The health care industry is highly regulated by a variety of criminal and civil fraud and abuse laws. An effective program to ensure compliance with those laws is essential to health care providers. This session will include a discussion of current compliance “hot topics” of particular significance to providers and their advisors. The session will cover the major court decisions interpreting the federal False Claims Act; how enhanced data analytics and the Yates memo have changed the way in which corporate and individual violators of the fraud and abuse laws are identified, investigated, and held accountable; the Trump administration's proposed reforms to current Stark Law and Anti-Kickback regulations to encourage value-based care; the 60-day Medicare and Medicaid overpayment statute and CMS's corresponding 60-day rule; and the components and value of effective compliance programs in the current regulatory environment.
Gain a better understanding of the 60-day overpayment provisions and the information that may trigger a duty to investigate potential overpayments.
Determine an awareness of major court decisions impacting compliance with federal laws, including the False Claims Act.
Obtain a reminder that the government also may seek to hold individuals accountable for regulatory violations.
Receive a broad overview of the government's recently-proposed reforms to federal fraud and abuse regulations.
Understand how to mitigate risk by implementing effective compliance programs.