How to create a robust compliance program

Loretta Cecil, general counsel of Change Healthcare, shares how the company went about making compliance accessible and understandable.

Change Healthcare wanted to find a way to over-communicate the importance of compliance, without burdening employees with too much information.

In 2017, Loretta Cecil was appointed general counsel of Change Healthcare and needed to start a new compliance program from scratch.

The program needed to evangelize the important role Change Healthcare employees play in ethics and compliance and how their actions impact the company at large. There needed to be a way to over-communicate that importance, without burdening employees with too much information.

Cecil says the legal department at the Nashville, Tennessee-based health care technology company took a programmatic approach to compliance. The first aspect of the program was to make compliance accessible and understandable.

Related: From COVID-19 to data security, these are the top 10 compliance issues for 2021

“We were not going to create a code of conduct that looks like the internal revenue code,” Cecil, who is based in the company’s Atlanta office, explains.

The legal department made a code of conduct that is user friendly and “inviting to the reader.” Once the code of conduct was created, the legal department went about creating fun and understandable training for all employees. From there, the legal department put the four business units at Change Healthcare through a rigorous risk assessment and mitigation plan.

“Those three pillars have been the fundamentals of our program: code of conduct, code of conduct training and the very specific business unit risk assessments that we did,” Cecil says.

The final pillar of the program was to bring Monica McCullough on board as the chief compliance and ethics officer. Another aspect of the program Cecil quips as one of her brilliant ideas.

“Not only is she an outstanding resource for the company, but she was also the company’s chief employment lawyer for quite a while,” Cecil says.

McCullough’s experience allowed her to understand how employees view and take in compliance and ethics. McCullough was given then the opportunity to add to the compliance program.

“One of the things that I said very early on was that our team members were at the heart of our compliance program,” McCullough, who is also based at the company’s Atlanta office, says.

While the code of conduct and code of conduct training was well engrained in the company, McCullough wanted to take it to the next level by having continuous compliance and ethics discussions. In the last fiscal year, McCullough oversaw the implementation of subject-expert videos called “Integrity Talks” that employees could directly relate to.

“As a supplement to that, I decided to visit 60 of our offices across the U.S. and Canada. I made it to almost 50 before the pandemic stopped me,” McCullough explains.

The goal in those visits was to reintroduce compliance to employees in a new way and remind them about the importance of knowing and following the law. During those visits, she also reiterated the importance of sharing concerns employees have while working.

“Having employees say that 97% of them know where to find our code of conduct and know how to report a concern was a sign to me that we’re on the right track,” McCullough says.

The benefits of having such a robust compliance program in place make the legal department’s job easier when working with the business.

“We in the legal and compliance department have a great partnership and alignment with other business units,” McCullough says. “We’re able to not just say no and talk about how we can reach a solution that is compliant but also meets the needs of the business.”

Communication has also been an important part of ensuring compliance throughout the company. That communication became even more important during as, like companies around the world, Change Healthcare employees moved to work from home.

When the pandemic began, the legal and compliance department had to move more quickly. It was the first function of the company to work from home before other employees did so.

For the first 45 days of the pandemic, the legal and compliance department was virtually working 24 hours a day and seven days a week.

Cecil says the regulations and guidance surrounding COVID-19 were not difficult. There were only a few new issues the team had to grasp such as local requirements for keeping an office open and how to sanitize those offices to meet local codes.

“It hasn’t changed. Health care, as a general rule, is highly regulated and highly complex. We’re always on high alert to understand what our obligations are,” Cecil says.

What changed was the speed that transactions occurred.

“You move from a situation where the rule is to take a problem and react to that problem in a timely fashion,” Cecil explains. “The issues were the same, they were just coming fast and furious,” Cecil says.

To make sure employees continued to engage with the ethics and compliance program, McCullough stressed the importance of the company’s online compliance corner.

The executive team made a decision to over-communicate to all employees on a variety of topics.

“We’ve had more town halls, we’ve had more sessions that have been specifically targeted towards various aspects to COVID-19,” Cecil says.

There is a broad range of employees at Change Healthcare. Some with very technical degrees and some who support local efforts.

“You have to have a lot of different ways to communicate well,” Cecil says.

With compliance and ethics in mind and over-communicating, the legal department was able to ensure three major transactions this past May. Change Healthcare completed a $213 million acquisition of eRx Network LLC, a provider of claims processing and other services to pharmacies; the sale of its connected analytics unit to Madison Dearborn Partners LLC-backed Kaufman, Hall & Associates LLC for $55 million and the acquisition of PDX, a leader in providing patent centric and innovative technologies for pharmacies and health systems for $208 million.

Cecil says those acquisitions went smoothly in part because the executive team is nationally based and used to telecommunication.

“We pivoted immediately to a remote situation,” she says.

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