Compliance Perspectives

Debbie Sabatini Hennelly, Founder and president of Resiliti with a focus on organizational ethics, dives into the world of AI chatbots in reporting processes. She reveals that nearly 70% of employees feel comfortable using AI for helpline issues, citing benefits like anonymity and fairness. Trust is key—employees are more likely to report concerns when they feel secure and informed. Debbie discusses the importance of transparency and clear communication, along with the need for a welcoming environment for inquiries, not just formal reports.

By Adam Turteltaub If all you’re worrying about is tone at the top, you’re missing a key portion of the choir.  With most people reporting to middle managers, they play in integral role in ensuring a culture of compliance and ethics truly permeates the organization. Evie Wentink, Senior Compliance Consultant at Ethical Edge Experts observes that while many organizations invest in crafting comprehensive codes of conduct and articulate expectations for ethical leadership, they often fall short in equipping managers with the tools, training, and support necessary to fulfill those expectations. This gap can undermine the effectiveness of compliance efforts and leave companies vulnerable to ethical lapses. At the heart of the issue is a lack of intentional communication. Middle managers are frequently expected to embody and promote ethical leadership, yet they are rarely given a clear understanding of what that entails. To bridge this gap, organizations must develop structured plans that define ethical leadership in practical terms. These plans should include specific deliverables, resources, and expectations tailored to the manager’s role. By doing so, companies can ensure that managers are not only aware of their responsibilities but also empowered to carry them out effectively. Authentic, ongoing conversations led by these managers are a cornerstone of a successful compliance culture. These discussions should not be limited to formal training sessions or annual reviews. Instead, they must be woven into the fabric of everyday operations. Managers should be encouraged—and required—to initiate “ethics or integrity minutes” at the start of team meetings. These brief segments provide a consistent opportunity to address ethical topics, reinforce values, and normalize open dialogue about compliance issues. To support these conversations, organizations should provide managers with practical tools. These might include: Ethics spotlight cards that highlight key compliance themes. News articles that can be used to spark discussion around real-world ethical dilemmas. Access to updated policies and codes of conduct, with notifications when changes occur. Tracking and analyzing these conversations is equally important. Compliance teams should maintain records of who is engaging in discussions, what topics are being covered, and which issues are generating the most questions. This data can be invaluable in identifying risk areas, refining training programs, and tailoring future communications. Often, the most common questions arise immediately after a training session, indicating that such moments are prime opportunities for deeper engagement. Moreover, it’s essential to recognize the broader impact of middle management on organizational integrity. Prosecutors and regulators increasingly view middle managers as pivotal figures in corporate misconduct cases. Their actions—or inactions—can significantly influence whether a company succeeds or fails in maintaining ethical standards. Consequently, fostering a culture of accountability and proactive communication at this level is not just beneficial—it’s critical. Ultimately, the goal is to create an environment where ethical conversations are natural, frequent, and valued. When managers consistently lead by example and facilitate open dialogue, employees become more comfortable raising concerns and asking questions. This cultural shift enhances transparency, reduces risk, and strengthens the overall integrity of the organization. In summary, bridging the compliance gap at the middle management level requires a multifaceted approach: clear expectations, practical tools, authentic conversations, and ongoing tracking. By investing in these areas, organizations can transform their compliance programs from static documents into dynamic, living systems that truly support ethical behavior at every level from the top on down.

Alessia Falsarone, a non-executive director at Innovate UK with a focus on AI governance, dives into the pressing issue of AI explainability. She discusses the urgent need for transparency in AI decision-making, which can avert crises when systems go awry. Alessia advocates for practical solutions, like dashboards and decision logs, to illuminate how AI reaches conclusions. She also addresses common misconceptions, stressing that explainability should not be viewed merely as a technical challenge, but as a cross-functional necessity.

By Adam Turteltaub Despite being a Civil War era statute, the False Claims Act (FCA) always has something new going on.  To find out what’s hot these days, we spoke with Joshua Drew (LinkedIn), a former federal prosecutor and chief compliance officer and currently a Member at Miller & Chevalier. Lately, he explains, there has been a steady stream of activity. May:  The Civil Rights Fraud Initiative was announced by the administration and proposes to use the FCA against any federal funding recipient that it believes are operating DEI initiatives that violate antidiscrimination laws. July:  A new working group was created between the DOJ and HHS to focus on healthcare and life sciences.  It encouraged whistleblowers to file action in areas such as Medicare Advantage, drug device and biologics pricing and barriers to patient access, amongst others. August:  A trade task force was created to encourage whistleblowing against tariff violators. All of this occurs against a backdrop of activity by the Administration to identify and fight waste, fraud and abuse. Listen in to learn more about where the Administration is focusing and what compliance teams can learn from recent actions.

