Optional_2023 Board Resources

EXECUTIVE SUMMARY OF BANNER HEALTH’S CORPORATE INTEGRITY AGREEMENT

Introduction (Preamble) On April 10, 2018, Banner Health (Banner) entered into an agreement with the Department of Justice (DOJ) to settle allegations that short-stay patients were incorrectly admitted as inpatients rather than being treated as outpatients. Banner then executed a Corporate Integrity Agreement (CIA) with the Department of Health and Human Services Office of Inspector General (OIG). The Effective Date of the CIA is April 9, 2018. Term of the CIA Banner is obligated to comply with the terms of the CIA for a period of five years. Banner must maintain for inspection all documents and records relating to reimbursement from Federal health care programs and compliance with this CIA for six years (or longer if otherwise required by law) from the Effective Date. Scope of the CIA The CIA requires Banner to maintain and, in some cases, expand its existing Compliance Program, which applies to Banner in its entirety. The CIA defines Covered Persons to include (1) all owners who are natural persons, officers, directors, and employees of Banner; (2) all contractors, subcontractors, agents, and other persons who furnish patient care items or services or who perform billing or coding functions on behalf of Banner, excluding vendors whose sole connection with Banner is selling or otherwise providing medical supplies or equipment to Banner; and (3) all physicians and other non-physician practitioners who are members of Banner’s active medical staff at the Covered Facilities. Since the CIA is the result of a short-stay investigation at certain specific hospitals (Covered Facilities), some provisions only apply to those Covered Facilities. The 12 Covered Facilities are Banner Baywood Medical Center (Mesa, AZ), Banner Heart Hospital, (Mesa, AZ), Banner Boswell Medical Center (Sun City, AZ), Banner Del. E. Webb Medical Center, (Sun City West, AZ), Banner Desert Medical Center (Mesa, AZ), Banner Estrella Medical Center, (Phoenix, AZ), Banner Gateway Medical Center, (Gilbert, AZ), Banner University Medical Center Phoenix (Phoenix, AZ), Banner Ironwood Medical Center (San Tan Valley, AZ), Banner Thunderbird Medical Center (Glendale, AZ), North Colorado Medical Center (Greeley, CO) and McKee Medical Center (Loveland, CO). Moreover, if Banner wishes to purchase or construct another acute care hospital after the Effective Date, the CIA will also be binding on that facility unless otherwise agreed to by the OIG. Operational Requirements of the CIA I. Compliance Personnel A. Chief Compliance Officer Banner must maintain a Chief Compliance Officer for the term of the CIA. The Chief Compliance Officer must be an employee, a member of senior management, must report directly to the Chief Executive Officer, and cannot be subordinate to the General Counsel or Chief Financial Officer. At a minimum, the Chief Compliance Officer is