With ongoing regulatory changes and an evolving healthcare environment, it is likely that the Department of Justice (DOJ) will maintain its focus on enforcing actions against healthcare providers who prioritize their financial gains over patient well-being and unlawfully siphon funds from government programs. In this presentation, we will discuss recent enforcement actions and highlight themes related to specialty and methodology. We will also describe how organizations should manage Stark law and antikickback violations when prevention efforts fail. Lastly, we will introduce the DOJ’s Health Care Fraud Unit, whose primary mission is to combat fraud and abuse in the healthcare industry, and detail guidelines and corporate compliance priorities the DOJ issued to encourage organizations to implement effective compliance programs.
Program Agenda
Regulatory changes in the healthcare industry;
Managing the Stark law;
DOJ: Recent enforcement actions;
Enforcement actions as they relate to medical specialty and methodology;
Discussion of the DOJ’s Health Care Fraud Unit; and
Discussion of DOJ guidelines and corporate compliance issues.
Learning Objectives
Provide details specific to recent enforcement actions related to the volume of cases by year and associated outcomes/settlement dollars;
Identify trends in recent enforcement actions relating to specialty, compensation components and methodology, and documentation compliance;
Detail the benefits of self-disclosure;
Provide an introduction to the DOJ’s Health Care Fraud Unit; and
Share highly relevant information included in DOJ corporate compliance priorities.
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