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Chapter 85: Risk Management

85.050 Health Care Compliance Policy—Defense and Protection of Employees

Bd. Min. 2-3-94; 10-15-99.

  1. Purpose
    1. The purpose of this policy is to establish a procedure for defense and protection of employees in matters where the U.S. Health Care Financing Administration (HCFA), the Office of the Inspector General, the Department of Justice, or any federal or state administrative agencies with jurisdiction are alleging violations of federal and state health care laws, statutes, and regulations.
  2. Defense and Protection -- Civil Proceedings -- Defense and protection against loss, damage or expense will be provided to:
    1. Employees -- An officer, faculty member, or other employee of the University in connection with any claim or suit allegedly rising out of the performance of duties for, or employment with, or by The Curators of the University of Missouri, a public corporation; and
    2. Such an officer, faculty member or employee who, individually or with others is named a defendant in legal actions or is the subject of a claim submits a request for such defense and protection to the President.
      1. Such a request shall include:
         
        (1) A brief description of the circumstances surrounding the incident giving rise to the legal action or claim; and
        (2) Documentation to verify that the named individual was acting within the scope of his or her official duties at the time of the incident; and
        (3) A copy of the summons or petition served on the named individual or any other information concerning the claim.
      2. The President determines that the named individual was acting in good faith and within the scope of his/her employment or authority.
      3. Such defense or protection is legally permissible.

      4.  
  3. Defense and Protection -- How Provided
    While such defense and protection normally will be provided by insurance maintained by the University, this policy applies without regard to the availability of insurance coverage. If the initial determination is made by the President that the named individual is entitled to defense, it shall be provided either by insurance or by the General Counsel or by an outside counsel appointed by the General Counsel on behalf of the individual.
  4. Defense -- Criminal Proceedings -- Defense will be provided to an officer, faculty member, or other employee of the University in a criminal investigation, subject to the conditions and requirements of Paragraph B above, until the occurrence of one of the following:
    1. The individual or the University is advised in writing by a representative of the U.S. Attorney's office or an appropriate official of the prosecuting attorney's office that the person is a target of the criminal investigation; or
    2. The individual is named the defendant in an indictment issued by a grand jury, or is named the defendant in an information, or is named the defendant in a complaint filed by a prosecuting attorney which complaint charges the commission of a crime; or
    3. The President concludes that the individual was not acting in good faith or within the scope of his/her employment or authority.
  5. Reimbursement -- Attorney Fees -- When
    When an officer, faculty member or other employee is refused defense by the University under the terms of Paragraph D1 or D2 above, and the officer, faculty member or other employee retains an attorney to represent him or her in the criminal proceeding such person shall be entitled to reimbursement for fees paid to the attorney if:
     
    1. The individual is acquitted or the criminal charges are dismissed; and
    2. The President determines that the charges for which reimbursement is sought are reasonable.
  6. Financial Protection -- When Provided
    When an officer, faculty member, or other employee is provided a defense under Paragraph B above, and if legally permissible, the University will protect officers, faculty members or other employees from civil penalties imposed by such outside agencies, but will not protect officers, faculty members and employees from fines levied in any criminal proceedings. No protection will be provided if a court determines that the action arose out of malfeasance in office or willful or wanton action or neglect of duty.

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