Platform Features

The complete healthcare compliance platform.55+ features. Zero compromises.

RuleResource covers the full compliance practice lifecycle: regulatory intelligence, program management, operations, enforcement, billing audit, risk management, document generation, and CMS data analysis.

Pillar 1 - Intelligence

Regulatory Research & Monitoring

Ask a compliance question in plain English. Get a cited memo in minutes. Stay current across 51 jurisdictions.

  • Analysis drawn exclusively from official federal and state sources, with every statement cited to a specific CFR section, federal statute, or OIG advisory opinion
  • 12-section structured output: Executive Summary, Applicable Law, Federal Standards, State Requirements, OIG Advisory Opinions, Case Law, Enforcement History, Risk Assessment, Implementation Guidance, Compliance Checklist, Documentation Requirements, and Strategic Recommendations
  • Federal jurisdiction plus all 50 states and the District of Columbia
  • Risk Watch flag on results with elevated enforcement attention or active regulatory scrutiny
  • Intelligence Feed: daily briefings on OIG updates, CMS final rules, enforcement actions, and executive orders curated for healthcare compliance
  • Doc Alerts: watch specific regulatory sources and receive alerts when content changes
  • OIG Work Plan Tracker: FY2024-2025 OIG audit priorities with risk ratings and action checklists
  • Regulatory Timeline: chronological view of regulatory changes and your research activity
  • Daily Compliance Minute: opt-in digest email summarizing the most significant developments of the prior 24 hours
  • Export to PDF and Word, formatted for immediate distribution to leadership

Used by CCOs to answer board questions before they become urgent. Used by in-house counsel to scope regulatory exposure before M&A transactions. Used by compliance teams to build policy documentation from authoritative sources and stay current on enforcement trends.

Pillar 2 - Program

Compliance Program Management

Build, measure, and continuously improve your compliance program against OIG guidance and industry benchmarks.

  • CPG Navigator: OIG General and Long-Term Care Compliance Program Guidance self-assessment, all 7 elements, 1-5 scoring, prioritized 30/60/90-day improvement roadmap
  • Annual Work Plan: OIG 7-Element aligned compliance workplan with task assignments, deadlines, status tracking, and progress reporting
  • Risk Assessment Wizard: 50-question guided assessment across governance, policies, training, auditing, monitoring, enforcement, and privacy producing a risk register and board-ready report
  • Audit Readiness Dashboard: real-time green/yellow/red status for each OIG element with gap identification and remediation tracking
  • Benchmarking: compare your program against HCCA survey data and OIG enforcement benchmarks across 10 dimensions with maturity scoring and budget justification
  • KPI Overview: executive dashboard aggregating screening, training, breaches, arrangements, change impacts, and assessment scores into a single compliance program snapshot
  • Scorecard: compliance program performance scoring across multiple domains
  • Program Assessment: 5-domain scored evaluation covering Governance, Policies, Training, Auditing, and Response with formatted gap analysis report
  • Risk Heat Map: 15 compliance domains with visual likelihood-by-impact scoring for committee and board presentations
  • Compliance Calendar: 20+ regulatory deadlines with recurring tracking, responsible parties, and custom deadline support
  • Template Library: 45 ready-to-use compliance policy templates organized by category with proper legal formatting

Pillar 3 - Operations

Compliance Operations & Workforce

Run every aspect of day-to-day compliance operations from a single platform: meetings, hotline, incidents, training, attestations, and disclosures.

  • Committee Meetings: agenda builder with 12 standard compliance committee sections, 5 meeting templates, action item tracking, and minutes generation
  • Hotline & Intake: case tracking system for hotline calls, questions, and compliance requests with triage, assignment, priority levels, follow-up management, closure plans, and analytics dashboard
  • Incident Reporting: HIPAA breach tracking with 60-day notification timeline management, breach risk assessment, notification letter generation, and HHS reporting threshold tracking
  • Corrective Action Plans: cross-program CAP tracker linking to audits, incidents, and investigations with root cause analysis, milestone tracking, and effectiveness verification
  • Policy Attestation: distribute compliance policies to workforce members, track read-and-sign acknowledgments, manage attestation campaigns with completion dashboards
  • COI Disclosures: annual conflict of interest disclosure management with disclosure forms, review workflows, conflict identification, and management plan tracking
  • Training Tracker: workforce compliance training management with 12 pre-built programs, employee assignment, completion tracking, and compliance reporting
  • Training Library: 12 full educational modules covering HIPAA, Anti-Kickback, Stark Law, billing compliance, workplace safety, and more, each with structured content, knowledge quizzes, and completion certificates

Pillar 4 - Enforcement

Enforcement Intelligence & Investigations

Real enforcement cases. Privileged investigation management. Government interaction protocols.

  • FCA Case Library: 30 real False Claims Act and healthcare enforcement cases with settlement amounts, violation types, provider settings, CIA requirements, and practitioner takeaways
  • Investigations: full privileged investigation management with privilege framework, team rosters, task tracking, research integration, crisis communications playbook, and government interaction protocols
  • Government interaction protocols for subpoena response, unannounced agent visits, voluntary self-disclosure, and cooperation strategy
  • Privilege documentation: attorney-client, work product, and self-evaluative privilege establishment and maintenance guidance

Pillar 5 - Billing & Audit

Billing Analysis & Audit Management

Analyze billing patterns with CMS data, manage claims audits from protocol to corrective action, and track payer appeals through all five Medicare levels.

