Health Law Monitor

OIG and Industry Leaders Release New Compliance Guidance for Health Care Boards

May 5, 2015

By: Rachel D. Ludwig

On April 20, 2015, the U.S. Department of Health and Human Services Office of Inspector General (“OIG”), in collaboration with the American Health Lawyers Association (“AHLA”), the Association of Healthcare Internal Auditors (“AHIA”) and the Health Care Compliance Association (“HCCA”) released new compliance guidance for health care boards entitled “Practical Guidance for Health Care Governing Boards on Compliance Oversight.” The new resource provides practical tips for boards as they oversee their organization’s efforts to comply with state and federal laws that regulate the health care industry.  The new guidance will also assist internal auditors, lawyers, and compliance officers that report to health care boards. 

The document, which builds upon guidance published by the OIG and AHLA in 2003, 2004, and 2007, addresses: 1) the roles of and relationships between the organization’s compliance, audit, and legal departments; 2) regular reporting to the board about the organization’s risk mitigation and compliance efforts by various members of management in key leadership roles; 3) appropriate identification and auditing of potential risk areas in a rapidly evolving health care environment; and 4) methods to encourage accountability and foster a culture of compliance throughout the entire organization.  The document also includes assorted tools and tips that boards overseeing health care organizations of varying size and resources should consider implementing.  These specifically identified tools and tips may serve as a new standard that the OIG will rely on to hold board members accountable in the event of a compliance problem at the organization.  Boards should carefully review the new guidance and consider what changes, if any, are necessary, with the understanding that the OIG clearly expects boards to undertake an active role in overseeing the organization’s compliance program functions. 

This article was authored by Rachel D. Ludwig, Jackson Kelly PLLC. For more information on the author, see here.