Earn CEU credit Cathy Garrey, Connect with your - Health Care ...

It was established in 1969 in response to the
Community Mental Health Act, and since
then it has built a history of success in managing
a comprehensive community human
service system of care that includes collaborative
and financial relationships with federal
and state mental health and welfare agencies,
as well as with public and private agencies.
My responsibilities include ensuring that
our funded agencies are compliant with
Medicaid-Medicare rules and regulations.
The MHB audits agencies for compliance
triggered by utilization trends that are over
or under the expected norm by about 15%
based on monthly reports. If a problem with
compliance emerges during a routine audit,
audits may take place monthly until the
problem is resolved.
During an audit, charts and case notes are
examined to review all required information.
I look for trends in billing records that reflect
the need to develop a plan to ensure quality
of care. An audit also examines treatment
plans, which are reviewed every six months.
All provided services should be part of the
plan. We also make sure that new clients have
a mental health assessment.
Once an audit is completed, we arrange for
an exit conference, and then we structure a
formal report.
GI: What attracted you to the compliance
profession and why do you remain in the
compliance profession
CG: I became a compliance professional
quite by accident. While working as the
Assistant Manager of a community mental
health program, the organization received
notice of an upcoming state Medicaid audit.
At the time, I was the only one available to
review charts and make sure we were ready. I
found that I enjoyed the challenge and had a
knack for the work. Eventually, I became the
Director of Quality Assurance and Training at
that organization. I remain in the compliance
profession because it is challenging. Things
are forever changing. No two days are the
same, and the work is very rewarding. There
are always new things to learn and new
networking opportunities.
GI: I see that you have been Certified
in Healthcare Compliance (CHC) by the
Health Care Compliance Association. When
did you become certified, and why you chose
to do so
CG: I became Certified in Healthcare
Compliance in 2006. At the time, I was
developing a corporate compliance program
for an organization and came across the
Health Care Compliance Association website.
I signed up for This Week in Corporate
Compliance, and within a few weeks, I
joined the association. When I presented
the idea of getting certified to my supervisor,
he was supportive. We agreed that the
certification would enhance my credentials
as a Compliance Officer. I signed up to
attend a Compliance Academy and had the
opportunity to meet people from all over the
country. The training was excellent. I sat for
the certification exam on the Friday morning
after completing the four-day training. The
many resource materials presented at the
training proved quite useful.
GI: How has CHC helped you as a compliance
professional, generally and specifically,
in your role at the McHenry County
Mental Health Board Has CHC certification
brought you professional recognition within
your organization How has this helped you
to be an effective compliance professional
CG: Certification necessitates staying
abreast of what is happening in the health
care field in matters of compliance, because
continuing education is one of the requirements.
CHC also allows access to HCCA
website information developed by experts in
the field, offering opportunities to conduct
Gabriel L. Imperato
Health Care Compliance Association • 888-580-8373 • www.hcca-info.org
research on compliance issues. Additionally,
it provides networking opportunities that put
me in touch with professionals around the
country, and that offers a much larger base of
knowledge and information. When we have
a difficult question regarding compliance, I
can connect with experts who are willing to
share their knowledge and tools. Certification
means that I can count on other professionals
to help resolve specific problems.
Here in McHenry County, I meet with
compliance professionals on a monthly basis.
Reading Compliance Today and attending
Compliance Institute training sessions
provides up-to-date information that I can
share with my colleagues. They appreciate my
access to professionals around the country,
which expands their knowledge base as they
develop their compliance programs.
Recently, three compliance professionals
and I developed a comprehensive training for
executive directors, finance managers, and
human resource managers. Information in the
portion that I covered came from materials
that I received at the recent Compliance Institute
and from articles in Compliance Today.
A month later, my executive director showed
me an article she had read on corporate
compliance. Our group had covered it all.
GI: What value does CHC certification
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October 2008