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Sponsored by Lorman Education
Product ID: 400514EAU
 
Credit & Course Provided by:

Protecting Against Health Care Fraud: Strategies, Tips and Tricks for Health Care Providers

OnDemand Webinar (88 minutes)

Learn ways to manage health care fraud risk preemptively and during an investigation.Healthcare providers have long faced significant risk from fraud enforcement investigations and actions due to the complex regulatory environment in which they operate. These risks have been compounded by the way the healthcare industry was changed by 2020 and the COVID-19 pandemic. This topic will explore the effects of 2020 on the healthcare industry and where it intersects with current and future fraud enforcement trends. The material will cover strategies for healthcare providers to help better position themselves to identify and respond to these risks in the current environment, both in terms of proactive compliance and in responding to investigations.

Authors

Meredith Auten, Morgan, Lewis & Bockius LLP Kayla Kaplan, Morgan, Lewis & Bockius LLP Kathleen McDermott, Morgan, Lewis & Bockius LLP

Agenda

The Way 2020 Changed the Healthcare Landscape

• COVID-19 Impacts on Nature and Cost of Services

- Heightened Safety Concerns, Staffing Issues, Materials Shortages

- Restrictions on Elective Procedures and Financial Impacts

- Increase in Digital Health and Telehealth

• COVID-19 Reactive Regulations and Legislation

- Prep Act

- Cares Act

- Cms and Oig Regulatory Waivers and Flexibilities

• Other Regulatory Changes

- Changes to Anti-Kickback Regulations by Hhs

- Changes to Stark Law Regulations by Cms

• Case Updates

- Circuit Split Over FCA Liability for Differences of Clinical Opinion

Strategies for Managing Risk in the New Landscape

• Keeping Abreast of Regulatory Changes

• Importance of Robust Compliance Program and Employee Education

• Role of Whistle-Blowers in Healthcare Fraud Enforcement

• Addressing Cms Audits

• Other Considerations

- Using Big Data to Identify Risks

On the Enforcement Horizon

• How Enforcement May Change in a Biden Administration

• Hhs Creation of FCA Working Group With DOJ and Hhs-Oig

• Continued Focus

- Medicare Part C Billing (One-Way Reviews)

- Kickbacks and Unlawful Marketing

- Elder Fraud Initiative

• New Focus

- Cares Act and PPP Loan Risk

- National Nursing Home Initiative

- Electronic Health Records

Strategies for When an Investigation Hits

• Responding to Subpoenas

• Cooperation Credit Updates

• Brand Memo Updates