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Health Care Fraud: Utilize Best Practices to Reduce Your Risk

Includes a Live Event on 08/24/2021 at 2:00 PM (EDT)

On May 17, 2021, shortly after CMS announced its most significant recoupment of improperly reimbursed Medicare funds since the Program’s inception, several of the most influential Federal enforcement agencies announced a collaborative plan to reduce the prevalence of and exercise a broad range of enforcement authority for provider violations involving healthcare fraud.

The “Medicare Fraud Strike Force” and “Operation CARE” have been operationalized with staff affiliated with the following: United States Attorney General, Office of Inspector General, Department of Health and Human Services, Centers for Medicare and Medicaid Services, Office of Civil Rights, and Department of Justice.

Several Federal investigative patterns and targeting methodology can be taken away from the most recent healthcare fraud investigations.

These takeaways can prove essential for providers in understanding the new risk areas. Providers can effectively utilize its QAPI and corporate compliance programs to prioritize the activities of these committees and assess individualized provider risk areas.

A provider who can demonstrate that it has a history of exercising reasonableness in its utilization of risk reduction procedures to diminish the risk of such an investigation; appropriately implementing goal-oriented plans; and monitoring the effectiveness of same will be in a much better position, should an investigation take place, than a similarly situated provider who cannot demonstrate that it adhered to best practices, including official guidance issued on the relevant focus area.

This session will serve to educate members on the most current information related to Federal healthcare fraud oversight and enforcement actions at the regulatory, civil, and criminal levels. 

The information provided to members during this session has been aggregated and summarized for utilization by members in at least two advantageous ways, including but not limited to: (1) effective and rationally based prioritization of QAPI and corporate compliance agendas, activities, and plans; and (2) substantive development of educational programs for staff and contracted providers with an emphasis on focus areas discussed.

Meet the speakers
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John P. Hessburg, Attorney, The Kitch Firm     Andrea DeLand, Attorney, The Kitch Firm     Angie Szumlinski, Director or Risk Management, HealthCap RMS
This webinar is available to everyone. 
How to Register:
  • To avoid technical problems, use Google Chrome. 
  • Registrants will need to log in using their existing AHCA/NCAL username and password first. 
  • Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
  • If you have forgotten your password click here
  • If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register for the webinar. 

Need further assistance? Email educate@ahca.org

Once you are logged in, click the image button found in the upper right corner of your screen 

OR 

Follow these three easy steps below! 

 

  • To avoid technical problems, use Google Chrome. 
  • Members will need to log in using their existing AHCA/NCAL username and password first. 
  • Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
  • If you have forgotten your password click here
  • If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register for the webinar. 

Need further assistance? Email educate@ahca.org

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