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OnDemand Course

Protecting Against Health Care Fraud: Strategies, Tips and Tricks for Health Care Providers

Learn ways to manage health care fraud risk preemptively and during an investigation.

Healthcare providers have long faced significant risk from fraud enforcement investigations and actions due to the complex regulatory environment in which they operate. These risks have been compounded by the way the healthcare industry was changed by 2020 and the COVID-19 pandemic. This topic will explore the effects of 2020 on the healthcare industry and where it intersects with current and future fraud enforcement trends. The material will cover strategies for healthcare providers to help better position themselves to identify and respond to these risks in the current environment, both in terms of proactive compliance and in responding to investigations.

88 minutes
Course Exam
Certificate of Completion
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Why Lorman?

Over 35 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Agenda

The Way 2020 Changed the Healthcare Landscape

  • COVID-19 Impacts on Nature and Cost of Services
    • Heightened Safety Concerns, Staffing Issues, Materials Shortages
    • Restrictions on Elective Procedures and Financial Impacts
    • Increase in Digital Health and Telehealth
  • COVID-19 Reactive Regulations and Legislation
    • Prep Act
    • Cares Act
    • Cms and Oig Regulatory Waivers and Flexibilities
  • Other Regulatory Changes
    • Changes to AntiKickback Regulations by Hhs
    • Changes to Stark Law Regulations by Cms
  • Case Updates
    • Circuit Split Over FCA Liability for Differences of Clinical Opinion

Strategies for Managing Risk in the New Landscape

  • Keeping Abreast of Regulatory Changes
  • Importance of Robust Compliance Program and Employee Education
  • Role of Whistle-Blowers in Healthcare Fraud Enforcement
  • Addressing Cms Audits
  • Other Considerations
    • Using Big Data to Identify Risks

On the Enforcement Horizon

  • How Enforcement May Change in a Biden Administration
  • Hhs Creation of FCA Working Group With DOJ and Hhs-Oig
  • Continued Focus
    • Medicare Part C Billing (OneWay Reviews)
    • Kickbacks and Unlawful Marketing
    • Elder Fraud Initiative
  • New Focus
    • Cares Act and PPP Loan Risk
    • National Nursing Home Initiative
    • Electronic Health Records

Strategies for When an Investigation Hits

  • Responding to Subpoenas
  • Cooperation Credit Updates
  • Brand Memo Updates
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Why Lorman?

Over 35 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Credits

OnDemand Course

Applications have not yet been submitted for Delaware, Idaho, Kentucky, Maine, Ohio, Oklahoma, South Carolina, and Wyoming CLE for this course. However, if you are interested in obtaining CLE for any of the listed states or have any additional credit questions please email us at [email protected] or call us at 866-352-9540.

This course was last revised on February 16, 2021.

Call 1-866-352-9540 for further credit information.

  • AR CLE 1.5
     
  • This course has been approved for 1.5 hours of CLE by the Arkansas CLE Board.
     
  • CA MCLE 1.5
     
  • Lorman Business Center, LLC. is a State Bar of California approved MCLE sponsor and this course qualifies for 1.5 CLE hours of participatory credit.
     
  • WA CLE 1.5
     
  • This program has been approved by the Washington State Board of Continuing Legal Education for 1.5 hours of A/V credit under the Law & Legal Procedure category.
     

To earn each credit Lorman offers through the OnDemand learning platform, you need to watch 100% of the program. Also, for certain credits you will need to fulfill additional requirements which will be displayed on the "credits" tab when viewing the course.

This program does NOT qualify, nor meet the National Standard for NASBA accreditation.

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Why Lorman?