By Adam Turteltaub The possibilities of AI don’t stop with generative AI such as ChatGPT.  Agentic AI may have more potential for compliance teams, Zahra Timsah, co-founder and CEO of i-GENTIC AI tells us. Unlike generative AI, which is well known for its ability to create content, agentic AI can be used an internal enforcement agent.  Trained properly, she tells us, it can look for a potential violation and stop it.  For example, it can spot personal health information that is about to be transferred and redact the sensitive data automatically. This ability to step in and take action will, she believes, free compliance teams from many routine tasks and allow them to shift their focus to matters that are more complex and fall within the grey area.  It will also help teams speed up the rate in which new laws and regulations turn into effective internal policies. In addition, agentic AI will be able to produce measurable value by demonstrating what it can do to manage risk, improve trust and increase efficiency. Listen in to learn more about agentic AI’s ability to improve your compliance program.

Lewis Eisen, an expert on policy writing and author of RULES, reveals how to revamp policies for better engagement. He critiques the patronizing language that often alienates employees from policies. His approach advocates for simplified, value-driven statements while keeping complex details in separate guides. Eisen discusses common pitfalls in policy-making, emphasizing the importance of neutral tone and positive intent. He believes that aligning policies with organizational values can enhance adherence and connection among employees.

Andrew McBride, Founder and CEO of Integrity Bridge and an expert in ethics and compliance, dives into the transformative potential of AI for compliance programs. He highlights five practical use cases: AI as an Interpreter for translating and summarizing documents, as a Drafter to refine policies and create training scenarios, helping as a Data Analyst to connect training with outcomes, and serving as an Investigator to flag issues in data. McBride emphasizes the need for tailored AI applications and mindful management of AI-generated information.

Kristy Grant-Hart, an author and compliance expert, dives into the pitfalls of poorly designed due diligence questionnaires. She emphasizes the importance of asking targeted questions that genuinely inform decision-making, rather than overwhelming with unnecessary detail. Kristy shares insights on who should contribute to these questionnaires and discusses key risk areas like bribery and privacy. Her rule of thumb? If the answer won't alter your decision, don't ask the question. Discover how to streamline due diligence for more effective outcomes.

Vera Cherepanova, Executive Director of the nonprofit Boards of the Future, sheds light on the crucial intersection of board governance and compliance. She reveals that many boards underestimate culture as a core risk, falling short of their responsibilities in today's regulated environment. Discussion reveals how events are forcing boards to engage deeply with compliance issues, especially in light of supply chain challenges and regionalization. Vera advocates for greater inclusion of compliance experts on boards to enhance ethical decision-making and navigate non-financial risks effectively.

By Adam Turteltaub With a rising focus on value-based care, and a new program seeking to make the approach mandatory, we spoke with Ed White (LinkedIn), Partner at Nelson Mullins. Previous efforts to move toward value-based models, such as Accountable Care Organizations (ACOs), faced significant barriers due to regulatory frameworks like the Stark Law and Anti-Kickback Statute. These laws were designed to prevent financial incentives from influencing medical decisions, but they also limited the ability of hospitals and physicians to collaborate in ways necessary for effective value-based care implementation. Recognizing these constraints, CMS and the Office of Inspector General (OIG) collaborated in 2020 to issue new regulations aimed at facilitating the transition to value-based care. The next step in the transition is the new Transforming Episode Accountability Model or TEAM program, which will become mandatory in 2026. This program includes 740 hospitals across the country and targets five specific surgical procedures. Participating hospitals must coordinate care with a range of providers—including specialists, primary care physicians, labs, durable medical equipment (DME) providers, hospice agencies, and others. The TEAM program is designed to last for five years, during which time hospitals are responsible for ensuring that patients are connected to appropriate post-discharge care, including follow-up with primary care providers. The goal is to reduce complications, avoid emergency room readmissions, and promote better health outcomes—all while keeping costs below a CMS-established target price. To drive efficiency, the TEAM program introduces three financial risk “tracks”: Upside-only track – Hospitals can earn shared savings if costs come in below the target price. Moderate risk (upside/downside) track – Hospitals can either earn savings or incur penalties depending on performance. Full-risk track – This track will offer both greater risks and rewards. According to industry consultants, two-thirds of participating hospitals are expected to lose money in the early phases of the TEAM program. Hospitals must rethink their compliance, care coordination, and partnership strategies in the wake of these changes. Listen in to learn more about what this all means for your compliance program both today and in the future.