133: Compliance Blind Spots That Put Your Agency at Risk

SPEAKER_1 (0:02)

You're listening to Home Health Revealed, where the business of home health comes to life. Hosted by Hannah Vale, each episode brings real conversations with the leaders, innovators, and experts shaping the future of the industry. From reimbursement and technology to leadership and growth, this is Home Health Revealed.

Hannah Vale (0:17)

Welcome to Home Health Revealed. I'm your host, Hannah Vale, and I have a guest with me today that's bringing a lot of really great information and things that I've been wondering about, I bet you've been wondering about.

Jamie Davis is a Fractional Chief Compliance Officer and Attorney who specializes in home health and home care in DME. She is an attorney in New Jersey and turned owner operator of three health care businesses, as well as an active real estate investor. She has spent nearly 15 years leading compliance at Fortune One Scales, Walmart, AMC, you may recognize some of those names, before walking away to build regulated health care businesses simultaneously. So she now serves as Fractional Chief Compliance Officer to home care, home health, and DME operators across multiple states, as the founder of Build and Comply Consulting Group.

That combination, the compliance attorney lens plus owner operator is unusual. It gives her a specific, strategic, very unique point of view. And she was recently a guest speaker at the Health Entrepreneurship Tour in Miami, and HME News in Austin on fraud and DME moratorium. So we're going to talk a little bit moratorium today. We're going to get into some information about compliance with 1099 employees. We're just going to hit a bunch of these big topics, but welcome, Jamie.

Jamie Davis (1:55)

Thank you so much for the invitation. Super excited to be here. And yes, I do have a different perspective being an attorney, a compliance professional, and an operator myself. So I do have a different lens that I'm able to help my clients with, with Build and Comply Consulting. So yes, I do have a different lens, and a lot of times people are like, whoa, you've done a lot. But when you see some of the gaps, like I said, my goal is to help and to be a service to those and to the patients as well.

Hannah Vale (2:21)

Yes. And I can see how that's so valuable for people that you're working with and to have done so much in such a short amount of time. Truly congratulations and congrats on the new business.

Jamie Davis (2:32)

Thank you.

Hannah Vale (2:34)

You've talked about some real cases, operators who didn't know the law or knew it and ignored it. Anyway, sometimes it's just ignorance is bliss, right?

I want you to start by just walking us through one of these cases and what happened to them.

Jamie Davis (2:52)

Yeah. Now, I will tell you, right? A lot of times people aren't evil. They're not evil. A lot of times people get into things because they're either in a rush, they're just trying to rush and start their business, they're trying to rush and make money, they're just trying to rush and just get it started, right? And then also you do see some greed as well, right? I think we have one case where someone was buying into a business and he trusted the seller, right? So the seller had, he didn't do his due diligence, right? And when you think a lot of times about these stories, about people buying these regulated health care businesses, you have to do your due diligence. So you have to really understand their billing company.

Because when you buy a business, you're buying their assets and you're buying their liabilities. And a lot of times people don't understand that. They're like, I'm excited, I want to buy a business, I want to, and they're trusting the seller, right? Trust but verify, the seller, sellers are usually liars. That's what we say in real estate.

Sellers are liars because they're never going to tell you, oh, that this pipe burst in the apartment building that you're looking to buy. They're never going to tell you that unless they truly, truly have to, right? So when you're looking to buy, whether it's a DME business, a mental health clinic, a hospice, you want to make sure that you're doing your due diligence, you're interviewing the staff, you're looking through the employee files, you're looking through the case files, you need to understand who is the billing company. He trusted the seller, right? The seller said, oh, we have this vendor that does marketing for us, and nobody's job was to ask those hard questions, right?

A lot of times people say, oh, well, due diligence is boring, but it protects you, right? So now we're looking at different claims because you didn't do the part of understanding the ownership. You didn't understand the contracts that the owner was in, that now you inherit because you bought the business, right? So, you know, a public example is like I kind of talked about, you know, there was a Texas D&E owner that got 90 months in federal prison in March, right? And they called it kickbacks because the marketing, if you're going to list someone else as the owner, you know, on your Medicare enrollment, that's fraud. If you're the owner, you're the owner. Also, if you're doing, you know, but you're using that as the kickback, right, for marketing.