Create 'open culture' to address employee complaints

YARMOUTH, Maine - Healthcare attorney Elizabeth Hogue says she's mystified that whistleblower claims filed by employees or former employees aren't met with more skepticism by law enforcers.

“They feel that if an insider says it, it must be true,” said Hogue. “It seems to me there are plenty of disgruntled insiders or insiders who don't have all the information.”

Traditionally, whistleblower claims are based on false or lack of documentation, kickbacks, and other issues, but attorneys say they are seeing more claims based on marketing practices, including a recent filing against Lincare subsidiary Diabetic Experts.

It's critical to have an internal compliance plan that requires employees to bring any concerns to management first, attorneys say.

“It's not necessarily going to stop everybody, but it creates a culture which says, 'If you've got a problem, come to us first,'” said Hogue. “We'll either identify and fix the problem or explain to you what you didn't understand.”

At the heart of a good compliance program: a compliance officer that is respected and trusted by employees.

“Employees need to feel comfortable bringing concerns to that person and knowing they will be treated with the utmost seriousness,” said Hogue.

The company should spell out very clearly in employee handbooks and policies and procedures that retaliation is not allowed and that there is a process in place for documenting a potential problem and for investigating that problem, she said.

“That brings some assurance to employees that their complaints will be investigated carefully—even if they later discover there isn't an actual problem,” said Hogue.

One thing Hogue cautions against, however, is inserting anonymity into the complaints process.

“In my experience, you'll get an anonymous report and there's not enough information to follow up, or the complaint has nothing to do with fraud and abuse compliance,” she said. “I don't recommend anonymous hotlines or anything like that. What we're after is an open culture.”