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Fraud & Abuse, Stark & Anti-Kickback Issues
- Federal bases for allegations of healthcare fraud
- The Federal Stark Law
- The Federal Anti-Kickback Law
- Common Scenarios that get providers in trouble
- What to do if you realize you are in one of these Common Scenarios
- Develop and understanding of the basics of the federal laws prohibiting healthcare fraud
- Learn to recognize and eliminate "red flags"
- Understand common scenarios that are considered fraud and how to modify these scenarios to be compliant
Overview of the webinar
The presentation will provide an overview of the Federal Stark and Anti-Kickback laws and corresponding regulations including the history and purpose of these laws. The presenter will provide the background upon which these laws were determined to be necessary and developed. The attendees will be provided with an overview and description of the laws, why they were instituted, what they do and do not cover and who they are and are not applicable to. Once the basic constructs of the laws themselves are reviewed, the presenter will then go over the most common exceptions to these laws. Exceptions include specific scenarios in which the law allows physicians, practices and providers to participate in activities that may otherwise be deemed prohibited under both laws.
Who should attend?
- Physicians
- PAs/APNs
- Practice Managers
- Health Care Providers
- Pharmaceutical Representatives
- Billing & Coding Professionals
- Financial Managers/Advisors
- Compliance Officers
Why should you attend?
Physicians, health care providers, practice managers and anyone who works in for or with a medical practice of any kind can gain valuable knowledge about the "red flags" of fraud. Red flags can be anything from unusually high volume of reimbursement to unclear division between two separate medical practices functioning in the same space. Fraud can result in a thriving medical practice suddenly becoming a recipient of the Federal Prison Retirement Plan and this concerns all members of the practice, not just the physicians. In recent headlines, we have all seen physicians, laboratory owners, practice managers and billers being walked out of various offices in handcuffs. This is not what you want your practice to be famous for. Medical practices, physicians and health care providers cannot accept payment for referrals, but do you know what the federal government considers a "payment for a referral"? If you have a sublease that is not in writing, or is not quite for fair market value, you may be giving/receiving a kickback. If you take a colleague to lunch and pick up the bill, you may be giving/receiving a kickback. When it comes to federal law, ignorance is not bliss and is certainly not an excuse or a defense when caught in the crosshairs of the federal Stark or Anti-kickback laws. Educate yourself and protect yourself.
Faculty - Ms.Gina L. Campanella, Esq.
Gina Campanella, focuses on Corporate counsel healthcare regulatory and transactional matters federally and in New Jersey, New York, Vermont, the District of Columbia and Pennsylvania. She has assisted clients with transactional services and regulatory compliance consulting, as well as general counsel services to small practices and large societies and medical groups alike. Clients also seek her expertise when reviewing employment agreements, formation of new practices, separation from and sale of practices, business structuring, and surgical center licensing and registration, including preparation for Department of Health, AAAHC and AAAASF surveys of licensed and Medicare deemed facilities, as well as preparation and implementation of resulting plans of correction. She lectures nationally on issues of health care law and compliance for events and organizations such as: the New Jersey Association of Osteopathic Physicians and Surgeons, the Atlantic Regional Osteopathic Conference, the New Jersey Chapter of the American College of Emergency Physicians, the New Jersey Podiatric Medical Society, the Health Care Compliance Association, the New Jersey Medical Group Management Association, the New York Medical Group management Association, Columbia University Medical School, the Advanced Emergency & Acute Care Medicine CME Conference, the CentraState Medical Center Practice Managers Group, Bassett Medical Center Medical Staff, the New Jersey State Society of Physician Assistants, MentorHealth and Skillacquire.