Ober, Kaler, Grimes & Shriver, A Professional Corporation  
Ober|Kaler Health Law Alert - Fall/Winter 2003




In this Issue

From the Chair

Welcome

Guide to Terms

Ober|Kaler in Print

OIG Activity
Contractual Joint Ventures Scrutinized Anew

OIG Tackles Discount Issues

Beware of Misuse of "Medicare" in Marketing Practices

OIG States Position on DME Telemarketing

OIG Advisory Opinions

CMS Developments
Final Outlier Rule to Curb Abuses

Proposed Medicare Enrollment Rule

Group Therapy: Seeing Through the Murky Water?

Long Term Care
Security Issues for Long Term Care Providers

Pharma
NPIA Exempts Resales to Hospital Workers

Compliance
Compliance Guidance for Pharmaceutical Manufacturers

Boards' Role in Compliance Clarified

Privacy
Final HIPAA Security Standards

Reimbursement
Earlier Wage Index Deadlines in Place

Provider-based Rules Take Effect

FCA
"Person" Under FCA Varies - Even in Same Case

Contractual Remedy Precludes FCA Liability

Courts Interpret "Public Disclosure" Bar of Qui Tam Suits

Litigation
Hospital Pleads Guilty After Ignoring Fraud

"Lick and Stick" Allegations Yield Nation's Largest Medicaid Fraud Settlements

 

Boards' Role in Compliance Clarified

Michele Vicente, Paralegal

In a collaborative effort designed to help health care organization boards of directors exercise their oversight responsibilities, the OIG and American Health Lawyers Association have issued a Corporate Responsibility and Corporate Compliance Resource that offers a series of "knowledgeable and appropriate" questions directors should be asking of management with respect to their organization's compliance efforts. Periodic consideration of these questions by directors, according to the Resource, will help the board establish and follow a "reasonable compliance oversight process."

Health care compliance experts view the Resource as a tool that compliance officers can use as a platform for communicating with their boards about the function of the compliance program. Panelists discussing the Resource during a teleconference sponsored by the Health Care Compliance Association note that, by opening lines of communication between boards and compliance officers, the Resource allows compliance officers to educate directors about the compliance process and to manage their expectations regarding the compliance program.

The 18 recommended questions are divided into two categories: (1) questions directed at the compliance program's structure that should help the board understand the scope of the organization's compliance program and (2) questions directed at the operation of the compliance program that should give the board some understanding of the effectiveness of the compliance program.

Like compliance programs themselves, asking the questions suggested by the Resource is not mandatory and does not provide any guarantees that problems will not arise. Following the guidance offered by the Resource, however, will demonstrate that the board has made a good faith effort to fulfill its compliance oversight responsibilities.

Copyright© 2003, Ober, Kaler, Grimes & Shriver