Yesterday, the Office of Inspector General (“OIG”) published its Compliance 101 website. The website synthesizes OIG resources and offers the OIG’s perspective on a variety of compliance issues. Compliance 101 also offers compliance education materials for Boards of Directors for health care organizations (“Boards”), including a video in which Lou Morris, Chief Counsel to the Inspector General, outlines the role of Boards in overseeing quality and compliance in health care organizations.  

According to the OIG, a health care organization’s corporate culture should focus on two goals: (1) promote quality of care and (2) embrace compliance with the law.

The OIG provides the following six suggestions for Boards to promote quality of care:

1. Create a comprehensive policy and objectives to define your organization’s quality improvement and patient safety program, ensure stakeholders share a common goal of quality, and incorporate objectives into performance evaluations and incentive compensation;
2. Establish a Board quality committee and make quality of care a standing agenda item;
3. Ensure you have sufficient clinical expertise on the Board;
4. Understand medical staff credentialing and stay current on best practices;
5. Implement a conflict of interest policy to identify and manage financial interests that may influence clinical judgment; and
6. Use dashboards and benchmarks to measure improved outcomes and patient satisfaction and compare your organization to your peers.

The OIG provides the following six suggestions to enhance Board oversight:

1. Ask questions that assess the effectiveness of your compliance program;
2. Protect the compliance officer’s independence by separating this role from legal counsel and senior management. All decisions effecting the compliance officer’s employment or limiting the scope of the compliance program should require prior Board approval;
3. Learn how quality, patient safety, and compliance information flows to the Board;
4. Ensure your organization can validate the accuracy of quality data. The Board should understand that federal program reimbursement is tied to quality of care – concealing unfavorable information and failing to investigate sufficient inconsistencies undercuts quality improvement and can lead to civil and criminal liability;
5. Personal appearances by Board members at staff meetings demonstrate a top-down commitment to quality and compliance and provides time to talk to employees about the culture of compliance; and
6. Perform regular self-assessments of the Board, including an evaluation of the composition of compliance and quality committees and the Board’s response to systemic failures and lapses in patient care.