December 2012 - Questsoft has released the latest in its annual video series - the Christmas Compliance Telethon, bringing humor to the area of lending compliance. Their YouTube channel also has the episodes from the past years of this annual present to the industry. If things are getting too serious in your compliance office, here's an antidote.
November 2012 -The Institute of Business Ethics has released a "Good Practice Guide"on the use of scenarios in ethics training. It contains sample case studies that can be modified for particular settings as a well as case studies from companies that use scenarios as part of their training efforts. This and other publications are available at the Institute's website
The University of Texas has launched a program called Ethics Unwrapped -that "explores the organizational pressures and psychological biases that often cause well-intentioned people to act unethically." Part of this exploration includes sharing video and other resources that can be used to teach ethical concepts like conflict of interest as well as stories from missteppers like Jack Abramoff.
November 2012 - The Department of Justice and the Securities and Exchange Commission have published "A Resource Guide to the U.S. Foreign Corrupt Practices Act" which includes a section (beginning p. 56) on "Corporate Compliance Programs" and what the agencies look for in a company's prior efforts when deciding what action to take in a possible FCPA prosecution. Although the Guide stresses that there are no "formulaic requirements" for a program to pass muster, none of the features discussed is new and most are footnoted to the Sentencing Guidelines model. What is different is the focus of the analysis on actions that the company has taken - e.g. not "has a Code of Conduct with certain content" but "is the Code periodically reviewed, updated and enforced with appropriate incentives and discipline?" Multiple examples and case studies make the document of value to even those who don't have the FCPA on their list of regulatory risks.
[[#x2013---November 2012 - Business Ethics for the Real World, a MOOC online course is being offered by the Markula Center for Applied Ethics at Santa Clara University. According to the course description,"[w]hile the course includes some ethical theory, it is designed to be approachable by the seasoned manager, the novice businessperson, and students in business schools. No specific background or preparation is necessary." It's free - but limited to the first 500 who sign up.]]November 2012 - Business Ethics for the Real World, a MOOC online course is being offered by the Markula Center for Applied Ethics at Santa Clara University. According to the course description,"[w]hile the course includes some ethical theory, it is designed to be approachable by the seasoned manager, the novice businessperson, and students in business schools. No specific background or preparation is necessary." It's free - but limited to the first 500 who sign up.
October 25, 2012 - Get the Message? The DHHS OIG's Annual published "Workplan" has long been used by compliance and ethics folk to tailor their monitoring and auditing efforts. But now the office has gone a step further and made highlights of the plan more accessible though a 30 minute video, OIG Outlook 2013. The film features peppy music, introductions by experienced reporter Robert Baskin, and "interviews" of the IG and his senior deputies. Beyond a few brief mentions of specific audit and investigation topics the overriding message here is the amount and significance of the Office's work and how it makes its strategic decisions. Lots of references to "billions", "very big numbers", "you've got your work cut out for you" and past successes. Individual 4-6 minutes segments are also available "for a presentation or educational session in your organization."
October 10, 2012 - The DHHS OIG released a report summarizing feedback from roundtable discussions with 32 companies that are or have been subject to Corporate Integrity Agreements (CIAs) with the department since 2009. The most surprising feedback? Even within organizations on public corporate probation it seems that the compliance function can still have difficulty getting sufficient resources to accomplish its goals.
Be Kind To Your Compliance People (2012) (video) - a revealing and lyrical look at how others in the organization may feel about the function.
Applying for Medicare Part A Certification or Changing Ownership? A new step along the way will be another DHHS office - the Office for Civil Rights which must grant you a "civil rights clearance" based on submission of a checklist and copies of your related policies. OCR's official estimate of how long the checklist takes to complete is 8 hours - that might be a little optimistic....
Safeguarding Your Medical Identity - is a newish (August 2012) online course from the Centers for Medicare and Medicaid Services. What's new - the "Medical Identity" being discussed is the physician's as well as the patient's, with lots of examples from recent prosecutions on how both "identities" can be used to perpetrate insurance fraud.. There is CME credit for physicians who watch a video and complete a test. The rest of us can just watch the video on Youtube using this link.
