The Third Annual Medical Device Regulatory, Reimbursement and Compliance Congress How to establish a Compliance Program that will Minimize the Impact of.

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Presentation transcript:

The Third Annual Medical Device Regulatory, Reimbursement and Compliance Congress How to establish a Compliance Program that will Minimize the Impact of an Investigation Douglas S. Strang PricewaterhouseCoopers Advisory Services Partner

The Third Annual Medical Device Regulatory, Reimbursement and Compliance Congress Compliance Program Best Practices Seven steps for an effective compliance program as set forth by the Federal Sentencing guidelines – Can your Company pass the Test?? 1. Compliance Program, Standards and Procedures 2. Governance and Accountability 3. Due care in delegating authority and responsibility 4. Communication and Training 5. Monitoring, Auditing, Reporting 6. Consistent Discipline 7. Ongoing Improvement

The Third Annual Medical Device Regulatory, Reimbursement and Compliance Congress The Compliance Program Who should be involved? Executive Management Auditors Third-Party Assessor Internal Audit Division Leaders Employees What should the program contain? Formal Training Formal Business and Ethical Standards Reporting System and Helpline Third-Party Due Diligence Independent Compliance Audits Risk Assessments Internal Controls and Timely Monitoring

The Third Annual Medical Device Regulatory, Reimbursement and Compliance Congress Benefits of an Effective Compliance Program Potential limitation to scope of investigation Increased ability to respond to requests Potential decrease in fines/sentencing Minimization of risks associated with an investigation – Loss of employee time – Additional findings Quickly resolve minor whistleblower issues

The Third Annual Medical Device Regulatory, Reimbursement and Compliance Congress Benefits of an Effective Compliance Program Minimize government scrutiny Potentially reduce the scope of a resulting Corporate Integrity Agreement including the requirements of the Independent Review Organization Preparation for Electronic Discovery is timely and costly

The Third Annual Medical Device Regulatory, Reimbursement and Compliance Congress Monitoring and Auditing “Common Issues” Are you effectively testing international operations consistent with domestic operations? Are you monitoring and auditing all aspects of Health Care Provider Interactions? Is there an integrated approach between your Internal Audit and Compliance Departments? Are Hotline calls being effectively evaluated to ensure adequate follow-up and resolution?

The Third Annual Medical Device Regulatory, Reimbursement and Compliance Congress Effective Training Information on Trends and Hot Topics – Industry’s Compliance Problems – Current Enforcement Trends – Company’s Compliance History » Prior Problems » Complaints » Subpoenas and Inquiries Routine Training events (Min. 1 per year) Discussion of effects on overall business Knowledge of Risks Internally/Externally Includes all employees (Top-Down Approach)