JR - Health Care Compliance Association

CONDUCTING A COMPLIANCE INTERVIEW...continued from page 17
interruption on the chance that the
interviewer is not “clicking” with the
interviewee intellectually. In such circumstances,
letting the interviewee talk
offers a greater chance for facts to spill
out. While this can make interviewing
tedious, the interviewer might obtain
facts he or she would never have
obtained if the interview was presumptively
cut short.
12. Reassure the interviewee that
“it’s OK” if he or she doesn’t remember
Memories are not perfect. Sometimes a
person’s memory needs time to “brew.”
A day after the interview a person
might recall with great clarity a fact that
was completely lost or buried the day
before. Encourage interviewees to call
the interviewer if there are facts that
need correcting or a discovery of a new,
relevant fact. Reassure an interviewee at
the end of the interview that if he or
she remembers anything else, you are
available to talk–and assure the person
that it is OK if he or she needs to clarify
or correct something said during the
interview
13. Plan plenty of time for an interview–they
are almost always longer
than you expect
Often times interviews do not go as
planned. A new fact is frequently identified
or an issue is raised which takes
the investigation in an unexpected
direction. Within reason, time must be
allotted to go where the interview goes.
This author’s experience is that an issue
that begins an investigation rarely looks
the same by the end of the investigation.
14. If interviews identify an important
meeting, interview everyone at the
meeting
Meetings which are at the center of
events should be investigated thoroughly,
including interviewing everyone at
the meeting. You can be sure that the
government will investigate a critical
meeting thoroughly, and so should you.
Even if a person would not seem on the
surface to hold any key information, go
through the process of interviewing him
or her on the events of the meeting.
15. End all interviews by asking the
interviewee if there is anything else
he or she wants to relay to you or any
other compliance he or she wants to
talk about
If the interviewee answers with an
answer of “I don’t know anything else,”
then this puts the person on record as
having told the interviewer everything
he or she knows about a particular issue
as well as not knowing of any other
compliance problem. This is important
not only to be sure that nothing else is
lurking which the interviewer should
know about but if there is something
which is later revealed that the interviewee
knew but did not disclose, then
compliance personnel are insulated
from accusations of lack of thoroughness
or cover-up. Of course it is not
uncommon for an interviewee to supply
the interviewer with another wholly
different compliance issue. ■
FOR
CA and
LA County
to pay $73
million to U.S.
for overbilling Medicaid program
On June 20, the U.S. Department of
Justice announced that the State of
California and the County of Los
Angles will pay the federal government
$73.3 million to settle allegations that
they violated the False Claims Act with
August 2002
18
YOUR INFO
respect to claims submitted to
Medicaid.
This settlement resolves allegations that
the state and the county directly or indirectly
billed the federal health care program
for services provided to certain
minors when these jurisdictions had no
basis for concluding that these individuals
financially qualified for Medicaid
services. The services included drug and
alcohol abuse, pregnancy and pregnancyrelated
services, family planning, sexual
assault treatment, sexually transmitted
diseases, and mental health services.
The Whistleblower, Singh Khalsa, an
employee of the LA Department of
Mental Health, will receive approximately
$1.36 million of the total recovery
as his statutory award. For more;
http://www.usdoj.gov/opa/pr/2002/June/
02_civ_364.htm ■