Because we all need a pause now and then for reflection - this collection of "Ethical Reflections" courtesy of the County of San Bernadino's Office of Compliance and Ethics.
August 6, 2012 - Free Webinars on Accessibility Issues - Accesability Online, a joint project between the US Access Board and the ADA National Network (both government funded) presents free monthly webinaris and audio conferences on accessibility issues. Recordings and presentation materials from past sessions are also archived on the site.
July 30, 2012 - A "Compliance Officer" Quit Tam Plaintiff - A law suit filed by a radiologist and the "Compliance Officer" of the radiology practice against an Orlando hospital chain has survived a motion to dismiss. The Order denying the hospital's motion details the allegations against it. The Orlando Sentinal also has the story.
July 19, 2012 - Adverse Events in Hospital Care - The DHHS OIG released the latest in a series of reports on adverse events that occur during the care of hospitalized patients. The data on which all these studies depends is a randomized sample of records for Medicare patients hospitalized in October 2008. Physician reviewers looked at all the records for the occurrence of an adverse event, whether the event was preventable and what harm the event caused, if any, to the patient. The reviews were guided by adverse event definitions developed by Medicare (hospital acquired conditions) and the National Quality Forum, a national nonprofit organization concerned with quality of care.
From that work the OIG has extrapolated national rates of Medicare patients that suffered an adverse event while hospitalized (1/4), those suffering a severe adverse event (1/7), those suffering an event that contributed to their death (1.5%) and a cost of these events to the Medicare program of $4.4 billion annually, based on a determination that 44% of the events were preventable.
What’s New: A report showing that few of the adverse events identified in the original study were reported to the mandatory State event reporting systems which exist in about one half of the States. But only 12% of the events met state criteria for reporting to these systems. Even more telling - only 4 out of 35 identified events were reported to internal hospital event reporting systems.
What else is new: The collection of all of these studies together into a “Spotlight Article” on the OIG website which will make it easier for those interested to connect the different pieces of work that the Office has done in this area over the past few years. There’s even a Podcast to listen to.
July 5, 2012 - Calling All Employers - Free Department of Justice OSC Webinairs on How to Complete the I-9 . Here's the video PSA on why and how to sign up.
June 27, 2012 - The ADA and AIDS / HIV Discrimination - Following several recent settlements with healthcare providers, the US DOJ released a "Technical Assistance" document entitled Questions and Answers: The Americans with Disabilities Act and Persons with HIV/AIDS. Those advising employers, health care providers, other "public accommodations" like restaurants, day care centers, gyms and shopping malls as well as state and local governments will want to review the DOJ examples of what is and what is not discrimination under the ADA with their clients.
June 26, 2012 - The federal Office for Civil Rights has published its Audit protocols for completing audits required under the HITECH Act around HIPAA information security (77 elements) , privacy and breach response (combined into 88 elements). The protocols can provide covered entities a template for their own proactive reviews before a visit from OCR.
Finding information about federal regulations just got MUCH easier - The Legal Information Institute at Cornell University has created a keyword searchable form of the Code of Federal Regulations (CFR). The results also have linked to each section clickable tabs that display the "Currency" of that section, related sections of the United States Code, and current related rulemaking (with links to the Federal Register texts). Click here for an example relating to HIPAA "business associate" requirements.
June 5, 2012 - Benchmarking - PWC and Compliance Week released selected findings from their annual survey instrument "State of Compliance: 2012". The current report reflects input as os April 2012, but the survey remains open until December and participants receive a free report showing how their responses benchmark against others in the database.
June 4, 2012 - HIPAA Enforcement Training - In 2011 the federal Office of Civil Rights (OCR) trained States Attorneys General across the United States on HIPAA and how the AG offices could enforce information privacy and security. Now OCR is making that training available for anyone to review in video and computer based training formats.
