Troutman Pepper’s Miranda Hooker joins the Integrity Through Compliance podcast to discuss her 20 years of experience as a white-collar attorney in the healthcare space, both as corporate defense attorney and as a federal healthcare fraud prosecutor. Together with AMI’s Jim Anliot and Jesse Caplan, she discusses the the growing opportunities, the significant compliance risks, the available compliance guidance (and the limits to that guidance), and how to mitigate the potential for government investigations and enforcement actions. There are huge potential opportunities for healthcare entrepreneurs in 2021, in addition to potential landmines that business leaders trip upon when they aren’t properly prepared. Visit the Affiliated Monitors website for the episode transcript.
Topics discussed:
• How the pandemic has prompted huge opportunity for improvement in innovation and infrastructure of the healthcare system — national efforts at collecting COVID data have demonstrated how much room there is for improvement
• The huge increase in the adoption of telehealth services, and the scope of services which can be delivered remotely; the opportunities to better operationalize these innovations
• How to view healthcare from a more holistic perspective, rather than simply treating one specific condition
• How the future may shift away from the typical “fee for service” payment model in favor of alternative methods, such as value-based care models (which incentevise patient outcomes), accountable care organizations, concierge medicine (which involve a flat yearly fee for a range of services)
• How state licensing boards are adapting to interstate flexibility with the rise in telehealth services
• What entrepreneurial investors and venture capitalists need to know about entering the healthcare industry
• Where fraud and abuse concerns fall among the many considerations of entrepreneurs as they develop products and services
• The conflicting perspectives from which entrepreneurs and regulators view the healthcare marketplace
• Getting quality advice, and learning the regulatory landscape before launching a business, to assess whether the proposed business model will even work
• New DOJ guidance on compliance that reflects their understanding that it’s a constantly evolving landscape, and there is no one size fits all approach
• The importance of having a compliance officer who is visible throughout the company, and who is seen as a resource for making things better, as opposed to a “supercop” enforcer.
• The importance of a training program that involves compliance — not only in terms of the rules, but how the compliance program affects their particular role
• Whistleblower protections: employees need to know that if they report a problem, they will be protected from retaliation
Email podcast@affiliatedmonitors.com with comments or questions.
Engineering, production, and music by Dan Barton
