George B. Breen, Chair of the firm’s National Health Care and Life Sciences Practice Steering Committee, presents “Healthcare Fraud Enforcement in 2015 and Beyond; Health Plans in the Spotlight” at the Institute for Health Plan Counsel, hosted by the American Health Lawyers Association (AHLA) on October 26 and 27.
The Institute is designed specifically for in-house counsel at health plans and their outside counsel and advisors. Health plan counsel must be prepared to address the significant legal and operational developments resulting from the rapidly changing marketplace.
Mr. Breen’s in-depth breakout session, presented at 9:45am and 2:45pm on October 27, will cover topics such as:
- The government is increasingly interested in risk adjustment data: Where are the land mines here and what should plans be doing given this enforcement effort?
- More than ever, quality of care issues are intersecting with FCA risk. Are plans liable for provider activities?
- The Government is looking at provider data, patient charts and outcomes and questioning medical necessity decisions: Where should plans be looking and should they be incorporating quality into their compliance programs?
- Should overpayments matter to plans? If so, what policies and procedures should they have in place to address this risk area?
- Does life in the exchange bring more FCA risk? If so, where are plans now most vulnerable and why?
Additional details can be accessed on the AHLA website.