May 31, 2012 -“Inside the Mind of a Whistleblower” - The Ethics Resource Center issued its first ever supplemental report to the National Business Ethics Survey looking beyond the numbers of individuals who report to questions about what influences whether and where they report. Among the report’s findings – monetary rewards have little or no impact on the likelihood of “reporters” coming forward, but they may convince “non-reporters” to speak up. In addition, the report calculates the effect of specific elements of compliance and ethics programs on reporting rates. To download the whistleblower report or the entire NBES (email registration required) click here and pick “download reports”.
May 21, 2012 - Trends in business ethics from 2008 to 2012: - more Codes of Ethics, more data collection about ethical issues, and less leadership review of the information collected. These are three of the findings from a recent survey ("Managing Responsible Business") of Chartered Global Management Accountants (CGMAs) sponsored by their accrediting associations, CIMA and the AICPA in both 2008 and 2012. The full reports can be downloaded here.
May 15, 2012 - The US announced a settlement with Temple University and its former Chairman of Ophthalmology of a variety of claims relating to the billing of services performed by resident physicians but billed as though performed by the former chair - who wasn't even at the Hospital - and "other fraud" in his department's activities. What's most interesting about the settlement is the credit given to Temple's compliance efforts - Temple could show that the physicians involved had been trained on billing requirements, it discovered the problem, voluntarily disclosed it and shared the results of its internal investigation. The result? No CIA - just repayment, jointly with the physician, of the claims that were improperly billed to federal and private payers.
May 11, 2012 - New York's Office of the Medicaid Inspector General posted a new 40 page Compliance Guidance for Hospitals. More prescriptive than the federal "Guidance", this one contains lists of required "elements", "requirements" and "recommendations."
May 2, 2012 - The Senate Finance Committee issued an open letter to "the health care community" asking for ideas on how to "combat waste, fraud and abuse" in the federal healthcare programs. Deadline for submissions is June 29, 2012.
May 2, 2012 - CMS has developed a CME credit approved web based training course covering the material in it's Roadmap for New Physicians.
May 1, 2012 - The Ethics Resource Center (ERC) published the final version of its report evaluating the effectiveness of the FSGO model for compliance and ethics programs - "The Federal Sentencing Guidelines for Organizations at Twenty Years". This final version incorporates public comments on the draft circulated last November. Those comments and the text of the final report, all 128 pages, are available on the ERC website.
April 24, 2012 - DHHS Inspector General Daniel R. Levinson testified before the Senate Committee on Finance, describing "The Anatomy of a Fraud Bust: From Investigation to Conviction". The IG's testimony includes teh model used by the Medicare "Strike Force" to develop and review cases for prosecution as well as details on an intricate Home Health agency fraud case in Florida.
Beginning April 25, 2012 - The Ethics and Compliance Officers Association (ECOA) will offer "ECOA Law School", a series of professional development webinairs for those in Compliance and Ethics. ECOA has also offerred "Ethics School" and "Business School" in a similar format.
March 2012 - Following a rather public turnover in its senior leadership last year, NPR has published a new Ethics Handbook for the news organization, including a guideline on "Whom To Turn To" with questions. For background and a review of the new handbook by another media source, check out this story. NPR also has a new "Ombudsman" to serve as target for reader commentary about how NPR does reporting the news. A brave fellow indeed.
March 23, 2012 - The Secretary of Health and Human Services delivered a statutorily required report to Congress detailing the first 18 months of implementation of the Medicare Self-Referral Disclosure Protocol (SRDP) which was included in the Affordable Care Act. The SRDP permits healthcare providers and suppliers who identify violations of the Stark Self-Referral prohibitions to "self-disclose" the violation in exchange for two potential benefits - a tolling of the sixty day deadline for returning related "over-payments" from the Medicare program AND a reduction of that liability by exercise of discretion now granted to the Secretary of HHS. According to the report, in its first 18 months the SDRP has received 150 submissions and settled six as of the date of the report. (A seventh has been posted to the CMS website since). Unfortunately, the report does not contain enough detail on those settlements to determine if the participants in the SRDP actually received a significant reduction in their potential liability to the Medicare program.
