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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
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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Course Content
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