Overcoming Government Investigations and Audits: Current Trends in Enforcement and Appeals

Presentations

Health care reform brought many new and amended rules governing fraud and abuse. Federal and state agencies have enhanced enforcement weapons which subject health care providers to increased exposure to potential civil and criminal liability, fines, and exclusion from the Medicare and Medicaid programs. The Government is also using the tools in its arsenal in a myriad of ways, including addressing quality of care through the false claims act. In addition, Medicare contractors are working diligently to reduce fraud and abuse and recoup overpayments made to health care providers. These contractors are utilizing various methods to recover overpayments, including random audits and data mining, and predictive analytics which often result in contested claims.

This program will:

• Assist providers in identifying areas of potential fraud, waste, and abuse, or inappropriate payment of funds, under federal or state administered programs;
• Discuss ways to implement and maintain effective compliance programs to avoid liability for Medicaid fraud;
• Help providers understand how the Government is using enforcement tools to address quality of care issues
• Address the intricacies of the administrative process for appealing audit results and demands for repayment; and
• Assist providers with practical instructions for appealing claims.

You should attend this program if you are an administrator, chief executive officer, chief financial officer, compliance officer, in-house attorney, or billing manager of any health care provider, including an academic medical center, ambulance provider, clinical laboratory, DMEPOS supplier, home health agency, hospice, hospital, long-term care facility, pharmacy, physician group, or skilled nursing facility.

Registration Fee: $30.
Health care organizations that register multiple attendees have a maximum registration fee of $90.00.

Please RSVP no later than May 13, 2013.

To register, please click here.

For additional information, please email Denise Grant or call 713/300-3220.