Fraud & Abuse, Stark & Anti-Kickback Issues
10:00am - 11:00am
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.
Attendees will learn how these laws are different and why, even though they are different, they are very often “lumped” together and referred to simultaneously. Moreover, attendees will get a brief overview of how these laws may interact with other laws and regulations and guidance on how to interpret similar state laws in the overall context of the federal requirements.
The presenter will go through several common examples of the most frequent scenarios that get physicians in trouble under these laws including, subleasing, leasing from other physicians, laboratory partnerships, accepting gifts from colleagues or contractors, contractor agreements and more!
Do not become a statistic! You are not working hard to build your practice to end up losing it all – attendance at this webinar will provide a core understanding of what is required of physicians, health care providers, practices and ancillary services providers and attendees will leave with a strong understanding of what is good in their practice, and what may need to be modified immediately.
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.
Areas Covered in the Session:
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
Who Will Benefit:
Health Care Providers
Billing & Coding Professionals
Gina L Campanella – MentorHealth Speaker Profile
Gina L. Campanella focuses on healthcare regulatory and transactional matters federally and in New Jersey, New York and Pennsylvania. Ms. Campanella 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.
Event link: https://www.mentorhealth.com/webinar/–801766LIVE
Netzealous LLC – MentorHealth
Phone No: 1-800-385-1607
Contact: Netzealous LLC MentorHealth
Contact Phone: 8003851607
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