March 21, 2012 - marked the effective date of a broad series of regulations implementing Title III of the Americans with Disabilities Act, which will apply to "places of public accommodation" and "commercial facilities". Basically, if you run a business that interacts with the public elsewhere than on an aircraft or railroad locomotive, there is something in these regulations that applies to your operations. The Department of Justice has provided illustrations and explanations along with the extensive regulations. Private plaintiffs and enforcement actions will undoubtedly follow. April 21, 2012 - DOJ announced free webinairs on the application of these new requirements to making pools accessible.
March 13, 2012 - Hotline reporting by text message? At least one company, Home Depot, has figured out a way to make it anonymous according to a article coming out this month in Ethikos.
March 9, 2012 - A carrot + a greatly reduced "stick" are the potential rewards for employers participating in the Immigration and Customs Enforcement (ICE)'s voluntary IMAGE "self compliance" program. To become a "member" an employer must agree to create a written policy about checking I-9 related documentation, use the free federal "e-verify" and social security number verification services and undertake several other compliance measures. In return "members" qualify for free training from ICE, receive waivers or minimum penalties if found not in compliance and a two year "free from inspection" period following a confirmation visit. Outreach forums about the program are being scheduled throughout the country in 2012.
March 2, 2012 - A new webpage from the DHHS OIG "Compliance 101" gathers together the various materials it has published to assist those interested in Medicare / Medicaid compliance.
February 24, 2012 - The DHHS OIG released a report of fraud and abuse identification and response activities by contractors in the Medicare Advantage program. Based on self-reported data from the contractors, who are required to have compliance programs focused on potential fraud and abuse, the OIG's analysis makes interesting reading about the effectiveness of mandating effective compliance programs. One contractor identified 78% of all the "incidents" of potential fraud or abuse; three accounted for 95% - that's 3 out of 188 contractors in 2009. Some contractors had proactive auditing measures in place; others relied solely on hotline calls to "identify" fraud and abuse. The numbers get even more interesting on what happened after the incidents were "identified".
February 14, 2012 - The international Institute for Business Ethics (IBE) published a report detailing the experiences of six companies who experienced organizational failures resulting in widespread loss of trust - and what they did about it. "The Recovery of Trust: organizational failures and trust repair" is available for download at the Institute's website.
January 26, 2012 - The Department of Justice filed a Complaint and Settlement with the State of Virginia resolving an investigation under the Americans with Disabilities Act of the state's provision of services to those with intellectual and developmental disabilities. Under the Supreme Court's Olmstead decision such services must be provided in the most integrated appropriate setting - a standard allegedly not being met by Virginia's existing system. As part of its settlement obligations the state agreed to establish an incident reporting system with related protocals, training and "appropriate action" against those who failed to resport and /or take corrective actions. In addition the state will be monitoring 8 specific parameters relating to the quality of its services and if they meet the regulatory requirements. And an "independent reviewer", paid for by the state, will see if it carries through on these undertakings.
January 19, 2012 - The DHHS OIG published "Compliance Program Basics" - a short video covering its view of what makes an effective program. 4 minutes of "must watch" viewing. January 24, 2012 - The next installment in this series, Tips for Implementing an Effective Compliance Program, is worth watching no matter what field you are doing compliance in.
60% of Compliance and Ethics professionals reported that in the last 12 months they have considered leaving their jobs due to job related stress. In any economy, that would a startling finding. A copy of the survey report is available from from HCCA / SCCE.
January 6, 2012 - The Ethics Resource Center published the results of its biennial National Business Ethics Survey showing record high levels of reported retaliation by employers for whistleblowing. The full report is available on the ERC website. You can sign up there as well to participate in a webinair briefing from ERC staff on their findings.
January 5, 2012 - The DHHS OIG continues to publish reports of its "Compliance Reviews" of various providers' Medicare claims. These not only demonstrate the continuing significance of "old" issues like short stays and same day readmissions to acute care hospitals, but also the differences in the compliance approaches of various providers.
Welcome to the New in 2012 Archive!
