Host Jonathan Porter welcomes Brett McNeal and David Traskey to the show to discuss challenges associated with interpreting agency guidance—particularly advisory opinions from the Department of Health and Human Services’ Office of Inspector General (HHS-OIG)—as it relates to regulatory compliance in the healthcare industry. The conversation begins with a review of “first things,” or the short list of fundamentals that figure prominently in the regulatory setting, such as the origination and generation of business and whether federal See more +
Host Jonathan Porter welcomes Brett McNeal and David Traskey to the show to discuss challenges associated with interpreting agency guidance—particularly advisory opinions from the Department of Health and Human Services’ Office of Inspector General (HHS-OIG)—as it relates to regulatory compliance in the healthcare industry. The conversation begins with a review of “first things,” or the short list of fundamentals that figure prominently in the regulatory setting, such as the origination and generation of business and whether federal money is involved in a service or product area.
Advisory opinions often speak to these fundamentals, but the opinions are not always crystal clear. The conversation discusses how HHS-OIG advisory opinions are constructed, the statutory mandates that call them into existence, and the purposes they serve. While the opinions are legally binding on HHS and the parties that request them, their publication (in redacted form) can create issues owing to their highly qualified nature. Advisory opinions sometimes only hint broadly at how healthcare law might apply to any given situation, generating as many questions as they answer.
So how should healthcare providers approach HHS-OIG advisory opinions? The short answer is Very Carefully. Healthcare industry entities should consider their options fully prior to requesting advisory opinions and think through why it is they want the opinion and what the implications of the opinion could be. Jonathan, Brett, and David impart some practical tips on how to lead that conversation and analysis, offer thoughts on how the regulatory framework could be improved, and predict where healthcare fraud and abuse regulation could be heading. See less -
