How to Build a Healthcare Compliance Budget Your CEO Will Approve

A healthcare compliance budget covers the people, processes, and tools your organization needs to build, manage, and document for an effective compliance program. OIG’s General Compliance Program Guidance (GCPG), released in November 2023, describes seven elements of an effective program, and each element needs someone assigned to it and money to support it. That makes the level of funding a decision your organization should be able to document and explain.

During Compliancy Group’s “Two Views on 2027 Compliance” webinar, Chief Compliance & Privacy Officer, Brian Burton, and CEO, Crispin Vary, looked at the budget from both sides: the compliance leader who builds the request, and the executive who approves it. Their advice was to start with people and processes, then fund the tools needed, and present each request on one page that accurately reflects the investment and the expected outcomes.

When healthcare organizations build their annual budgets, the compliance department’s request often arrives as a list of mandates, software renewals, and audit expenses. To a Chief Compliance Officer, these items represent essential requirements to manage the recommendations of the GCPG. To a CEO or CFO, they can look like unquantified and unverified expenses.

Every item in a compliance budget should tie back to a requirement, such as the GCPG, HIPAA, or a contractual obligation to a payor. Executive leadership still has to weigh it against the broader organizational budget. For each line, the CEO and CFO want to know what it costs, what it replaces, who is responsible for it, and when it will show results.

Before you build the request, find out what leadership is measuring. Crispin Vary, Compliancy Group’s CEO, recommends asking your CEO or manager two questions: How is the board measuring the organization’s success next year? And how might it measure compliance’s contribution? Then frame each budget line around those priorities.

If your request answers those questions on one page, links each line to a requirement, and reaches leadership before the budget is drafted, it is easier to approve and manage.

A compliance budget covers the people, tools, and resources required to build, manage, and evidence the seven elements of an effective compliance program, as set out in the GCPG.

The GCPG scales with organization size. A small practice may have a part-time compliance officer, while a large system may need a full department, and in either case the organization should be able to explain the level of resourcing it requires.

Build each part of the budget in this order:

1. People. Compliance officer, compliance team, and committee time, department leaders and contributors, employee training hours away from clinical and operational work, and outside advisors or counsel. If one person serves as both compliance officer and privacy officer, budget for both roles.
2. Process. The annual risk assessment and monitoring, remediation of findings, training content, vendor diligence, and incident response. Vendor diligence and incident response are often unplanned and can consume time, effort, and costs; it is recommended to plan for an agreed-upon contingency reserve.
3. Tools. The system that holds the record and produces evidence, plus implementation, integrations with HR and identity systems, and the retirement of any tools it replaces and return on investment.

When training, policies, vendors, and incidents are tracked in separate systems, someone spends hours reconciling them, and that time is usually lost as salaries. It helps to separate two kinds of effort. Collection hours are spent finding and matching documentation, while judgment time is spent deciding what is required and defining the next steps or detailing and implementing corrective actions.

To estimate the collection hours, sample how long your team takes to answer questions such as which employees are behind on training, which vendors handle protected health information (PHI), or which risk assessment findings are still open. That figure gives the compliance team and finance a concrete estimate of effort to fund budget items that help staff shift more effort to judgment decisions.

Finance teams are more likely to approve a request that comes with verifiable and objective data points and follows the same format as every other department’s budget.

Your own budget history is the most useful benchmark for a compliance request. Comparing this year’s request with what past cycles cost and delivered shows finance how the program performs and where the money goes.

Here are some figures you can pull from your records for the last two or three budget cycles:

• The spend on people, process, and tools compared with the plan
• Hours spent collecting and reconciling records, and how they changed after any new tool
• Risk assessment findings opened and closed, and what it cost to close them
• Incidents, and what each one cost to resolve

Review these figures at your mid-year check-in and carry them into the next request. They are easier to pull when training, risk assessments, vendor records, and incidents are tracked in one system rather than spread across spreadsheets and separate tools.

Ask your finance team which budgeting method it uses, and build the compliance request the same way.

Match your request to the method before you write the numbers. Then address the objections finance is likely to raise, such as overlap with existing tools or the cost of leaving a gap open, in the request itself instead of waiting to be asked.

Tie each tool request to the process it supports and the costs it removes. At renewal, check whether the tool cuts manual work or adds effort and time to document in another system.

The Department of Justice’s Evaluation of Corporate Compliance Programs asks whether compliance is adequately resourced and has timely access to data.

Each major budget line should fit on a single page, with supporting detail in an appendix that finance can request.

