Provider Beware: Operating Under Heightened Government Enforcement

The Patient Protection and Affordable Care Act ("PPACA") brought health care reform and, along with it, many new and amended rules governing fraud and abuse. Key changes include amendments to the federal False Claims Act, the Anti-Kickback Statute, and the Civil Monetary Penalty Statute, as well as new rules for the treatment of exchange payments and overpayments. PPACA also brought additional and enhanced enforcement weapons, including a vigorous screening process for new and existing providers and suppliers and the potential for enrollment and payment suspensions. These changes together with an increase in RAC, MIC, and ZPIC audits, make it imperative for a health care provider to proactively implement and update a compliance program to better prevent and detect fraud, waste, and abuse.

Speakers:

Schedule:

8:00 am - 8:30 am Continental Breakfast and Networking
8:30 am -10:30 am Presentations

This seminar 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 Medicare and Medicaid fraud;
• Identify the function and differing objectives of a RAC, MIC, and ZPIC;
• Explore proactive measures that a health care organization can implement to decrease potential exposure resulting from a government contractor audit; and
• Address the intricacies of the administrative process for appealing audit results and demands for repayment.

You should attend this program if you are an owner, an officer, a director, an administrator, a manager, a compliance officer, in-house counsel, or a member of the billing staff of any health care organization that receives federal or state reimbursements for services, including an academic medical center, ambulance provider, clinical laboratory, DMEPOS supplier, hospital, long-term care facility, managed care organization, pharmacy, physician group, or skilled nursing facility.

Registration Fee: $20

Registration is free for each additional attendee from the same health care organization.

Please RSVP no later than Tuesday, April 4, 2011.

To register, please click here.

For questions regarding this event please click here.

This program is pending approval for 2.4 Compliance Certification Board (CCB) Continuing Education Units in Compliance Training and Education and Auditing and Monitoring for Compliance. Granting of prior approval in no way constitutes endorsement by CCB of the program content or the program sponsor.

NOTE:

EBGWH has been approved by the State Bar of Texas for CLE credits. Please note that to receive full credit for attending, registrants must be present for the entire session. EBGWH provides assistance to those with financial hardship who wish to attend; please submit requests for assistance with an explanation to Michelle Walker (mwalker@ebglaw.com) or Laurie Morse (lmorse@ebglaw.com) in the Houston office. The briefings are accessible to persons with disabilities; please notify Michelle Walker if accommodations are needed.