Columbia/HCA, feds close in on settlement deal
Less than 60 days from ending its sweeping internal investigation of possible fraud and abuse, Nashville, TN-based Columbia/HCA Healthcare Corp. is moving quickly to put in place an effective compliance program. Meanwhile, the company says it won't be ready to negotiate a possible settlement with federal investigators until its own probe is concluded.
Last week, the company installed 200 facility ethics and compliance officers (ECOs) at various of its hospitals around the country. Each ECO attended a two-day training workshop in Nashville, the first of four such workshops to be held throughout February.
"None of [the ECOs] are new people," says Jeff Prescott, a spokesman for Columbia/HCA. "They're people who were at the hospital in some type of leadership role who've been asked to lead the local effort - to keep compliance, ethics and corporate responsibility in the front of people's minds as they go through their local decision making processes every day."
Under the guidance of Alan Yuspeh, senior vice president for ethics, compliance and corporate responsibility, the company's also busy developing a new code of conduct and supporting policies, which company officials expect to be adopted soon by the board of trustees.
Other actions taken include:
w production of a videotaped training program on the code of conduct;
w establishment of a compliance committee of the board of directors and an internal compliance committee;
w development of an enhanced ethics hotline for employees to report ethics and compliance issues.
The development of the chain's corporate compliance program comes within two months of potential settlement talks with federal investigators, Prescott says.
Thomas Frist, MD, Columbia/HCA's chairman and chief executive officer, first announced the possibility of such a settlement on Jan. 13, at a meeting of the Nashville Health Care Council. Talks will only commence, however, following the completion of its internal probe.
Columbia/HCA is keeping details of its own investigation under wraps, saying only that it will examine all hospital assets. "We're looking at a wide variety of issues that we're involved in regarding compliance efforts and legal issues, top to bottom," Prescott says.
Company statements, however, have hinted that the chain is focusing on improving its reporting and reimbursement system and better monitoring of physician transactions. The company has already established a coding compliance program for its laboratories.
Last summer, Columbia hired the accounting firm of Deloitte & Touche and the Los Angeles-based law firm Latham & Watkins to conduct the investigation, which Prescott says will be completed within two months. "At that time, we will feel comfortable approaching the government to begin discussions with a process of their choosing - whatever timeline and whatever process that they choose to start with," Prescott says.
Prescott contends that the internal investigation serves as a necessary prelude to any settlement discussions with the government. "It's going to be 30 or 60 days before we feel comfortable even saying to the government, 'We think we know what we've got here,'" Prescott says. "When the investigation's over, we'll have some idea what we have in the company that we need to work on and what doesn't need to be worked on."
Despite the scope of the investigation, however, don't expect the company to release a lengthy report detailing its findings. "There's not going to be one," he says.
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