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Medical Technology Use Spurs New C-Suite Titles, Which Bring Opportunity and Risk
September 07, 2016

Medical Technology Use Spurs New C-Suite Titles, Which Bring Opportunity and Risk

The C-suite of the healthcare industry has grown dramatically over the last several years, and has been spurred by legislation that ties reimbursement rates under Medicare and Medicaid to the use of technology in medicine.
As a result of these recent changes in DOJ policy, when a new C-suite manager working to implement an EMR finds out that the company accidentally retained payments, or that the new system employs a questionable coding scheme, he or she must speak up to avoid potential personal liability. This may come as a daunting decision point, as the employee’s livelihood may be put in jeopardy.

These new C-suite employees should know that federal and state law provide robust protections for employees who speak up about reasonable concerns. For example, under the False Claims Act, employees are protected from retaliation if they engage in lawful efforts to stop a violation of the False Claims Act. These protections apply to both internal and external reports of wrongdoing. Another law, the Sarbanes-Oxley Act, protects employees of publicly traded companies, their subsidiaries, and contractors from retaliation. If a company does not address the problems raised internally, the False Claims Act also permits insiders with knowledge of fraud to bring a lawsuit, called a qui tam action, against the company to recover the government’s money. Successful whistleblowers are entitled to a reward of up to thirty percent of the money recovered for the government. 

Take Aways for New C-Suite Managers
  • Seek out training opportunities. Many employers are happy to help pay for education and training for their staff, especially when it enables them to promote from within. Look for opportunities to stay abreast of the newest requirements for Medicare, Medicaid, and Tricare.
     
  • Understand your company’s reporting structure. Know who to contact with problems. If you find a problem, communicate your concern clearly in writing and give your employer an appropriate opportunity to investigate.
     
  • Identify internal resources and other subject matter experts. Find out whom you can go to with questions. Many compliance offices, though intimidating, have an open door policy.
     
  • If you feel that you are experiencing retaliation, or if your employer refuses to fix the problem, talk to a lawyer. Many laws exist to protect employees who report or oppose wrongdoing, even if they are mistaken.


 
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