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New OIG Guidance Offers Deep Dive Into Compliance Issues

Following up on DOJ’s recent memo on “Evaluation of Corporate Compliance Programs,” the Office of Inspector General at the U.S. Department of Health and Human Services released its own compliance program evaluation memo last week. In “Measuring Compliance Program Effectiveness: A Resource Guide,” HHS-OIG offers its own framework for the types of inquiries it will make in the context of an investigation. The guide tracks the Detailed Content Outline in the handbook for those seeking certifications in healthcare compliance and covers seven compliance topics:

  • Standards, Policies, and Procedures

  • Compliance Program Administrations

  • Screening and Evaluation of Employees, Physicians, Vendors, and Other Agents

  • Communication, Education, and Training on Compliance Issues

  • Monitoring, Auditing, and Internal Reporting Systems

  • Discipline for Non-Compliance

  • Investigations and Remedial Measures

While the DOJ guidance set forth 115 “Sample Topics and Questions” in its framework, the HHS-OIG guidance covers a larger number of “compliance program metrics”: more than 400 in all. Within these 400 metrics are over 700 different action items and questions that offer significant insight into HHS-OIG’s evaluation process for compliance programs. Many of these metrics delve into the minutiae of compliance-related issues – for example, one evaluates whether an organization’s policies and procedures are understandable at a tenth grade reading level under the Flesch-Kincaid readability measures. While many of these metrics may at first appear duplicative, multiple references to a single issue instead encourage an examination of that issue from different perspectives. Like the DOJ guidance, though, the HHS-OIG resource guide explicitly recognizes that “one size truly not does fit all,” and notes that how much of the guidance will be relevant to a company’s compliance efforts is dependent on the company’s risk areas, size, resources, and industry. 

As corporate compliance issues have increasingly come into focus, it is hard to know where to look for true relevance among the many volumes of guidance and other information being generated. A great majority of the information contained in this resource guide transcends healthcare concerns, though, and would be relevant to the compliance efforts of many non-healthcare organizations. As such, the HHS-OIG resource guide is a great companion piece to the DOJ memo and contains much more detailed information that companies can use in creating, strengthening, or refining their compliance programs.

Copyright © 2022 Womble Bond Dickinson (US) LLP All Rights Reserved.National Law Review, Volume VII, Number 94
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About this Author

Ripley Rand Womble Bond Dickinson Law Firm Criminal Defense Attorney
Partner

Ripley Rand brings more than twenty years of federal and state courtroom experience to Womble Carlyle’s White Collar Criminal Defense Team. His practice focuses on white collar criminal defense, health care fraud defense, internal investigations, and regulatory enforcement.

In 2010, Ripley was nominated by President Barack Obama to serve as the United States Attorney for the Middle District of North Carolina. After being unanimously confirmed by the United States Senate, Ripley was the United States Attorney...

919-755-8125
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