Over 35 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Faculty

Meredith Auten

Meredith Auten

Morgan, Lewis & Bockius LLP

  • Partner in the office of Morgan, Lewis & Bockius LLP
  • Practice emphasizes all aspects of government and regulatory agency investigations and litigation involving alleged health care fraud, government contracts fraud, Foreign Corrupt Practices Act (FCPA), and business frauds
  • Conducts regular seminars and workshops on numerous white-collar litigation topics, in-cluding issues related to the FCA, internal investigations and opioids
  • Awards include Philadelphia Business Journal Best of the Bar, White Collar (2019); Who’s Who Legal Healthcare and Investigations (2020), Expert Guides, Expert, White Collar (2020)
  • Memberships: Vice President, Board of Trustees of the Philadelphia Bar Foundation; Na-tional Co-Chair, Criminal Justice Section White Collar Committee Qui Tam Subcommittee, American Bar Association; Vice Chair, Women's White Collar Defense Association, East Coast Region; Chair, Women's White Collar Defense Association, Philadelphia Chapter; Member, Trustees Council of Penn Women; Fellow, Litigation Counsel of America
  • University of Pennsylvania Law School
  • Can be contacted at 215-963-5860 or [email protected]
Kathleen McDermott

Kathleen McDermott

Morgan, Lewis & Bockius LLP

  • Partner in the Washington, D.C. office of Morgan, Lewis & Bockius LLP
  • Practice emphasizes healthcare industry enforcement and compliance matters. She has a national corporate defense practice in the health industry and is lead counsel in several government investigations and litigations related to violations of the False Claims Act and parallel criminal and administrative statutes. Served as an Assistant U.S. Attorney and DOJ health care fraud coordinator.
  • Active in teaching, publishing and speaking on health industry government enforcement and corporate compliance matters and serves as adjunct faculty at the University of Maryland Francis Cary School of Law, teaching the healthcare fraud seminar.
  • Awards include HHS-OIG Inspector General’s Integrity Award for her work in government health care fraud matters; National Litigation Star, White-Collar Crime/Enforcement/Investigations, Benchmark Litigation (2016–2018); Life Sciences Star, Non-IP Litigation and Enforcement, LMG Life Sciences (2016–2020); Life Sciences Star, Fraud and Abuse, LMG Life Sciences (2012–2016); Best Lawyers, Washingtonian magazine (2007–2019); Recognized, White Collar Matters, Washington, DC Corporate Counsel Super Lawyers; Recognized, Health Care and Criminal Defense: White Collar, Washington, DC Super Lawyers (2007–2009, 2014–2020)
  • Membership information includes Advisory Board of the Bloomberg BNA Medical Device Industry Publication; Chair of the Federal Bar Association Health Law Section; member of the Women’s White Collar Defense Association; Co-Chair, White Collar Crime False Claims Act Subcommittee of the American Bar Association; Chair, American Health Lawyers Association Fraud and Abuse Practice Group and Program Committee for Annual Fraud and Compliance Forum; Chair, Litigation Section of the Maryland State Bar Association; Fellow, Maryland Bar Foundation; Fellow, American Bar Association Foundation
  • J.D. degree, cum laude, Suffolk University Law School
  • Can be contacted at 202-739-5458 or [email protected]
Kayla Stachniak Kaplan

Kayla Stachniak Kaplan

Morgan, Lewis & Bockius LLP

  • Senior associate in Morgan Lewis & Bockius LLP’s litigation practice, based out of the Washington, D.C. office
  • Represents clients across all industries in complex commercial litigation and internal and government investigations, with a focus on civil False Claims Act (FCA) cases
  • Her clients have included both corporations and individuals in the aerospace and defense, financial services, insurance, health care, pharmaceutical, real estate development, and manufacturing industries
  • Regularly writes and speaks on civil FCA developments, including substantial contributions to one of the most frequently cited FCA treatises, Wolters Kluwer’s fifth edition of Civil False Claims and Qui Tam Actions
  • Graduate, James Kent Scholar, Columbia Law School
  • Can be contacted at [email protected] or 202-739-5736
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Over 35 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

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Product ID: 400514
Published 2021
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