The Art of Compliance
In December 2018, Dr. Christopher Duntsch lost his appeal and the court upheld his life sentence. The name may not sound familiar, but to the medical community in Dallas, Texas, Christopher Duntsch represents what happens when every part of the medical regulatory system fails to protect patients. Christopher Duntsch was given the nickname “Dr. Death” in November 2016 when the DMagazine ran a cover story on him and his victims. In 2018, Wondery produced a six-part podcast series named “Dr. Death” detailing Duntsch’s educational and medical history and the acts that led him to incarceration.
In September 2018, the Food and Drug Administration (“FDA”) announced a new policy that provides for the release of a list of retailers that have received a food subject to recall. In the past, the FDA did not release such information because the agency deemed it confidential commercial information. The lack of information on the part of the FDA has been a huge detriment to the public. Prior to the new guidance, the public would only find out information about the particular food that was being recalled, not where this recalled food was available for purchase. The public was told just to stop purchasing that recalled food, whether it be romaine lettuce or beef, even if there were retailers who were selling non-contaminated products. This procedure not only hurts the public but also has a huge financial effect on those retailers who are not selling contaminated or recalled products. The FDA has effectuated a new guidance because they have found that such information is necessary to enforce a recall and to ensure public safety.
Cheryl Miller is the Director of Risk, Compliance and Legal – and Chief Compliance Officer for Presbyterian Homes, a Life Plan Community (formerly branded as a Continuing Care Retirement Community (CCRC)) in Skokie, Illinois. Ms. Miller worked as a corporate paralegal for several years before and during law school, first at a large law firm and then at Brookdale Senior Living. She moved into healthcare regulatory work, and from there learned about the Health Care Compliance Institute and went to the annual meeting. “The preciseness of Stark and Anti-Kickback and the other multitude of regulations enthralled me. I was on-site at a client (Presbyterian Homes) two days per week providing risk management services. I asked about their compliance program and gave (what I thought was) constructive criticism. A year or so later, Presbyterian Homes hired me away from the firm.” Ms. Miller was recently invited by Professor Larry Singer to speak to his Health Care Business and Finance class about the Long-Term Care industry. Her discussion enlightened many of the students and inspired enrollment in Loyola’s Long-Term Care course. The following is an interview that highlights her insight and experiences about her work in an often-overlooked area of healthcare.
Most major American corporations develop and implement an ethics and compliance (E&C) program. However, too often, the ethics division of these programs falls to the wayside, with companies putting more focus on legal compliance rather than creating an ethical corporate culture. While it is true that compliance can technically function without an ethics component, a robust ethics program can be an extremely efficient way for a company to promote legal compliance, as well as consumer trust and loyalty.
The Mental Health Parity and Addiction Equity Act (“the Parity Act”) is a federal civil rights and consumer protection law. The Parity Act prohibits most public and private insurance plans from imposing more restrictive standards on mental health (“MH”) and substance use disorder (“SUD”) benefits than they impose on similar medical/surgical benefits. However, ten years since its passage, states have failed to appropriately enforce the Parity Act.
Earlier this year, Bitcoin, and cryptocurrencies writ large, occupied many financial headlines as onlookers began to divert their attention to the “unexplained” rise, and subsequent fall in the price of one the more popular (and maiden) cryptocurrencies: Bitcoin. Naturally, because many of the onlookers didn’t realize what Bitcoin was (or is), the media took lead on the story. Earlier this month, Bitcoin began to make its appearance in headlines, once again.
Since the enactment of the Affordable Care Act, hospitals have faced strict and substantial regulations regarding the provision of financial assistance to patients in the form of “charity care.” An essential element in a hospital’s ability to maintain tax-exempt status and financial solvency, charity care has worked to serve uninsured and indigent patients while helping charitable hospitals serve their mission and retain the benefits that come with it. The state of Pennsylvania recently passed legislation requiring more explicit and affirmative acts to provide charity care to more eligible patients. The change is unprecedented, and other states look to be slowly responding in their own ways. Compliance with these changes is most beneficial with proactive measures and risk assessments even before change comes through the doors.
Ted Banks is a partner at the firm Scharf Banks Marmor and is also an adjunct professor at Loyola University Chicago School of Law, where he teaches a course on corporate compliance. At Scharf Banks Marmor, Mr. Banks concentrates his practice on compliance, antitrust, food law, and other corporate issues. He entered compliance by accident many years ago, and has been an innovator in the field ever since. Mr. Banks has been recognized as an Illinois “Super Lawyer” in the areas of corporate governance and compliance, and he has also been named a Risk & Compliance Trailblazer and Pioneer by the National Law Journal. Here, he has shared his story, tells us the real deal about compliance, and gives advice to students who wish to make compliance their career.
Ryan Meade Editor-in-Chief Director, Regulatory Compliance Studies at Loyola University Chicago School of Law The academic year for 2018-2019 has kicked off at the Center for Compliance Studies. It promises to be a big year with even more robust blog activity planned, a symposium in February 2019 that will be one of the first academic looks …
Modern business thinking has come to accept that reputation is as important as financials. As investors look for companies that demonstrate this understanding, compliance professionals are in a unique position to make their companies more appealing.