Home > Certification > Certified Medical Compliance Officer (CMCO)^® > Curriculum / Prerequisites

Certified Medical Compliance Officer (CMCO)^® Course Outline:

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 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

• 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

• Role of the Compliance Officer in the organizational hierarchy
• Zone Program Integrity and Medicare/Medicaid Recovery Audit 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

• Permissive vs. mandatory exclusion
• Co-payments, deductibles and write-offs
• Overpayments, federal Anti-kickback and False Claims Act 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

• 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

A complete curriculum in medical office compliance management

The material presented in the CMCO program provides candidates with advanced knowledge that very few practice management professionals have attained. This specialized training results in relevant skills to develop, implement, and manage a complete compliance program. The CMCO certification is an ideal platform to promote professional growth.

What to expect in the classroom

Robert Liles and D.K. Everitt are experts who are intimately involved in the business of health care 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.

Certification exam

A thorough examination process is crucial for maintaining the integrity of the certification. CMCO certification candidates must demonstrate competency by examination. Five hours are allotted for completion of the exam. A score of 70% or better is required to be awarded the CMCO certification. If a passing grade is not achieved on the first attempt, candidates may re-test for an additional fee.

Certified Medical Compliance Officer (CMCO)^® Prerequisites/Supplemental Material

Candidates should have at least one year of medical coding experience. Participants with less than one year of experience should complete supplemental coding and medical records training prior to enrollment in this program.

Required Class Materials

Students do not need any supplementary reference manuals for this program. For additional support, upgrade to the pre-recorded lecture for an additional $299, available with live class enrollment.

CEUs

PMI Certified Professionals (CMC, CMIS, CMOM) who complete the CMCO program are eligible to receive 32 Continuing Education Units (CEUs). All others seeking CEUs should check with their credential provider prior to enrollment.

View Printable Brochure

Back to Main Certification Page

About PMI |

Meet the Faculty |

PMI Learning Centers |

Contact PMI

More than 22,181 PMI Certifications have been earned to date.