(A)
Policy statement
The university of Toledo hospitals,
clinics and its health care science campus and their respective employees,
faculty and students collectively referred to as "UTMC" will cooperate with any
authorized government inquiries and investigations. While doing so, the
organization through its authorized representatives will assert all protections
and privileges afforded by law during any such inquiries and
investigations.
(B)
Purpose of policy
UTMC may receive inquiries for
information or documents from the federal and State agencies "government
investigators" or such government investigators may appear unannounced at
UTMC's facilities or at the homes of present or former employees for purposes
of interviewing and obtaining documents. Accordingly, this policy serves to
establish a mechanism for the orderly response to government investigations to
enable the organization to protect its interest while cooperating with any
government inquiries and investigations.
(C)
Roles and
responsibilities
(1)
Government investigator request for interview
(a)
If approached by
a government investigator, the employee, staff or student should
immediately:
(i)
Obtain the name, title, agency, phone number and address of
the investigator (business card should suffice);
(ii)
Immediately
notify the chief executive officer of UTMC who should then notify the
compliance officer and the office of legal affairs, health science campus or
the director of environmental health and radiation safety, safety and health if
appropriate.
(iii)
Employees should direct the investigator to wait until
a representative arrives as directed by the chief executive officer of
UTMC.
(b)
If a government investigator requests an interview with
an employee, staff or student, such persons in most instances have the right
to:
(i)
Participate in the interview;
(ii)
Refuse to answer
any questions;
(iii)
Request that legal counsel be present before answering
questions;
(iv)
Have the interview conducted during normal business
hours at the organization's offices;
(v)
Stop the
interview at any time;
(vi)
Take notes during the interview; and
(vii)
Retain an
attorney to be present during the interview costs may be borne by the
individual.
(c)
During the interview with a government investigator,
employees, faculty and students should follow the guidelines:
(i)
Tell the
truth;
(ii)
Respond to all questions with statements of fact - do
not speculate or guess or offer opinions. If the person does not recall
something nor has no knowledge of what is being asked, the person should say
so.
(iii)
Answer questions completely, accurately and
concisely.
(iv)
Executive director of UTMC, compliance officer or legal
counsel may be present at any interview.
(2)
Government
search warrant, subpoena, court order or authorized investigative demand
(i)
Employees,
faculty and students are not authorized to provide, send, copy or distribute
UTMC's documents to government investigators without approval through the
appropriate administrative channels.
(ii)
The chief
executive officer of UTMC or the office of legal affairs will conduct
disclosure of documents and other information. This may include payment and
claims information, patient charts, remittance advice, correspondence,
transactional documents, policy and procedures or other requested
documents.
(iii)
Employees, faculty and students must not change, move,
alter or destroy any records, including paper, tape and electronic records that
are the subject of any government investigation.
(iv)
The university's
legal counsel may be present during all government searches.
(v)
Employees,
faculty and students must not obstruct or interfere with any government
searches.
(3)
Scheduled surveys, site visits, occupational safety and
health administration "OSHA" visits, audits by third-party payors, tax audits
and requests for medical records are excluded from this policy.
(D)
Definitions
Government investigator means any
employee of the government who seeks information from the university that is
investigative or criminal in nature.
Federal or state agency means a variety
of agencies may be involved in investigating the university, including: office
of inspector general "OIG", centers for medicare and medicaid services "CMS",
federal bureau of investigations, "FBI", department of defense, United States
attorney general's office, United States department of justice "DOJ", food and
drug administration "FDA", centers for medicare and medicaid "CMS" or Ohio
department of health for CMS or itself "ODH" and state medicaid
agencies.
