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HHS OIG Releases Guidance for Healthcare Boards

Posted in Fraud and Abuse, Hospitals and Institutions, Legislation and Public Policy, Medicare and Medicaid, White Collar

On April 20, the U.S. Department of Health and Human Services Office of Inspector General (OIG), in collaboration with the Association of Healthcare Internal Auditors, the American Health Lawyers Association and the Health Care Compliance Association, published a new guidance document for governing boards of healthcare organizations on their obligations concerning compliance oversight.

The 16-page “Practical Guidance for Health Care Governing Boards on Compliance Oversight” includes sections covering a board’s compliance oversight expectations, roles and responsibilities related to compliance, procedures for reporting to the board, and identifying and auditing potential risk areas.  Examples of the practical suggestions for consideration by governing boards include:

• Develop a formal calendar to educate board members on compliance topics, including the organization’s highest risks

• Conduct discussions with compliance and internal audit managers, without senior leadership present, to encourage more open communication on the level of compliance within the organization

• Clearly and formally define the independence yet interrelationship of the organization’s audit, compliance, legal, quality improvement and human resources functions

Healthcare entities and their advisers should review the Guidance as it discusses fairly specific situations that boards may want to examine, such as the Medicare 60-day repayment rule and whether hospital-physician relationships comply with Stark Law and Anti-Kickback Statute requirements.

Lastly, healthcare organizations may want to consider distributing the document to their board members to provide guidance on the OIG’s expectations.

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