Monday, April 27, 2015

OIG Releases Compliance Oversight Guidance to Health Care Boards

Dianne De La Mare


The US Department of Health and Human Services, Office of Inspector General (OIG) has released new guidance, Practical Guidance for Health Care Governing Boards on Compliance Oversight, in collaboration with the American Health Lawyers Association (AHLA), the Association of Healthcare Internal Auditors (AHIA) and the Health Care Compliance Association (HCCA), to assist governing boards of health care organizations fulfill their compliance plan oversight obligations. Health care board members have a duty to act reasonably to ensure that the company has an information and reporting system and that the system is adequate to provide the Board with appropriate compliance information, according to the guidance.

Health care Board members should consult OIG’s compliance guidance and also the Federal Sentencing Guidelines and Corporate Integrity Agreements as benchmarks for the Board’s compliance efforts. The OIG recognizes the potential burden on smaller entities; but also states that a company’s legal, compliance and internal audit functions should be separate and independent, which may require hiring additional employees.

Other OIG recommendations in the guidance include:
1) enter into executives sessions (without management present) with only employees responsible for compliance;
2) establish a formal plan to stay up to date with changing regulations;
3) include someone on the Board who is a compliance expert; and
4) consider an employee incentive program focused on compliance.

Overall, the guidance makes clear that health care Board members must play an active role in their organization’s compliance.

For more detail, see our General Counsel, Reed Smith Client memorandum at http://www.healthindustrywashingtonwatch.com/2015/04/articles/other-oig-developments/oig-partners-with-industry-associations-by-issuing-practical-guidance-for-health-care-governing-boards-on-compliance-oversight/index.html.

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