ObamaCare Takes Aim at Healthcare Fraud and Abuse

Webinar Id: 800506

Duration: 60 Minutes

  • Recorded
  • Only for one participant ?
  • Price $179.

Overview:

This webinar will discuss the various anti-fraud and abuse provisions of the Affordable Care Act and will discuss the actions of that should be taken to minimize enforcement activities. Medicare it is a higher risk Federal program and has been designated as such by the GEN accountability office since 1990. Its vast size and complexity make it vulnerable to fraud, waste and abuse.

Lewis Morris, chief counsel to the Office of Inspector General, Department Of Health and Human Services, testifying before the Senate Finance Committee in 2009, stated, "Although we cannot measure the full extent of the health care fraud in Medicare and Medicaid, everywhere we look we continue to find fraud in these programs." Conservative estimates indicate that as much as $60 billion of total national health care spending is fraudulent. According to the New England Journal of Medicine, federal investigators have found that the Medicare System is being infiltrated by criminals and organized crime. However, fraud is not limited to the activities of organized crime.

In Morris’s testimony, he indicated, "Major corporations such as pharmaceutical and medical device manufacturers and institutions such as hospitals and nursing facilities have also committed fraud, sometimes on a grand scale." The Obama Administration has created a cabinet-level anti-fraud task force, overseen by the deputy attorney general and the deputy HHS’ secretary. This task force will oversee "strike force teams," composed of investigators from various federal agencies. The initial teams will be doubled and will target cities where healthcare fraud is rampant. Obamacare includes sweeping provisions to combat healthcare fraud and abuse. You should attend this webinar to learn about these provisions and how you can protect yourself and your organization.

Areas Covered in the Session:

  • More money to prevent and fight fraud
    • Hiring new agents and investigators
    • New task force
  • Better screening and compliance activities
    • Pre-enrolment screening program
    • Oversight of providers and suppliers
    • Moratorium to prevent new providers from joining program
    • Withholding payment where credible allegation of fraud made
    • New controls on high risk programs
    • Expand RAC program
    • Expand security bond program
    • Compliance programs required
    • Limits time for filing claims
  • New fines and penalties
    • Stronger civil and monetary penalties
    • Increase in sentencing guidelines for healthcare fraud
    • New fines and penalties for failure to return overpayments
    • Recapture fraudulent funds
    • New penalties for false claims
    • New penalties for marketing violations
    • Increased investigative power for nursing home fraud
  • Greater data sharing
    • Centralizes claims data
    • New data bank
    • Centralized data bank to identify "false front" providers
    • DOJ and OIG has greater access to CMS claims and payment data
    • Requires states to report additional Medicaid data
    • Requires faster sharing of terminated provider data with states
  • Actions that should be taken

Who Will Benefit:
  • Chief Executive Officers
  • Chief Operating Officers
  • Corporate Compliance Officers
  • Hospital Corporate Counsel
  • Chief Financial Officers
  • Physician Practice Managers

Speaker Profile
William Mack Copeland MS, JD, PhD, LFACHE, practices health care law in Cincinnati at the firm of Copeland Law, LLC. He is also president of Executive & Managerial Development Group, a consulting entity providing compliance and other fraud and abuse related services. 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. He was awarded the American College of Health Care Executives Senior-Level Healthcare Executive Regent’s Award in 2007.


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