OIG Issues Guidance for Health Care Governing Boards on Regulatory Compliance Oversight

On April 20, 2015, the Office of Inspector General of the Department of Health and Human Services (the "OIG") published a handbook entitled Practical Guidance for Health Care Governing Boards on Compliance Oversight (the "Guidance"), which provides guidance to health care governing boards in determining the adequacy and effectiveness of their organization's compliance program. The publication was co-authored by the Association of Healthcare Internal Auditors (AHIA), the American Health Lawyers Association (AHLA) and the Health Care Compliance Association (HCCA).

The Guidance, which expands on previous guidance provided by the OIG, makes clear that compliance programs are not "one size fits all" and may vary depending on the size and resources of the organization. The Guidance also provides practical tips to assist governing boards in their oversight role with regard to compliance with state and federal laws applicable to the health care industry. The Guidance includes:

1. Expectations for board oversight and use of existing pubic resources and assessment tools in establishing a compliance plans, and in determining the scope and adequacy of the compliance program;
2. The roles and relationships between the organization's audit, compliance and legal departments;
3. Reporting processes within an organization;
4. Suggestions for identifying regulatory risks and encouraging accountability for achieving organizational-wide compliance goals and objectives; and
5. The importance of using regulatory, compliance and legal experts in developing and reviewing compliance programs.

As the OIG makes clear, boards should be actively involved in the compliance process; they need to ask the right questions of management to determine the adequacy and effectiveness of their organization's compliance program and to assess the performance of those who develop and carry out the program. In order to do so, boards must keep abreast of changes in the regulatory landscape.

Hinshaw & Culbertson attorneys have extensive experience assisting health care organizations in the design and implementation of compliance programs and advising governing boards on transparency, governance and compliance issues. We would be happy to work with your organization to assist you. 

For more information, please contact your regular Hinshaw attorney.

This alert has been prepared by Hinshaw & Culbertson LLP to provide information on recent legal developments of interest to our readers. It is not intended to provide legal advice for a specific situation or to create an attorney-client relationship.