One on one
Levinson talks Stark law, big data
Editor’s note: Daniel Levinson, HHS’ inspector general, sat down with Modern Healthcare reporter Joe Carlson for an exclusive interview last week after Levinson addressed thousands of compliance officers at the Health Care Compliance Association’s annual Compliance Institute in Las Vegas. The questions and answers have been edited for clarity and space.
Modern Healthcare: One of the things I hear a lot from providers is that the Stark law is simply too complicated.
Levinson: Unfortunately, I’m not in charge of deciding what the law should be when it comes to healthcare compliance. We have an array of statutes of which Stark is a very important part. And our job in the IG’S office is to enforce all the laws that we are empowered to enforce.
Modern Healthcare: So you’re enforcing the law as it is, you’re not making the law.
Levinson: That’s the job of the inspector general’s office when it comes to not only the Stark law, the False Claims Act, all the five laws I mentioned (the anti-kickback statute, the civil monetary penalties law and the exclusions statute). We take our obligation, our responsibility that is given to us by lawmakers, very seriously, and we enforce those laws aggressively but fairly.
Modern Healthcare: Is the Stark law too punitive? Does it penalize things that are sort of minor, in a major way?
Levinson: You know, I understand the reasons for the Stark law, and we enforce that law as it is, in a way that we try to do justice to what was intended by it.
Modern Healthcare: Any thoughts on the CMS’ efforts to use big data, as you said before, and digital tools, data-mining?
Levinson: Those efforts are still being rolled out, if I understand the posture of where those things are right now. We need to look at whether the hoped-for results are happening. I think we’re in the process of evaluating the CMS’ efforts.
Modern Healthcare: Hard to say One PI (a project integrating claims data across Medicaid and all parts of Medicare) hasn’t had some time to come into being.
Levinson: Yeah, well, things invariably take longer than we would like to see them happen. We really don’t tend to comment on where things are when it comes to technological developments. And I don’t think that we’ve actually issued any reports on that.
Spokeswoman Roberta Baskin: No, it’s not something you want to talk about because of your role in terms of oversight of it down the road. But there’s been a lot that has been done in terms of data-mining and data-analysis in the OIG enforcement efforts.
Levinson: To a certain degree, I think the successes we’ve had on being able to get real-time data on some of the Strike Force cases we’ve been dealing with is because the CMS has been able to supply it. This data isn’t ours. This data, in terms of government ownership, is by and large the CMS’. To a certain degree, you can say that what CMS is doing is allowing us to do in many cases the kind of job in protecting the programs that in the past we weren’t in a position to do.
Deputy Inspector General Larry Goldberg: And one issue, of course, is it does not now include Medicaid data, largely since that would come from each particular state. So the goal is for it to become more comprehensive.
Modern Healthcare: I was interested in your idea, the thing you mentioned before about deputizing compliance officers. Could you talk a little bit more about that, about how you think a compliance officer should be viewed or you hope they could be viewed in an organization?
Levinson: Yeah, the purpose was to underscore the value that we place on corporate compliance officers and the importance that they should be viewed as having within their organization. The kind of chatter that exists around conferences like that is corporate compliance officers do not get the kind of hearing, at least in some venues, that they should have in order for their message to be effective. It’s unfortunate not only for them and for their provider, but for our programs.
When I hear about the kinds of stress levels induced (on) compliance officers who feel like they aren’t being listened to, I think that is a cause for concern. And I think it is an important message to send to compliance officers in the community that I view their role as very, very important. And their role should be viewed as very important within their organization.
Modern Healthcare: The CMS just released their proposed regulations for the 60-day repayment rule. Is that something where you are communicating with them? And do you have any thoughts on that rule and how it works? And if your office would be involved with it as well?
Levinson: I’m not talking at the moment to the CMS about it, but then again, I personally don’t often have occasion to be able to do that in the course of these things.
Modern Healthcare: You wouldn’t be able to offer an opinion on the 60-day repayment rule?
Levinson: I wouldn’t now, no.
Modern Healthcare: Anything else you think is important to bring out?
Levinson: I think the fact that we have 2,700 people attending this conference is a positive indication that the world of compliance is getting bigger. And from the informal conversations I have had, is getting more sophisticated. It is drawing more impressive talent, as the stakes get larger and more people are understanding that where we are headed with coordinated care and this emphasis on quality means a larger and more strategic role that compliance officials might play in the futures of their organizations.