AT: Before we get into the work you are currently doing as the vice president of compliance and privacy at Northern Light Health in Maine, I want to go back earlier in your career. You spent almost 25 years working for the US government. What led you to public service?
EH: After college, I briefly worked for a manufacturing company as an inventory control specialist. I liked the job but did not find it intrinsically rewarding. I had friends who worked in law enforcement and it seemed like an exciting, fulfilling career.
I spent the first five years of my federal career working as a U.S. Park Police officer in the Washington, DC area. This was a great opportunity to gain skills I would use throughout my career, particularly the ability to apply laws and regulations, investigate crimes, conduct interviews, testify in court, and establish rapport with a wide range of people. I enjoyed helping people when they were in crisis and the feeling that I was helping society. I was able to complete my Master of Business Administration during this period and after graduating, I began applying for special agent jobs.
After leaving the Park Police, I worked for a year as a special agent with the U.S. Department of Commerce, Office of Export Enforcement (OEE). The position was in OEE’s headquarters and involved supporting field agents, developing leads, liaising with other agencies, working on policies and projects, and creating and administering training programs. I really wanted to be in the field conducting investigations and was fortunate to be able to transfer to the U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) in Maine.
AT: What appealed to you about a position at OIG?
EH: There were several things that attracted me to the position. I liked the idea of investigating fraud cases, the position was located in Maine, and OIG agencies typically do not force their agents to relocate during their careers.
When HIPAA passed, it created the Health Care Fraud and Abuse Program, resulting in new criminal healthcare fraud statutes and increased funding to OIG and the Department of Justice (DOJ). As a result of that funding, OIG Office of Investigations (OI) opened suboffices throughout the country and hired a large contingent of agents. I was fortunate to be part of that group of agents and opened the first OIG office in Maine.
AT: What advice would you give others without investigation skills? How can they best develop them?
EH: Investigative skills can be developed through training. At OIG, we often hired auditors, accountants, clinicians, and others as agents, since it is easier to teach an auditor police skills than it is to teach a police officer to be an auditor.
At a minimum, there are two types of training I would recommend to anyone doing investigations, whether it is for compliance, risk management, human resources, or insurance fraud:
1. A general overview course on conducting investigations provides the basic foundational knowledge to conduct investigations. For many people starting out, their knowledge of investigations comes from television shows and movies, and basic investigative training can help build a framework within which to operate and correct any misconceptions.
2. Interview training, since there is so much more to interviewing than simply asking questions and writing down answers. In my opinion, interviewing is the single most important skill to develop as an investigator and yet it is often overlooked. I was fortunate to attend the Reid School of Interviewing and Interrogation after five years at OIG. By that point in my career, I had over 10 years of law enforcement experience and had been through two training academies. I thought I knew how to conduct interviews pretty well. I learned an incredible amount from the training and highly recommend it to anyone conducting investigations.
The Health Care Compliance Association (HCCA) and the National Health Care Anti-Fraud Association both provide excellent training for compliance professionals.
AT: Any specific do’s and don’ts you found for conducting healthcare investigations?
