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Internal Audit’s Role in Compliance

Internal Audit’s Role in Compliance. Laurisa Riggan, CPA, CHE Children’s Mercy Hospitals and Clinics September 26, 2000. Similar Characteristics. High Level of Reporting Direct Access to Board of Directors Independent Objective Effective Communication Skills. Program Guidance Elements.

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Internal Audit’s Role in Compliance

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  1. Internal Audit’s Role in Compliance Laurisa Riggan, CPA, CHE Children’s Mercy Hospitals and Clinics September 26, 2000

  2. Similar Characteristics • High Level of Reporting • Direct Access to Board of Directors • Independent • Objective • Effective Communication Skills

  3. Program Guidance Elements • Standards and Procedures • Program Oversight • Education and Training • Communication and Reporting Mechanisms • Monitoring and Auditing • Response and Prevention • Enforcement and Discipline

  4. Standards and Procedures • Identify topics and risk areas • Draft policies and procedures • Review and comment • Conduct baseline assessments

  5. Program Oversight • Compliance Committee • Governing Board

  6. Education and Training • General Awareness Training • Policies and Procedures • High Risk Topics • Targeted Training

  7. Communication and Reporting Mechanisms • Audit work • Informal Network • Program Coverage

  8. Monitoring and Auditing • Required Audits for CIA’s • Monitor Corrective Action Plans • Monitor High Risk Activities • Internal Audits of Compliance Subjects • Program Effectiveness Assessment

  9. Annual Audit Plan • Audit Population • Risk Assessment • Staffing Requirements

  10. Audit Population • OIG Program Guidance • OIG Work Plans • OIG Special Fraud Alerts • Internally Reported Concerns • Interviews • Organizational Chart • Chart of Accounts

  11. Risk Assessment • Quantitative Criteria • Variance from Budget • Percent of Assets, Revenue or Expenses • Qualitative Criteria • Potential for Fraud or Theft • Potential for Legal or Public Exposure • Employee Turnover • Education/Training Provided in the Area

  12. Audit Staffing Requirements • Financial Auditor • Information Systems Auditor • Clinical Auditor • Coding Auditor

  13. Program Reviewers • Independent • Access to resources and information • Prepare/present written reports • Identify necessary corrective action

  14. Assessment Techniques • Site visits • Questionnaires • Personnel interviews • Record and document reviews • Trend analyses

  15. Response and Prevention • Conduct or Assist in Investigations • Sample Selection • Identify Corrective Action Steps

  16. Enforcement and Discipline • Personnel File Review • Assuring consistency in discipline • Assuring non-retaliation • Background Investigations • Maintaining sanctions database • Conducting periodic reviews

  17. Contact Information Laurisa Riggan, CPA, CHE Children’s Mercy Hospitals and Clinics Kansas City, MO 816-234-3027 lriggan@cmh.edu

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