[Back to New in Compliance and Ethics]
December 2012 - Questsoft has released the latest in its annual video series - the Christmas Compliance Telethon, bringing humor to the area of lending compliance. Their YouTube channel also has the episodes from the past years of this annual present to the industry. If things are getting too serious in your compliance office, here's an antidote.
November 2012 -The Institute of Business Ethics has released a "Good Practice Guide"on the use of scenarios in ethics training. It contains sample case studies that can be modified for particular settings as a well as case studies from companies that use scenarios as part of their training efforts. This and other publications are available at the Institute's website
The University of Texas has launched a program called Ethics Unwrapped -that "explores the organizational pressures and psychological biases that often cause well-intentioned people to act unethically." Part of this exploration includes sharing video and other resources that can be used to teach ethical concepts like conflict of interest as well as stories from missteppers like Jack Abramoff.
November 2012 - The Department of Justice and the Securities and Exchange Commission have published "A Resource Guide to the U.S. Foreign Corrupt Practices Act" which includes a section (beginning p. 56) on "Corporate Compliance Programs" and what the agencies look for in a company's prior efforts when deciding what action to take in a possible FCPA prosecution. Although the Guide stresses that there are no "formulaic requirements" for a program to pass muster, none of the features discussed is new and most are footnoted to the Sentencing Guidelines model. What is different is the focus of the analysis on actions that the company has taken - e.g. not "has a Code of Conduct with certain content" but "is the Code periodically reviewed, updated and enforced with appropriate incentives and discipline?" Multiple examples and case studies make the document of value to even those who don't have the FCPA on their list of regulatory risks.
[[#x2013---November 2012 - Business Ethics for the Real World, a MOOC online course is being offered by the Markula Center for Applied Ethics at Santa Clara University. According to the course description,"[w]hile the course includes some ethical theory, it is designed to be approachable by the seasoned manager, the novice businessperson, and students in business schools. No specific background or preparation is necessary." It's free - but limited to the first 500 who sign up.]]November 2012 - Business Ethics for the Real World, a MOOC online course is being offered by the Markula Center for Applied Ethics at Santa Clara University. According to the course description,"[w]hile the course includes some ethical theory, it is designed to be approachable by the seasoned manager, the novice businessperson, and students in business schools. No specific background or preparation is necessary." It's free - but limited to the first 500 who sign up.
October 25, 2012 - Get the Message? The DHHS OIG's Annual published "Workplan" has long been used by compliance and ethics folk to tailor their monitoring and auditing efforts. But now the office has gone a step further and made highlights of the plan more accessible though a 30 minute video, OIG Outlook 2013. The film features peppy music, introductions by experienced reporter Robert Baskin, and "interviews" of the IG and his senior deputies. Beyond a few brief mentions of specific audit and investigation topics the overriding message here is the amount and significance of the Office's work and how it makes its strategic decisions. Lots of references to "billions", "very big numbers", "you've got your work cut out for you" and past successes. Individual 4-6 minutes segments are also available "for a presentation or educational session in your organization."
October 10, 2012 - The DHHS OIG released a report summarizing feedback from roundtable discussions with 32 companies that are or have been subject to Corporate Integrity Agreements (CIAs) with the department since 2009. The most surprising feedback? Even within organizations on public corporate probation it seems that the compliance function can still have difficulty getting sufficient resources to accomplish its goals.
Be Kind To Your Compliance People (2012) (video) - a revealing and lyrical look at how others in the organization may feel about the function.
Applying for Medicare Part A Certification or Changing Ownership? A new step along the way will be another DHHS office - the Office for Civil Rights which must grant you a "civil rights clearance" based on submission of a checklist and copies of your related policies. OCR's official estimate of how long the checklist takes to complete is 8 hours - that might be a little optimistic....
Safeguarding Your Medical Identity - is a newish (August 2012) online course from the Centers for Medicare and Medicaid Services. What's new - the "Medical Identity" being discussed is the physician's as well as the patient's, with lots of examples from recent prosecutions on how both "identities" can be used to perpetrate insurance fraud.. There is CME credit for physicians who watch a video and complete a test. The rest of us can just watch the video on Youtube using this link.
