Wednesday, November 15, 2023 1:00PM EST; 12:00PM CST; 11AM MST; 10AM PST
The predominant basis for federal fraud and abuse enforcement and settlements is the False Claims Act. While most of those enforcements and settlements turn on things like failing to perform services or under-documentation of the service billed, there are a host of requirements pertaining to clinical quality that can lead to false claims and other forms of fraud and abuse liability. In this crisp half hour program with a 17 page substantive handout and fifteen minutes for Q & A, Alice elucidates these little appreciated risks which merit focused attention from all providers.
- Conditions of participation and the new risks associated with medical necessity - Quality reporting and pay for performance issues - Value-based arrangements and enterprises - Other forms of quality failures - Penalties including exclusions, sanctions, quality-based civil money penalties, quality-based corporate integrity agreements, false claims liability -- including caselaw - Government guidance - Practical steps
