Compliance in Wartime

I am convinced that the Covid-19 pandemic is nature’s war against humankind, and a 120-nanometer virus is the enemy footsoldier. For context, a nanometer is a billionth of a meter, and a hydrogen atom is .1 nanometer across. As I write this, we are about a month into the declared national emergency, there are mandatory lockdowns practically everywhere, and the pandemic is expected to peak within weeks.

As a longtime healthcare compliance professional, this war has brought me perspective and reminds me that, even now, my discipline has its place and role. First, to help our organizations and clients serve patients at this time of crucial need. Second, to provide insight and reassurance to our organizations and clients (read “help steady the steering wheel”) through this storm.

A few more thoughts also come to mind:

• The government has and is deploying, at previously unimaginable speed and scale, financial and physical resources to confront and contain our foe. These include changes, at least for now, to the Stark and HIPAA laws, and the CMS fee schedules.

• Times of panic and despair sometimes cloud otherwise good judgment, especially around ethics and integrity. In the worst cases, ethical and integrity values are lost altogether.

• Remember, the False Claims Act, the government’s nearly 160-year-old primary healthcare fraud enforcement tool, was created during the Civil War, when unscrupulous military contractors were cheating the Union by selling worthless munitions.

• Mistakes and misdeeds, by the well and not-so-well intended, will inevitably occur.

To be clear, this unprecedented moment has found many heroes, whose selfless actions humble us all. Starting with our frontline essential providers, rushing into the brink of the unknown to care for frightened, traumatized patients, at great risk to themselves and their families. We will never be able to thank them enough. Our healthcare leaders, who have agilely guided their institutions, even as they sometimes lack the facilities and resources to deliver care as they normally would. Government leaders, whose swift response, coordinated across partisan lines, deployed almost limitless resources to address immediate needs and stabilize the economy. Science leaders, who are working tirelessly to quickly develop desperately needed therapeutic drugs, antibody tests and, hopefully soon, a vaccine. The list goes on.

There are other positives. Actions only recently considered experimental and therefore unlikely to ever be pursued on a large scale, are now happening out of necessity. Teleworking across nearly all industries. Telehealth services being delivered nationally. Advanced practice nurses working independently and at a broad scope nationally. Non-medical spaces, like hotels and dormitories, being used as care facilities. Learning will undoubtedly come from these efforts, stretching the realm of what was previously thought to be viable or even possible. We will forever be changed for the better.

But then, there are also those who see this time as a moment of opportunity, launching lab test, drug and charity scams targeting the most vulnerable. Government has swiftly responded, putting out advisory bulletins and assembling task forces. It has long been said that the first casualty of war is truth. If that is so then the second casualty is ethics and integrity.

Thankfully, we recognize that this storm too shall pass. Yes, we are still sheltering in place, isolated, frightened, and waiting for cases to peak. But a brighter time is coming. The promised antibody tests are almost here. They will tell us much about asymptomatic spread and immunity. Seventy prospective vaccines are currently in clinical trials. At least one of them is bound to work.

Just how the future will look is not entirely clear. Will handshakes be a thing of the past, like Victorian bows? Will wearing masks become a new social norm? Will healthcare fraud, waste and abuse enforcement actions surge? Only time will tell. Whatever happens, I take solace in knowing that my discipline and fellow compliance professionals will rise to the task, as they always have and always will. Until we meet again, stay safe, friends!

Reid Pearlman, JD, CCEP is Principal/Consultant of True Compliance Consulting, LLC. He may be reached with questions or comments at Reid@MyComplianceOfficer.net.