Because we all need a pause now and then for reflection - this collection of "Ethical Reflections" courtesy of the County of San Bernadino's Office of Compliance and Ethics.
August 6, 2012 - Free Webinars on Accessibility Issues - Accesability Online, a joint project between the US Access Board and the ADA National Network (both government funded) presents free monthly webinaris and audio conferences on accessibility issues. Recordings and presentation materials from past sessions are also archived on the site.
July 30, 2012 - A "Compliance Officer" Quit Tam Plaintiff - A law suit filed by a radiologist and the "Compliance Officer" of the radiology practice against an Orlando hospital chain has survived a motion to dismiss. The Order denying the hospital's motion details the allegations against it. The Orlando Sentinal also has the story.
July 19, 2012 - Adverse Events in Hospital Care - The DHHS OIG released the latest in a series of reports on adverse events that occur during the care of hospitalized patients. The data on which all these studies depends is a randomized sample of records for Medicare patients hospitalized in October 2008. Physician reviewers looked at all the records for the occurrence of an adverse event, whether the event was preventable and what harm the event caused, if any, to the patient. The reviews were guided by adverse event definitions developed by Medicare (hospital acquired conditions) and the National Quality Forum, a national nonprofit organization concerned with quality of care.
From that work the OIG has extrapolated national rates of Medicare patients that suffered an adverse event while hospitalized (1/4), those suffering a severe adverse event (1/7), those suffering an event that contributed to their death (1.5%) and a cost of these events to the Medicare program of $4.4 billion annually, based on a determination that 44% of the events were preventable.
What’s New: A report showing that few of the adverse events identified in the original study were reported to the mandatory State event reporting systems which exist in about one half of the States. But only 12% of the events met state criteria for reporting to these systems. Even more telling - only 4 out of 35 identified events were reported to internal hospital event reporting systems.
What else is new: The collection of all of these studies together into a “Spotlight Article” on the OIG website which will make it easier for those interested to connect the different pieces of work that the Office has done in this area over the past few years. There’s even a Podcast to listen to.
July 5, 2012 - Calling All Employers - Free Department of Justice OSC Webinairs on How to Complete the I-9 . Here's the video PSA on why and how to sign up.
June 27, 2012 - The ADA and AIDS / HIV Discrimination - Following several recent settlements with healthcare providers, the US DOJ released a "Technical Assistance" document entitled Questions and Answers: The Americans with Disabilities Act and Persons with HIV/AIDS. Those advising employers, health care providers, other "public accommodations" like restaurants, day care centers, gyms and shopping malls as well as state and local governments will want to review the DOJ examples of what is and what is not discrimination under the ADA with their clients.
June 26, 2012 - The federal Office for Civil Rights has published its Audit protocols for completing audits required under the HITECH Act around HIPAA information security (77 elements) , privacy and breach response (combined into 88 elements). The protocols can provide covered entities a template for their own proactive reviews before a visit from OCR.
Finding information about federal regulations just got MUCH easier - The Legal Information Institute at Cornell University has created a keyword searchable form of the Code of Federal Regulations (CFR). The results also have linked to each section clickable tabs that display the "Currency" of that section, related sections of the United States Code, and current related rulemaking (with links to the Federal Register texts). Click here for an example relating to HIPAA "business associate" requirements.
June 5, 2012 - Benchmarking - PWC and Compliance Week released selected findings from their annual survey instrument "State of Compliance: 2012". The current report reflects input as os April 2012, but the survey remains open until December and participants receive a free report showing how their responses benchmark against others in the database.
June 4, 2012 - HIPAA Enforcement Training - In 2011 the federal Office of Civil Rights (OCR) trained States Attorneys General across the United States on HIPAA and how the AG offices could enforce information privacy and security. Now OCR is making that training available for anyone to review in video and computer based training formats.
