Corporate Compliance

Tip: Help decrease the odds of a whistleblower suit

Compliance Monitor, December 22, 2004

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More than 75% of successful whistleblower actions in 2003 came from healthcare. According to the U.S. Department of Justice, federal officials recouped $2.1 billion in claims in 2003 under the False Claims Act. Of that total, $1.7 billion came from healthcare-up from $500 million in 1999.

Minimizing the odds of whistleblower suits begins with your organization's culture of compliance, said Britt Crewse, chief compliance officer for the Duke University Health System in Durham, NC.

Crewse spoke during the Health Care Compliance Association and American Health Lawyers Association's Fraud & Compliance Forum in Baltimore in September.

Creating a good climate starts with a code of conduct that includes a clear policy of nonretaliation. Crewse also recommends writing a must-report rule for employees who witness wrongdoing. "Put the burden on your employees," he said. "You have a compliance officer, a legal staff . . . You need to have a couple thousand other compliance officers . . . the entire staff."

Many organizations try to protect themselves against whistleblowers by creating an open-door environment that encourages employees to report wrongdoing, but to do so is harder than it looks. Determine whether your organization is taking the following steps to meet its stated policy:

  • Involve the compliance officer in staff meetings and public relations efforts, and ask him or her to reiterate your nonretaliation and self-reporting policies. As a result, employees will begin to know and trust the compliance officer
  • Act quickly on possible actions. When concerns come up, initiate a review and make an effort to resolve and alleviate them-don't let things sit on your desk
  • Facilitate communication between the compliance officer and the rest of the staff by publishing a newsletter outlining current compliance efforts as well as reiterating nonretaliation policies
  • Set up a hotline or e-mail address to which people can report wrongdoing
  • Show compassion by sitting down with frustrated employees, listening to their concerns, investigating their complaints (if it's a long investigation, keep the employee updated on your progress), and explaining your findings. These actions will go a long way toward making potential whistleblowers feel as though the problems they see are getting attention
  • Educate employees in billing, collection, and coding departments on compliance hot spots



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