the certification exam and a score of 70% or better is required to earn the CMCO certification. If a passing grade is not achieved on the first attempt, candidates may re-test for an additional fee.

Online Training

Start the Certified Medical Compliance Officer online training program anytime with access to twelve pre-recorded 90-minute instructor-led sessions.

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The CMCO is created for non-hospital compliance professionals to authenticate compliance expertise and provide a pathway for further growth in this important area of expertise. It is the first curriculum created specifically for compliance professionals in small physician practices, home health agencies, hospices, and DME companies. It is also well suited for consultants and those working in community mental health clinics, third-party billing companies, and other non-hospital healthcare environments.

Development Team

Robert W. Liles, JD, MBA, MS, was the first National Health Care Fraud Coordinator and subsequently worked as Deputy Director of the U.S. Department of Justice, Executive Office for United States Attorneys. As Managing Member in the Washington D.C. based office of Liles Parker, PLLC, Robert heads one of the nation’s leading law firms focused on health care fraud defense and regulatory matters representing providers in civil, criminal, and administrative proceedings. Robert’s background, education, and experience bring this class to life with a real-world perspective.

D.K. Everitt, CMCO, CCO, is a nationally-known Health Care Compliance Officer whose work includes assessing hundreds of medical facilities, implementing Corporate Integrity Agreements and OSHA compliance training. He has authored several compliance books and serves as President of The Compliance Division, L.L.C. He has spent the last 25 years developing and managing corporate compliance programs and shares his talents as an Adjunct Lecturer and Preceptor for Trinity University’s Health Care Administration Graduate Studies department.

Robert and D.K. are seasoned experts in the business of healthcare compliance and management. The material covered in this program represents a tremendous amount of information and real-world experience, systematically presented during each class meeting. 

The best defense is a proactive approach. Your compliance plan serves as evidence of a good faith effort to comply with applicable laws and regulations. Should the government ultimately choose to pursue criminal charges against you or your organization, your demonstrated use of an effective Compliance Plan will be favorably credited under the points system set out under the Federal Sentencing guidelines. 

    - Robert W. Liles, JD, MBA, MS

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