  • Billing Pattern Analyzer: CMS Medicare Part B data by NPI with risk scoring 1-10, peer benchmarks by specialty and geography, and OIG/RAC/ZPIC audit target indicators
  • Provider Network Screener: bulk input up to 50 NPIs with rule-based risk scoring across multiple dimensions and one-click full analysis launch
  • Claims Audit: 8 pre-built audit protocols for billing, coding, modifier usage, E/M leveling, telehealth, lab utilization, DME, and home health with sample selection, findings tracking, error rate calculation, and corrective action plans
  • Payer Audit Tracker: RAC, MAC, ZPIC, and UPIC audit tracking through all 5 Medicare appeal levels (Redetermination, QIC, ALJ/OMHA, Appeals Council, Federal Court) with deadlines, financial impact, and document management

Pillar 6 - Risk

Risk Management & Arrangements

Manage sanctions screening, physician compensation arrangements, vendor risk, regulatory change impact, and self-disclosure decisions.

  • Sanctions Monitoring: 42 databases total. 5 federal (OIG LEIE, SAM.gov, OFAC/CSL, Medicare Opt-Out, NPPES) plus 37 state Medicaid exclusion lists (10 direct state sources + 27 via OpenSanctions) covering AL, AK, AZ, AR, CA, CO, DE, FL, GA, HI, IL, IN, IA, KS, KY, LA, ME, MA, MD, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NC, ND, NY, OH, OR, PA, SC, TN, WA, WV, WY. Individual and batch screening up to 250 names, roster management for recurring checks, fuzzy name matching, audit-ready CSV export, and screening history with compliance report generation
  • Stark/AKS Arrangement Tracker: physician and referral source compensation arrangement management with Stark Law exception analysis, AKS safe harbor evaluation, fair market value tracking, and commercial reasonableness documentation
  • Vendor Due Diligence: third-party risk management with BAA tracking, exclusion screening dates, risk assessments, PHI access levels, and compliance status monitoring
  • Self-Disclosure Navigator: guided decision framework covering OIG Self-Disclosure Protocol, CMS Self-Referral Disclosure Protocol for Stark Law, and DOJ Voluntary Self-Disclosure with 60-day overpayment rule analysis
  • Change Impact Analysis: regulatory change gap analysis with affected area identification, gap severity scoring, remediation task generation, and implementation tracking
  • Credentialing & License Verification: verify provider credentials across 7 data sources including NPPES, DEA, CMS Medicare, OIG/SAM exclusion checks, and 50-state licensing board directory. Individual and batch verification with DOCX export

Pillar 7 - Documents

Document Generation & Reports

From research result to formatted deliverable in seconds. Tailored policies, board reports, and stakeholder briefings.

  • Six document types from any research result: Board Briefing, Executive Summary Memo, Compliance Policy, Implementation Work Plan, Gap Analysis, and Outcomes Report
  • Policy Generator: compliance policies drafted to your specifications with purpose, scope, definitions, procedures, responsibilities, training requirements, and regulatory references
  • Board Report Generator: executive-quality compliance reports synthesizing program activity, risk assessments, training completion, and regulatory developments
  • Stakeholder Briefings tailored to 9 audiences: CFO, CEO, Service Line Leader, Clinical Leadership, General Counsel, CCO, Compliance Committee, Board of Directors, and custom roles
  • Export to PDF and Word, formatted for immediate distribution without editing

The board briefing function alone justified the cost. I can turn a complex regulatory development into a one-page brief for our board in five minutes. That used to take me half a day.

Pillar 8 - Data

Data Intelligence

CMS and OIG public datasets structured, scored, and linked to enforcement theory.

  • Billing Pattern Analyzer: CMS Medicare Part B data by NPI with risk score 1-10, peer benchmarks, and OIG/RAC/ZPIC audit target indicators using 2022 post-COVID baseline
  • Provider Network Screener: bulk input up to 50 NPIs with rule-based risk scoring and one-click full analysis launch
  • Open Payments AKS Risk Analyzer: Sunshine Act data with Anti-Kickback Statute risk scoring by payment category, qui tam relator perspective analysis, and enforcement theory framing
  • Exclusion Check: OIG LEIE lookup by provider name or NPI returning exclusion type, date, reinstatement status, and applicable waiver states
  • Indexed Source Library: every government source cited in research results is readable in-platform with no external redirects or broken links

Built for practitioners

Every feature maps to a real workflow.

55+ features, eight pillars, and the full compliance lifecycle: from regulatory research to program management, operations to enforcement, billing audit to risk management, document generation to CMS data analysis. Every feature in RuleResource was designed around a workflow that compliance officers and in-house healthcare counsel actually have, not a workflow imagined in a product meeting by people who have never done this work.

The alternatives are inadequate in different ways. Generic AI tools produce citations that do not exist, to regulations that say something different from what the AI claims. Westlaw and Lexis are law firm tools, priced for law firms, with no compliance program infrastructure. Outside counsel is a gate on every question: a call, a scope, a bill, and days of waiting for an answer that should take minutes.

RuleResource is the first platform where every feature was designed by someone who has spent 38 years on the other side of these problems, as enforcement defense counsel, as compliance program architect, as a practitioner who knows what a CCO needs to walk into a board meeting prepared, what an in-house attorney needs to scope exposure before an acquisition closes, and what a compliance team needs to build a defensible program from a regulatory standard rather than a guess.

Generic AI

Generates confident-sounding citations to regulations that do not say what the AI claims, or do not exist at all.

Westlaw / Lexis

Law firm tools at law firm prices. No compliance program infrastructure. No OIG advisory opinion integration. No document generation.

Outside Counsel

A call, a scope letter, a bill, and days of waiting. $500-$2,100 per hour for questions that should take minutes.

See the platform working on your compliance questions.

Schedule a demo using your organization's actual service lines, operating states, and the regulatory topics your team is working on now.