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

On Demand Webinar- Credits HFMA, ACHE, CLE, AHIMA

February 16 at 1:00 - 2:30 pm EST

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.
Learning Objectives
  • You will be able to describe the impact of the unprecedented changes of 2020 on the healthcare fraud landscape.
  • You will be able to identify likely enforcement trends for 2021.
  • You will be able to recognize healthcare fraud enforcement risks.
  • You will be able to discuss ways to manage that risk preemptively and during an investigation.
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
Who should attend?

This live webinar is designed for medical records directors, health information directors, coders, business managers, office managers, nurses, hospital administrators, billing managers, release of records professionals, compliance managers and attorneys.

In Partnership With Lorman Business Center, LLC


Your Instructor


Meredith Auten
Meredith Auten
  • Partner in the office of Morgan, Lewis & Bockius LLP
  • Practice emphasizes all aspects of government and regulatory agency investigations and litigation involving alleged health care fraud, government contracts fraud, Foreign Corrupt Practices Act (FCPA), and business frauds
  • Conducts regular seminars and workshops on numerous white-collar litigation topics, in-cluding issues related to the FCA, internal investigations and opioids
  • Awards include Philadelphia Business Journal Best of the Bar, White Collar (2019); Who’s Who Legal Healthcare and Investigations (2020), Expert Guides, Expert, White Collar (2020)
  • Memberships: Vice President, Board of Trustees of the Philadelphia Bar Foundation; Na-tional Co-Chair, Criminal Justice Section White Collar Committee Qui Tam Subcommittee, American Bar Association; Vice Chair, Women's White Collar Defense Association, East Coast Region; Chair, Women's White Collar Defense Association, Philadelphia Chapter; Member, Trustees Council of Penn Women; Fellow, Litigation Counsel of America
  • University of Pennsylvania Law School

Kayla Kaplan

Morgan, Lewis & Bockius LLP

  • Senior associate in the Washington, DC office of Morgan, Lewis & Bockius LLP
  • Represents clients across all industries, including healthcare, in complex commercial liti-gation, internal and government investigations, and civil False Claims Act (FCA) cases
  • Regularly writes and speaks on civil FCA developments, including substantial contribu-tions to Wolters Kluwer's fifth edition of Civil False Claims and Qui Tam Actions.
  • Columbia Law School, James Kent Scholar

Kathleen McDermott

Morgan, Lewis & Bockius LLP

  • Partner in the Washington, D.C. office of Morgan, Lewis & Bockius LLP
  • Practice emphasizes healthcare industry enforcement and compliance matters. She has a national corporate defense practice in the health industry and is lead counsel in several government investigations and litigations related to violations of the False Claims Act and parallel criminal and administrative statutes. Served as an Assistant U.S. Attorney and DOJ health care fraud coordinator.
  • Active in teaching, publishing and speaking on health industry government enforcement and corporate compliance matters and serves as adjunct faculty at the University of Maryland Francis Cary School of Law, teaching the healthcare fraud seminar.
  • Awards include HHS-OIG Inspector General’s Integrity Award for her work in government health care fraud matters; National Litigation Star, White-Collar Crime/Enforcement/Investigations, Benchmark Litigation (2016–2018); Life Sciences Star, Non-IP Litigation and Enforcement, LMG Life Sciences (2016–2020); Life Sciences Star, Fraud and Abuse, LMG Life Sciences (2012–2016); Best Lawyers, Washingtonian magazine (2007–2019); Recognized, White Collar Matters, Washington, DC Corporate Counsel Super Lawyers; Recognized, Health Care and Criminal Defense: White Collar, Washington, DC Super Lawyers (2007–2009, 2014–2020)
  • Membership information includes Advisory Board of the Bloomberg BNA Medical Device Industry Publication; Chair of the Federal Bar Association Health Law Section; member of the Women’s White Collar Defense Association; Co-Chair, White Collar Crime False Claims Act Subcommittee of the American Bar Association; Chair, American Health Lawyers Association Fraud and Abuse Practice Group and Program Committee for Annual Fraud and Compliance Forum; Chair, Litigation Section of the Maryland State Bar Association; Fellow, Maryland Bar Foundation; Fellow, American Bar Association Foundation
  • J.D. degree, cum laude, Suffolk University Law School

Credits

OnDemand Course

This course was last revised on May 29, 2015.

