Obama health czar directed firms in trouble

Nancy-Ann DeParle, President Barack Obama's health policy czar, served as a director of corporations that faced scores of federal investigations, whistleblower lawsuits and other regulatory actions, according to government records reviewed by the Investigative Reporting Workshop at American University. Several of the companies were investigated for alleged kickbacks or engaging in other illegal billing schemes, while others were accused of serious violations of federal quality standards, including one company that failed to warn patients of deadly problems with an implanted heart defibrillator. Several of the cases ended with substantial fines paid to the federal government, even though the companies admitted no wrongdoing. Since leaving her government job running Medicare for the Clinton administration, DeParle built a lucrative private-sector career. Records show she earned more than $6.6 million since early 2001, according to a tally by the Investigative Reporting Workshop. Much of that corporate career was built at companies that have frequently had to defend themselves against federal investigations. After leaving government, DeParle accepted director positions at half a dozen companies suspected of violating the very laws and regulations she had enforced for Medicare. Those companies got into further trouble on her watch as a director. Now she's back in government as a leading voice in deciding the shape of health care reform. Named by Obama in March as director of the White House Office of Health Reform, making $158,000 a year, DeParle is the point person in pushing for the administration's plans for changing health care and the ways Americans pay for it–changes in which her former companies have a great deal at stake. Critics see DeParle's re-emergence as a classic case of Washington "revolving door" syndrome, despite Obama's suggestions that he would shut that door. The administration faces a "balancing act," said Steve Ellis of the nonpartisan Taxpayers for Common Sense. Obama must find leaders with the proper expertise, but who are "not so conflicted that they cannot engage in all facets of the debate." Advocates of a "single-payer" coverage plan say that DeParle may be indebted to the companies she served, and more broadly to the health care industry. "This woman owes her fortune to the corporations that she is making decisions about," said Dr. David Himmelstein, an associate professor of medicine at Harvard University and a co-founder of Physicians for a National Health Program. "She cashed in really big on her previous role in government and made millions and millions of dollars. Then she divests and all of a sudden she's Snow White. It's ridiculous." Among DeParle's corporate connections: * DaVita Inc., which owns and operates kidney dialysis centers, has been the subject of several government probes into its billing and drug-prescribing practices, most recently in December by Justice Department investigators in Georgia. DeParle joined the DaVita board in May 2001 and resigned in July 2008 "to devote more time to her other business activities," according to the company. She earned more than $2 million in compensation and stock sales, according to records at the Securities and Exchange Commission. * Boston Scientific Corp. reported to the SEC that it received five state or federal subpoenas during 2008, including ones from the Justice Department and Health and Human Services, which oversees the Medicare agency. In addition, Defense Department criminal investigators are looking into the company's "marketing interactions" with doctors at a U.S. Army hospital in Tacoma, Wash. DeParle joined the Boston Scientific board in April 2006 and resigned on March 4 of this year, two days after she was appointed to the White House post. She earned more than $1.4 million in compensation and stock sales from her years at Boston Scientific and a company it bought, the Guidant Corp. * Guidant, which already was in legal trouble for failing to disclose 12 patient deaths when DeParle joined the board in 2001, has since then faced new problems. After a college student died in 2005 when his implanted defibrillator failed on a biking trip, his doctor told Congress that Guidant officials had known of similar problems for three years, but failed to tell the public. Five of the corporations whose boards DeParle served on have paid a total of $566 million since 2003 to settle fraud or product liability cases, often involving tax dollars paid by Medicare. Four signed "corporate integrity agreements" in which they promised to tighten oversight of their billing practices in exchange for the government agreeing not to take legal action to kick them out of the Medicare program. "These raise eyebrows," said Ellis, of Taxpayers for Common Sense. "These are things that have to be considered and evaluated." The White House did not make DeParle available for an interview about her corporate ties. Her spokeswoman, Linda Douglass, said the White House would not have time to answer questions about DeParle's actions as a director. DeParle also declined interview requests from msnbc.com, which is co-publishing this article with the Investigative Reporting Workshop. A director's responsibility There is no reason to think that DeParle was directly involved in any of the actions that led to the investigations and sanctions. DeParle was a member of the board of directors of these companies, not the chief executive officer managing day-to-day operations. It is rare for directors to be held legally accountable for illegal dealings by management. However, the 2002 Sarbanes-Oxley law, passed by Congress after the scandals at Enron and other companies, requires directors to be more aware of what is happening inside companies. Federal guidelines tell directors they should exercise even more oversight in health care firms. Michael W. Peregrine, a corporate compliance lawyer in Chicago, said that while board members aren't obligated to "ferret out wrongdoing," they need to question management once they learn of regulatory problems and to "make sure something is being done about it. The board has to ask, 'What the hell's going on here?'" At three companies–Guidant, DaVita and Specialty Laboratories–DeParle was not only a director but also served on board committees responsible for monitoring the companies' compliance with laws and regulations. Publicly traded companies must disclose to shareholders the existence of investigations, enforcement actions or lawsuits that could affect their earnings. These filings, made with the Securities and Exchange Commission, often are short on specifics, including when the conduct that's under investigation allegedly occurred. These investigations typically drag on for years. It's therefore difficult to say in some cases whether DeParle's board service coincided with the company's suspicious conduct, or whether some of the conduct preceded her service but only came to light during her service. In a few additional cases, DeParle joined companies that had already gotten into trouble. For example, DeParle agreed to join the board of Guidant just days after it acknowledged it had covered up the deaths of 12 patients and more than 2,000 injuries caused by a faulty surgical device. She was on the board when the company pleaded guilty to 10 felony charges in the case, and paid $92 million in fines. The apparent cover-up in the separate case involving the implanted defibrillator came to light when DeParle had been on the board for two years. And she joined the board of Boston Scientific about a year after it had paid $74 million to settle a federal criminal investigation into the company's delay in recalling a faulty heart device. No charges were brought, and the company no longer sells the product, called a stent. It also denied wrongdoing as part of the settlement with prosecutors. Peregrine, the regulatory compliance lawyer, said potential directors should be "cautious" about joining the boards of companies with a history of clashing with regulators. Board members need to satisfy themselves that the organization has developed "a culture of compliance" with laws, he said. DeParle resigned her corporate board positions upon taking the White House position, according to a financial disclosure form dated May 13 but only released by the White House on June 12. A handwritten note on the first page says that, as of June 4, "all conflicting assets have been divested." Her spokeswoman said DeParle has recused herself from any matters that might affect these companies, and has sold her stock in them at a "fairly substantial financial loss to herself and her family." DeParle has "come into government with the understanding it would require a financial sacrifice. She is in complete compliance with all ethical requirements of the administration," Douglass said. "She gave it all up to come and work in a tiny cramped office on one of the most important issues the country is dealing with," Douglass said. "She's working seven days a week, not seeing her children and working incredibly long hours. She's doing this because she is a dedicated public servant."