Boards must demonstrate adequate governance

The managed care industry is under increasing pressure to demonstrate quality, efficiency and transparency under the Patient Protection and Affordable Care Act (PPACA). This scrutiny comes not only from beneficiaries and employers, but also federal and state regulators. As the law is implemented and as lawmakers are forced to address looming budget crises, government agencies will seek to hold not only companies, but also their officers and directors, accountable for lapses in compliance. PPACA initiates a dramatic increase in the number of Americans covered by government-sponsored health insurance; however, this business likely will require a contract with a federal or state government to ensure payment for services rendered. While the mechanics of governance and compliance programs will differ, standards of ethics and compliance are fundamental to any governance strategy.