Office of Inspector General Governance Guidance

On April 20, the Department of Health and Human Services Office of Inspector General (OIG), in conjunction with the Association of Healthcare Internal Auditors, American Healthcare Association and Health Care Compliance Association, issued new compliance guidance for health care organization governing boards. The new publication is titled, “Practical Guidance for Health Care Governing Boards on Compliance Oversight.” According to the publication, “it is intended as guidance and should not be interpreted as setting any particular standards of conduct.” Centered on compliance oversight, the publication gives examples of how Boards can better foster a corporate culture of compliance to meet the ultimate goals of protecting the integrity and viability of the nation's health care delivery system. In particular, the publication provides an overview of the interrelationship and reporting roles of audit, compliance and legal functions in a health care organization.

This recent guidance is yet another wake up call to Boards that the buck stops at the Board. The guidance is helpful to define the Board’s role in compliance and responsibilities. The guidance concludes that a health care governing Board should make efforts to increase its knowledge of relevant and emerging regulatory risks, the role and functioning of the organization’s compliance program in the face of those risks and the flow and elevation of reporting of potential issues and problems to senior management, and where appropriate, to the Board directly. Adherence to compliance starts at the top, the Board, and must be weaved into the culture of the organization. Even in those situations where there is a breach in compliance and the OIG and the Department of Justice do not hold any Board members personally accountable, the press and local community stakeholders very likely will. The Guidance, if followed, will help to insulate the organization and Board members against potential liability and will foster public confidence in the service-community by demonstrating that the Board and management are doing their best to protect the organization’s assets from potential abuse.

The guidance can be found here.