This program does NOT qualify, nor meet the National Standard for NASBA accreditation.

Live Webinar Registration

  • ACHE 1.5
  • The American College of Healthcare Executives no longer pre-approves courses or organizations. Participants in this program wishing to have the continuing education hours applied toward ACHE Qualified Education credit should indicate their attendance when submitting an application to the American College of Healthcare Executives for advancement or recertification. ACHE Qualified Education credit must be related to healthcare management (i.e., it cannot be clinical, inspirational, or specific to the sponsoring organization). It can be earned through educational programs conducted or sponsored by any organization qualified to provide educational programming in healthcare management. Programs may be sponsored by ACHE, chapters or other qualified sources, whether the programming is face-to-face or distance offerings (webinars, online seminars, self-study courses, etc.).
  • AHIMA 1.5 including Health Law and Compliance 1.5
  • This program has been approved for 1.5 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.
  • AL CLE 1.5
  • This course or a portion thereof has been approved by the Alabama State Mandatory Continuing Legal Education Commission for a maximum of 1.5 hours credit.
  • AR CLE 1.5
  • This course has been approved for 1.5 hours of CLE by the Arkansas CLE Board.
  • Arizona CLE 1.5
  • The State Bar of Arizona does not approve or accredit CLE activities for the Mandatory Continuing Legal Education requirement. This activity may qualify for up to 1.5 hours toward your annual CLE requirement for the State Bar of Arizona.
  • CA MCLE 1.5
  • Lorman Business Center, LLC. is a State Bar of California approved MCLE sponsor and this course qualifies for 1.5 CLE hours of participatory credit.
  • HI CLE 1.5
  • This program was approved by the Hawaii State Board of Continuing Legal Education for 1.5 CLE credit hours.
  • IL CLE 1.5
  • This course was approved for a total of 1.5 hours of MCLE Credit by the Illinois MCLE Board.
  • ME CLE 1.5
  • This course has been approved by the State of Maine Board of Overseers of the Bar. Lawyers who complete this course shall receive 1.5 hours of CLE credit under M. Bar R. 12.
  • NH MCLE 1.5
  • NH MCLE does not approve or accredit CLE activities for the NH Minimum CLE requirement. Lorman Education Services believes this course meets the requirement of NH Supreme Court Rule 53 and may qualify for CLE credit(s). Program Length: 90 Minutes.
  • NJ CLE 1.8
  • This program has been approved by the Board on Continuing Legal Education of the Supreme Court of New Jersey for 1.8 hours of total CLE credit.
  • PA CLE 1.5
  • This Distance Learning program has been approved by the Pennsylvania Continuing Legal Education Board for 1.5 hours of substantive law, practice and procedure CLE credit.
  • RI CLE 1.5
  • This program has been approved by the Rhode Island Mandatory Continuing Legal Education Commission for 1.5 hours of CLE credit.
  • VT CLE 1.5
  • This program has been approved by the Mandatory Continuing Legal Education Board of Vermont for 1.5 hours of CLE credit.
  • WA CLE 1.5
  • This program has been approved by the Washington State Board of Continuing Legal Education for 1.5 hours of Law & Legal Procedure credit.
  • WI CLE 1.5
  • This program has been approved by the Board of Bar Examiners for 1.5 hours for use toward the Wisconsin Mandatory CLE requirement.
  • WV MCLE 1.8
  • This program has been approved by the West Virginia State Bar MCLE Commission for 1.8 MCLE hours.
  • HFMA 1.5
  • This course is approved by HFMA for certification maintenance of continuous educational points and will equal 1.5 points of classroom instruction.

This program does NOT qualify, nor meet the National Standard for NASBA accreditation.

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