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Corruption enforcement actions target foreign doctors and hospital employees
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part of device but are required for successful
implantation of device Will that reimbursement
reasonable enough to cover the direct
and indirect costs involved in the surgery
and hospitalization Will this give rise to
charge compression Questions like this will
continue to daunt the service providers until
CMS provides further clarification on the
“Medicare cost report”.
On April 14, the Centers for Medicare &
Medicaid Services (CMS) released its fiscal
year (FY) 2009 proposed rule for the hospital
inpatient prospective payment system (PPS).
Comments are due June 13. A final rule will
be released by August 1, and changes will take
effect October 1. The FY 2009 IPPS rule may
hold the key to some of our questions. n
The information presented here express the views
of the author and not necessarily the Institution’s.
policy against such payments and have not
made any. Additionally, companies should
consider whether agents, distributors, dealers,
and other third-parties who are engaged in
connection with the company’s business operations
should be required to certify in writing
that they will not engage in corrupt activity.
Third, companies should assess the adequacy of
their internal monitoring programs to ensure
that sufficient resources are dedicated to the
implementation and enforcement of the companies’
FCPA policies. As with all compliance
efforts, careful documentation is important,
because it will evidence the company’s commitment
to anti-corruption efforts in the event
a violation does occur and an investigation by
the DoJ or SEC is undertaken.
Fourth, when a potential violation is uncovered,
the company should conduct a prompt,
thorough investigation of relevant facts and
examine whether the problem is isolated or
systemic. As the investigation proceeds, management
should consider whether compliance policies
or practices need modification in light of
what is uncovered, and should determine, with
the assistance of counsel, whether it is appropriate
to disclose the results of the investigation to
the DoJ and SEC.
Even the very best anti-corruption policies
and practices cannot always prevent rogue
employees from violating the law. Nonetheless,
health care companies should recognize
that a little advanced effort in anti-corruption
compliance can go a long way in minimizing
the risk of violation, and detecting and
containing such violations if they occur. All of
these are important factors when enforcement
agencies consider a companies’ culpability for
the conduct of its employees. n
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October 2008