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Format: On-Demand Webinar
Presenter: William Mack Copeland, MS, JD, PhD, LFACHE
Time: You can access the webinar anytime
Duration: 60 minutes
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This program is designed for health care executives, physicians and other health care providers and their managers who participate in and receive remuneration from Medicare, Medicaid, and other federal health care programs such as TriCare. Recent enforcement actions by the OIG bring home the realization that many activities that are common in other industries are a crime under federal healthcare fraud and abuse laws.

In this webinar, our expert will discuss critical trends and developments in health care fraud and abuse, compliance, and enforcement. Topics covered include recent government enforcement initiatives, Stark and Anti-Kickback developments, self-disclosures and settlements, trends, and changes in the industry that will impact health care organizations and their contracting and compliance efforts in 2024.

Hospital executives, as well as physicians and/or other health care providers, should be very concerned about the potential for the government to use the AKS as one of the prime methods for enforcing the federal fraud and abuse laws. In this webinar, you will learn about the elements of the AKS, along with any new safe harbors that you can rely on for protection against enforcement under these laws. This is important because healthcare fraud and abuse if becoming the focus of these enforcement efforts.

Learning Objectives

  • Learn about key case law trends from the past year to prepare them for risk assessment and analyses in 2024
  • Learn about trends in DOJ/OIG compliance guidance to prepare for 2024
  • Know about developments impacting enforcement under the physician self-referral law, Anti-Kickback Statute and beneficiary inducement
  • Understand the OIG’s advisory opinion regarding Physician-Owned Entities
  • To Comply with the Federal Laws – False Claim Act, Anti-Kickback Statute, Stark Law
  • Understand the anti-fraud provisions of the Affordable Care Act
  • Understand the Federal False Claims Act, Federal Anti-Kickback Statute and the Federal Anti-Referral Act (Stark II)
  • Provide a perspective of how the courts, the Department of Justice (DOJ), and the Department of Health and Human Services Office of the Inspector General (OIG) view compliance with the AKS
  • Discuss recent enforcement actions taken by the DOJ, OIG and law enforcement partners
  • Show how the courts deal with violations of these federal laws
  • Discuss fraud and abuse issues to watch

Areas Covered in the Session

  • Federal False Claims Act
    • False or fraudulent claim for payment to the Federal Government
    • Billing for work not performed, upcoding, unnecessary services, and even billing for services that were obtained in violation of other laws
    • Covers fraud against the federal government
  • The Federal Anti-Kickback Statute
  • The Medicare and Medicaid Patient and Program Protection Act
  • The Anti-Kickback Safe Harbors
  • OIG Advisory Opinions
    • Not based on referrals
    • Fair Market Value
    • Written Agreement
    • No less than one year
  • OIG Special Advisory Bulletins and Fraud Alerts
    • Speaker Programs
    • Physician Owned Entities
    • Contractual Joint Ventures
  • Recent Enforcement Cases
    • U.S v. HAGEN
    • U.S. v. Alexandre
    • U.S. v. Whitten
    • U.S. v. Baird & Hughes
    • U.S. v. Lee
    • U.S. v. Georges
    • U.S v. Brian Meshkin
    • U.S. v. Harper & Hill
    • U.S. v. Olshavsky & Linke
    • U.S. v. Ayala
  • The Anti-Fraud Provisions of The Affordable Care Act
  • Areas of Concern
  • The Federal Anti-Referral Law (“Stark law”)
  • Enforcement Actions
  • Planning Ahead: Trends To Watch
    • Voluntary Self-Disclosures
    • Implied False Certification Theory
    • Scienter – Intent
    • Non-Compete Provisions in Employment Agreements.

Suggested Attendees

  • Hospital Executives, Particularly CEOs, COOs, CFOs, CNOs, and CMOs
  • Physicians
  • Physician Organizations
  • Law Firms Representing Hospital or Physicians
  • Peer Review Organizations
  • Hospital Associations
  • Chief Compliance Officers
  • Providers
  • Physician Practice Managers
  • Attorneys and Legal Staff
  • Medical Providers Including Registered Nurses, Physician Assistants and Administrative Staff
  • Sales and Marketing Managers
  • Customer Service Managers
  • Risk Managers
  • Other Healthcare Provider Executives

About the Presenter

William Mack Copeland, MS, JD, PhD, LFACHE, practices health care law in Cincinnati at the firm of Copeland Law, LLC.  A graduate of Northern Kentucky University Salmon P. Chase College of Law, Bill is a frequent author and speaker on health law topics. Copeland is a member of the American Health Lawyers Association, American, Ohio and Cincinnati Bar Associations and is a life fellow in the American College of Healthcare Executives. A former hospital chief executive officer, he was awarded the American College of Health Care Executives Senior-Level Healthcare Executive Regent’s Award in 2007.

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