Each of these six parts answers a question finance is likely to ask:

1. The obligation: The element or regulation the line item serves, so the request reads as a requirement.
2. The number: The cost split into people, process, and tools, with the driver behind each line.
3. What it retires: Contracts that will end, staff hours returned, and duplicate spending removed.
4. What it prevents: The unplanned costs of risks it helps avoid, priced in your organization’s own terms.
5. What happens without it: The consequence to the organization, stated plainly.
6. When it shows results: The date you will report back and what you will show.

The figures below are illustrative, not based on a real organization. An organization with eight locations and 250 employees budgets $180,000 for its HIPAA Compliance program: $95,000 for people (half of a full-time role plus supporting resources), $55,000 for process (the risk assessment and remediation plan), and $30,000 for automation and software tools. The obligation is the HIPAA Security Rule’s risk analysis requirement and the auditing and monitoring element of OIG’s guidance.

The ranges below are one way to check the overall shape of a plan. They are illustrative and are intended only for consideration and planning.

Compliance budget planning works best when it starts well before the finance deadline for budget submissions.

Treat 90 days as a recommended minimum planning window, not an absolute requirement. Starting at least 90 days before your planning cycle closes gives you time to collect information, review previous years’ budgets, and build your next compliance budget.  Forecasting ahead of time gives the finance team time to model it into next year’s budget, instead of submitting alongside all the other departments. Compliance teams may consider keeping a budget item on the agenda for your Compliance Committee or Board reports. Mid-sized and large organizations may need four to six months.

Collaborate with the team that builds the financial model and the budget approvers. Then schedule a mid-year review, where you can demonstrate how the budget was delivered and make adjustments for organizational and regulatory oversight changes, and incidents, or workforce turnover.

The calendar below assumes a January 1 fiscal year. For other fiscal years, count back from the date your planning cycle closes.

You can complete these five steps within a month:

• List the hours, contracts, and renewal dates your program already uses, and what your last budget cycle approved or reduced.
• Time how long it takes to answer one question that spans workforce, risk, vendors, and incidents, and write the number down.
• Check your plan against people, process, and tools, and note any category that is at zero.
• Find the date your organization’s planning cycle closes, then count back 90 days.
• Hold a working session with your team, then review the inventory and any gaps with finance.

Compliancy Group’s advisors can also help you prepare for that working session.

Each audit in the plan needs named individuals assigned to it. Assign four roles:

• Auditor. The person who performs the review and records findings.
• Compliance or coding owner. The person accountable for education and corrective action after the audit.
• Operational owner. The practice manager, department lead, or provider who makes process changes.
• Reviewer. The compliance committee member or leader who reviews results and confirms follow-up.

Building a compliance budget is only part of the challenge. Healthcare organizations also need to ensure those investments support a program that’s manageable, effective, and able to demonstrate results.

The Guard, Compliancy Group’s healthcare compliance software, brings workforce compliance, risk assessments, third-party risk, and incident management together in one connected platform. Instead of relying on disconnected tools, spreadsheets, and manual tracking, teams gain greater visibility into their compliance activities, reduce administrative work, and maintain the documentation needed to demonstrate program effectiveness.

Our platform is also backed by experienced compliance advisors who provide guidance on identifying gaps, prioritizing improvements, and maintaining a stronger compliance program.

See how Compliancy Group can help you simplify compliance management and get more from your compliance investment.

For each change to the plan, record what changed, why, and the evidence behind it, such as an audit result or denial report. Date each revision so you can explain your decisions if an outside reviewer asks.

Use this as a starting template. Replace each row with your own ranked areas, then confirm that the total sample across all rows fits the auditor hours you have for the year.

Audit Manager+ helps healthcare auditing teams bring greater consistency and efficiency to that process. Configurable checklists, audit guidelines, and custom error categories help ensure auditors evaluate encounters against the same criteria, while the ability to review both provider and coder performance within a single encounter supports more comprehensive assessments.

By creating a more consistent auditing process and maintaining organized findings, teams can better understand where coding and documentation problems are occurring, evaluate corrective actions, and make more informed decisions about where to focus future audits.

The full recording covers each part of the compliance budget in more depth, along with the regulatory guidance behind it and the questions attendees asked.

Brian Burton, PMP, CHC, Chief Compliance & Privacy Officer, and Crispin Vary, CEO of Compliancy Group, presented “Two Views on 2027 Compliance: Compliance Budget Planning for Healthcare” on October 6, 2026. They covered what a compliance budget should include and how it is judged, what the program already costs, how to build the plan line by line, and how to present the request to finance, the board, and the CEO.

Watch the Recording

To start building your own request, download the compliance budget calendar and one-page business case from the session.

Download the Compliance Budget Template