Compliance programs should keep a sharp eye on all communications

Every word written or spoken in connection with a health care practice presents the potential for risk. At a Wolters Kluwer webinar entitled, Health Care Communication Risks—From a Compliance Perspective, two presenters pointed out various areas of concern and ways for compliance professionals to approach them. Robert Liles, managing partner at Liles Parker PLLC, and Paul Weidenfeld, chief legal officer of Exclusion Screening LLC, spoke from years of experience on topics such as criminal issues, administrative concerns, employment, and documentation.

Text messages

The presenters noted that smartphones, while convenient, have caused countless compliance issues. Communications as seemingly private and innocuous as a text message present a significant risk, as law enforcement can easily obtain information about texts that a service provider might tell a customer is unavailable. One example offered in the webinar told of a dentist who extracted a tooth from a sedated patient while on a hoverboard, then texted a video of the event to a friend; another example came from an office manager who texted her mother to tell her of pulling two teeth from a sedated patient.

Exam recordings

Many states have one-party consent laws for recording communications, and in such states only the party taping the conversation needs to know that it is being recorded. In these states, a patient might record a physician during an appointment or procedure without obtaining the physician’s permission. Such recordings can be used in malpractice cases, such as a recent case during which a physician made disparaging comments during a colonoscopy, before which a patient had started recording the procedure on his phone. The presenters suggested posting specific policies concerning such recordings, recommending language that prohibits use of recording devices unless specifically permitted by the provider.

Reducing risk

The presenters spoke of the seven elements to an effective compliance program identified by the HHS Office of Inspector General:

  • implementing written policies, procedures, and standards;
  • designating a compliance officer and committee;
  • conducting effective training an education;
  • developing effective communication;
  • enforcing standards;
  • conducting internal audits; and
  • responding promptly to detected offenses and developing corrective action.

One important piece of a program is a compliance hotline to allow employees an opportunity to report compliance issues. Employees should be able to do so anonymously, but also be able to provider his or her name with confidence in the organization’s confidentiality. Employees must be assured that they will not be retaliated against for reporting issues in the organization.