Ep. 67 – Integrating Quality & Safety into Your Compliance Program (Replay of Ep. 18)

If you’re trying to strengthen your organization’s compliance program, one of the most important recommendations from the Office of Inspector General’s (OIG) General Compliance Program Guidance is to integrate quality and safety oversight into your compliance function.

At first glance, this recommendation may seem obvious. However, implementing it, can be challenging- especially in organizations where quality and compliance have long operated in separate silos. So, how do you bridge that gap, bring both teams to the table, and implement this recommendation in a meaningful and collaborative way?

That’s the focus of our podcast this week and our free resource.

Common roadblocks: Why this is often harder than it sounds

Many organizations have historically kept compliance and quality/patient safety as distinct functions. That separation may be cultural, operational, or even political.

Some compliance officers trying to implement the OIG’s recommendation may run into “turf war” dynamics—where quality leaders worry compliance is trying to take over their domain, and compliance leaders are unsure how to proceed without alienating others.

If this sounds like your organization, you’re not alone—and there are ways forward.

Five steps to start integrating quality & safety into compliance

Here are five actionable ways you can begin incorporating quality and safety oversight into your compliance program.

1. Add a quality/safety leader to the compliance committee

This is a simple first step that immediately increases communication and alignment. If that’s not feasible, at least invite quality/safety leaders to present regular reports at your compliance committee meetings.

2. Review existing quality & safety reporting

Identify what reports are already being generated and determine which could (and should) be shared with compliance. Ask: What helps us monitor risks related to medical necessity, billing, and care adequacy?

Start by identifying which reports your organization is already doing. Then determine which one of these compliances could benefit from seeing, as well as whether any additional reports should be considered.

Make this an ongoing, collaborative conversation between compliance and quality leaders.

3. Include the compliance officer in quality/safety committees

This isn’t mandated by the OIG but is a best practice. Even as a non-voting member, having the compliance officer sit in on quality or patient safety meetings ensures early visibility into issues and fosters stronger collaboration between the two departments.

4. Include quality/safety in the compliance risk assessment

This is a core OIG recommendation. Quality and safety issues, especially ones that could lead to compliance violations, should be considered in your compliance risk assessment.

Work with your quality leaders to identify shared risks and develop joint mitigation strategies. This is a collaborative process—not a compliance takeover. Make sure quality/safety leaders are included in your compliance risk assessment process.

5. Evaluate how quality/safety incidents are investigated

Does your compliance department have a role in reviewing major patient safety events like never events (e.g., wrong-site surgery)? If not, consider a process where compliance is looped in to assist with root cause analysis and ensure inappropriate billing is prevented and other compliance issues (such as any mandatory reporting) are addressed.

 What if there’s pushback?

If your leadership is hesitant or resistant to compliance with getting involved in quality/safety, start small:

• Invite collaboration: Ask to join existing quality meetings or offer to present at them occasionally.
• Look for ways to help: For example, help ensure a serious safety event isn’t billed. It’s a simple, practical way to show that compliance adds value.
• Use enforcement examples: If CMS or the OIG has taken action against providers for poor quality or medically unnecessary services, cite those examples to justify involvement.

Ultimately, your goal is to be seen as a partner.

Start with baby steps, but start.

Not every organization will be ready for significant integration right away. But doing nothing is not an option. If full alignment isn’t feasible today, build toward it:

• Begin conversations.
• Share goals and resources.
• Identify mutual interests.
• Take one actionable step at a time.

Over time, this incremental progress can lead to a robust, collaborative, and fully aligned strategy where quality, safety, and compliance work hand in hand.

Final thoughts

Integrating quality and safety into your compliance program isn’t just about checking a box—it’s about improving care, reducing regulatory risk, and building a stronger organization.

Start where you can. Build relationships. Communicate clearly. And always position compliance as a value-adding partner.

Episode 67 Free Resource

Here’s a step-by-step guide to help align your compliance program with OIG recommendations by effectively integrating quality and safety oversight.