May 31, 2012 -“Inside the Mind of a Whistleblower” - The Ethics Resource Center issued its first ever supplemental report to the National Business Ethics Survey looking beyond the numbers of individuals who report to questions about what influences whether and where they report. Among the report’s findings – monetary rewards have little or no impact on the likelihood of “reporters” coming forward, but they may convince “non-reporters” to speak up. In addition, the report calculates the effect of specific elements of compliance and ethics programs on reporting rates. To download the whistleblower report or the entire NBES (email registration required) click here and pick “download reports”.
May 21, 2012 - Trends in business ethics from 2008 to 2012: - more Codes of Ethics, more data collection about ethical issues, and less leadership review of the information collected. These are three of the findings from a recent survey ("Managing Responsible Business") of Chartered Global Management Accountants (CGMAs) sponsored by their accrediting associations, CIMA and the AICPA in both 2008 and 2012. The full reports can be downloaded here.
May 15, 2012 - The US announced a settlement with Temple University and its former Chairman of Ophthalmology of a variety of claims relating to the billing of services performed by resident physicians but billed as though performed by the former chair - who wasn't even at the Hospital - and "other fraud" in his department's activities. What's most interesting about the settlement is the credit given to Temple's compliance efforts - Temple could show that the physicians involved had been trained on billing requirements, it discovered the problem, voluntarily disclosed it and shared the results of its internal investigation. The result? No CIA - just repayment, jointly with the physician, of the claims that were improperly billed to federal and private payers.
May 11, 2012 - New York's Office of the Medicaid Inspector General posted a new 40 page Compliance Guidance for Hospitals. More prescriptive than the federal "Guidance", this one contains lists of required "elements", "requirements" and "recommendations."
May 2, 2012 - The Senate Finance Committee issued an open letter to "the health care community" asking for ideas on how to "combat waste, fraud and abuse" in the federal healthcare programs. Deadline for submissions is June 29, 2012.
May 2, 2012 - CMS has developed a CME credit approved web based training course covering the material in it's Roadmap for New Physicians.
May 1, 2012 - The Ethics Resource Center (ERC) published the final version of its report evaluating the effectiveness of the FSGO model for compliance and ethics programs - "The Federal Sentencing Guidelines for Organizations at Twenty Years". This final version incorporates public comments on the draft circulated last November. Those comments and the text of the final report, all 128 pages, are available on the ERC website.
April 24, 2012 - DHHS Inspector General Daniel R. Levinson testified before the Senate Committee on Finance, describing "The Anatomy of a Fraud Bust: From Investigation to Conviction". The IG's testimony includes teh model used by the Medicare "Strike Force" to develop and review cases for prosecution as well as details on an intricate Home Health agency fraud case in Florida.
Beginning April 25, 2012 - The Ethics and Compliance Officers Association (ECOA) will offer "ECOA Law School", a series of professional development webinairs for those in Compliance and Ethics. ECOA has also offerred "Ethics School" and "Business School" in a similar format.
March 2012 - Following a rather public turnover in its senior leadership last year, NPR has published a new Ethics Handbook for the news organization, including a guideline on "Whom To Turn To" with questions. For background and a review of the new handbook by another media source, check out this story. NPR also has a new "Ombudsman" to serve as target for reader commentary about how NPR does reporting the news. A brave fellow indeed.
March 23, 2012 - The Secretary of Health and Human Services delivered a statutorily required report to Congress detailing the first 18 months of implementation of the Medicare Self-Referral Disclosure Protocol (SRDP) which was included in the Affordable Care Act. The SRDP permits healthcare providers and suppliers who identify violations of the Stark Self-Referral prohibitions to "self-disclose" the violation in exchange for two potential benefits - a tolling of the sixty day deadline for returning related "over-payments" from the Medicare program AND a reduction of that liability by exercise of discretion now granted to the Secretary of HHS. According to the report, in its first 18 months the SDRP has received 150 submissions and settled six as of the date of the report. (A seventh has been posted to the CMS website since). Unfortunately, the report does not contain enough detail on those settlements to determine if the participants in the SRDP actually received a significant reduction in their potential liability to the Medicare program.
