1. Ethics and Corporate Compliance for Health Care Entities: Any Potential Conflicts of Interest? Alaska Bar Association Health Law Section May 3, 2007 Presented by: Dawn Carman, Alaska Native Tribal Health Consortium Dick Monkman, Sonosky Chambers

2. Today’s Goal  To review duties and loyalties of health lawyers and compliance officers  To discuss potential conflict of interest situations facing health lawyers How do they arise? How do you spot them? How do you work through them?  Q&A

3. Overview  General Counsel as Compliance Officer  Hospital medical staff vs. administration  Compliance Officer reporting to the feds  Health care professional licensure issues  Attorneys on medical ethics committees  How to get ethics advice

4. General Counsel As Compliance Officer  Federal and professional organization guidance  ABA/HCCA professional conduct rules  Shared roles  Distinct roles  GC as CO less common in health care  Conflicts and dual role safeguards

5. Hospital Medical Staff Versus Administration  Nature of administration/medical staff relationship  Medical staff bylaw and rules issues  Policy conflicts  Peer review problems – HCQIA and Robson  Emergency discipline situations

6. Compliance Officer Reporting to the Feds  OIG Provider Self-Disclosure Protocol  Compliance work at most level not privileged  Working under direction of counsel  Privilege and work product  The Thompson Memo waiver  Self disclosure  Disagreement on self disclosure conflict

7. Health Care Professional Licensure Issues  Proper licensure a condition of employment and medical staff membership  Variety of licensing agencies: state, federal, sometimes local  Advising professionals of rights and remedies  Reporting issues  Conflicts arising from disclosures

8. Attorneys on Medical Ethics Committees  Law and ethics similarities/differences  Lawyers on committee  Contribution of legal knowledge  Hospital attorney on committee  Lawyers as medical ethics consultants  Hazards of legalism  Conflict of obligations

9. How to Get Ethics Advice  Alaska RPCs and Ethics Opinions  ABA Model Rules and Opinions  Call your local ethics committee member  Call Bar Counsel

10. Resources  Alaska Rules of Professional Conduct  http://www.state.ak.us/courts/prof.htm http://www.state.ak.us/courts/prof.htm  American Bar Association  http://www.abanet.org/cpr/mrpc/mrpc_toc.html http://www.abanet.org/cpr/mrpc/mrpc_toc.html  American Health Lawyer’s Association  http://www.healthlawyers.org/ http://www.healthlawyers.org/  Health Care Compliance Association  http://www.hcca-info.org/AM/Template.cfm?Section=Home http://www.hcca-info.org/AM/Template.cfm?Section=Home  American Medical Association  http://www.ama- assn.org/apps/pf_new/pf_online?f_n=browse&doc=policyfiles /HnE/E- 9.11.HTM&&s_t=&st_p=&nth=1&prev_pol=policyfiles/HnE/E- 8.21.HTM&nxt_pol=policyfiles/HnE/E-9.01.HTM& http://www.ama- assn.org/apps/pf_new/pf_online?f_n=browse&doc=policyfiles /HnE/E- 9.11.HTM&&s_t=&st_p=&nth=1&prev_pol=policyfiles/HnE/E- 8.21.HTM&nxt_pol=policyfiles/HnE/E-9.01.HTM&