OIG work plan zeroes in an integrity agreements

While the FY 2000 Work Plan put out by the Department of Health and Human Services' Office of Inspector General (OIG) is typically viewed as a blueprint for developing compliance plans, it may actually have more value as a tool to structure corporate integrity agreements (CIA), say several experts in this area.

Relying too heavily on the OIG's Work Plan while developing a compliance program is like driving down the street looking in your rear view mirror, warns Chris Idecker, a partner with Ernst & Young in Atlanta. "The place I do use these work plans quite a bit is in corporate integrity agreements."

Howard Pearl, a health care attorney with Winston & Strawn in Chicago, IL, points out that the Work Plan itself emphasizes the importance of those agreements. "The thing that jumped out at me was the emphasis on corporate integrity agreements," he says. "The OIG has spent the last several years drafting, and negotiating agreements and now we are entering what I would call Phase II."

According to Pearl, Phase II will increasingly require the OIG to shift its emphasis to monitoring agreements already in place. "The critical years are the second and third and a lot of people are coming up on those," he warns. "That is when your process starts uncovering all your problems, and the government knows that.

"The new wrinkle they have started this year, and that I believe based on the Work Plan will continue into the future are site visits," he adds. "I have done one and I think that is the immediate concern for health care providers who are subject to these agreements.

"This is something they really are intent on focusing on," Pearl contends, "and because it is new, nobody has any idea what it entails."

Idecker takes a similar position. "The big danger is that these agreements are written so poorly that is it difficult to comply with them and difficult to monitor them," he says. "There is a lot of risk to companies under these agreements and a lot of misunderstandings between providers, the accounting community, and the OIG as to how these things ought to be handled."

An upcoming issue of Compliance Hotline will offer advice on how to minimize the risks posed by CIAs.