March 21, 2012 - marked the effective date of a broad series of regulations implementing Title III of the Americans with Disabilities Act, which will apply to "places of public accommodation" and "commercial facilities". Basically, if you run a business that interacts with the public elsewhere than on an aircraft or railroad locomotive, there is something in these regulations that applies to your operations. The Department of Justice has provided illustrations and explanations along with the extensive regulations. Private plaintiffs and enforcement actions will undoubtedly follow. April 21, 2012 - DOJ announced free webinairs on the application of these new requirements to making pools accessible.
March 13, 2012 - Hotline reporting by text message? At least one company, Home Depot, has figured out a way to make it anonymous according to a article coming out this month in Ethikos.
March 9, 2012 - A carrot + a greatly reduced "stick" are the potential rewards for employers participating in the Immigration and Customs Enforcement (ICE)'s voluntary IMAGE "self compliance" program. To become a "member" an employer must agree to create a written policy about checking I-9 related documentation, use the free federal "e-verify" and social security number verification services and undertake several other compliance measures. In return "members" qualify for free training from ICE, receive waivers or minimum penalties if found not in compliance and a two year "free from inspection" period following a confirmation visit. Outreach forums about the program are being scheduled throughout the country in 2012.
March 2, 2012 - A new webpage from the DHHS OIG "Compliance 101" gathers together the various materials it has published to assist those interested in Medicare / Medicaid compliance.
February 24, 2012 - The DHHS OIG released a report of fraud and abuse identification and response activities by contractors in the Medicare Advantage program. Based on self-reported data from the contractors, who are required to have compliance programs focused on potential fraud and abuse, the OIG's analysis makes interesting reading about the effectiveness of mandating effective compliance programs. One contractor identified 78% of all the "incidents" of potential fraud or abuse; three accounted for 95% - that's 3 out of 188 contractors in 2009. Some contractors had proactive auditing measures in place; others relied solely on hotline calls to "identify" fraud and abuse. The numbers get even more interesting on what happened after the incidents were "identified".
February 14, 2012 - The international Institute for Business Ethics (IBE) published a report detailing the experiences of six companies who experienced organizational failures resulting in widespread loss of trust - and what they did about it. "The Recovery of Trust: organizational failures and trust repair" is available for download at the Institute's website.
January 26, 2012 - The Department of Justice filed a Complaint and Settlement with the State of Virginia resolving an investigation under the Americans with Disabilities Act of the state's provision of services to those with intellectual and developmental disabilities. Under the Supreme Court's Olmstead decision such services must be provided in the most integrated appropriate setting - a standard allegedly not being met by Virginia's existing system. As part of its settlement obligations the state agreed to establish an incident reporting system with related protocals, training and "appropriate action" against those who failed to resport and /or take corrective actions. In addition the state will be monitoring 8 specific parameters relating to the quality of its services and if they meet the regulatory requirements. And an "independent reviewer", paid for by the state, will see if it carries through on these undertakings.
January 19, 2012 - The DHHS OIG published "Compliance Program Basics" - a short video covering its view of what makes an effective program. 4 minutes of "must watch" viewing. January 24, 2012 - The next installment in this series, Tips for Implementing an Effective Compliance Program, is worth watching no matter what field you are doing compliance in.
60% of Compliance and Ethics professionals reported that in the last 12 months they have considered leaving their jobs due to job related stress. In any economy, that would a startling finding. A copy of the survey report is available from from HCCA / SCCE.
January 6, 2012 - The Ethics Resource Center published the results of its biennial National Business Ethics Survey showing record high levels of reported retaliation by employers for whistleblowing. The full report is available on the ERC website. You can sign up there as well to participate in a webinair briefing from ERC staff on their findings.
January 5, 2012 - The DHHS OIG continues to publish reports of its "Compliance Reviews" of various providers' Medicare claims. These not only demonstrate the continuing significance of "old" issues like short stays and same day readmissions to acute care hospitals, but also the differences in the compliance approaches of various providers.