Fraud and Abuse Enforcement in the Obama Era

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With the recent passage of historic health care reform legislation, the Federal Government is redoubling its efforts to control Medicare spending. Among the weapons at its disposal: Medicare fraud and abuse investigations. The Obama Administration has taken several steps to intensify its enforcement activities, including recent amendments to the False Claims Act and unprecedented coordination between the Department of Justice and the Department of Health and Human Services. The HHS Office of Inspector General has also indicated that it intends to bring increased enforcement actions against executives.

As most hospital, health system, and physician group executives understand, this increased scrutiny is about far more than errant Medicare billing or even expanded RAC audits. It’s also about ensuring that today’s innovative and often-complex hospital-physician alignment models are compliant with stricter Stark and Anti-Kickback scrutiny. In this environment, and with so many new alignment models to consider, it’s not surprising that many hospital executives are uncertain about best strategies for ensuring compliance – and even less sure about how to take corrective action once they’ve discovered a potential compliance violation.

This webconference is designed to help members make sense of the changing Fraud and Abuse landscape, with a special emphasis on how it relates to hospital-physician partnership, compensation, and co-management models. In partnership with our Health Care Law Roundtable, this presentation will feature two guest legal experts with significant experience with Fraud and Abuse prevention, investigation, and compliance support.

  • Curt Chase: a partner with Husch Blackwell Sanders LLP and chair of the firm’s Health Care Department, and 
  • Jesse Witten, a partner with Drinker Biddle & Reath LLP and a former Deputy Associate Attorney General who co-chaired the DOJ’s health care fraud task force.

Together, Mr. Chase and Mr. Witten will provide an overview of the government’s Fraud and Abuse enforcement agenda and other regulatory developments likely to impact members’ strategic decisions. To elucidate key implications for hospital-physician alignment initiatives, they will highlight some recent cases surfaced by both whistleblowers and self-disclosure, and they will offer some guiding principles for hospital, health system, and physician leaders looking to advance their alignment agendas without (knowingly or unknowingly) triggering potential compliance concerns.

Host: Brandi Greenberg

Printable Handout

For your convenience, the printable version of this webconference presentation is available for download.

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Topics: Medicare, Reimbursement, Finance, Payer and Regulatory Policy, Revenue Cycle, Clinical Co-Management, Hospital-Physician Alignment, Physician Issues, Denials Management, Health Policy, Market Trends, Strategy

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Wednesday, April 7, 2010, from 1:00PM ET - 2:00PM ET  |  Archived Webconference