Skip to main content

Paying for Referrals: Risky Behavior

Compliance Key INC - Medical Device training


                                       William Mack Copeland
William Mack Copeland, MS, JD, PhD, LFACHE is Keynote Speaker at Compliance Key INC. He practices health care law in Cincinnati at the firm of Copeland Law, LLC, where he is president and CEO. He is also president of Executive & Managerial Development Group, a consulting entity providing compliance and other fraud and abuse related services. A graduate of Northern Kentucky University Salmon P. Chase College of Law, Bill is a frequent author and speaker on health law topics. 
 Webinar Id: LSHCWLP001
 10:00 AM PT | 01:00 PM ET
 12/07/2017
 Duration 60 mins 
Overview
The session will provide an overview of the Anti-Kickback Statute (AKS) and review what it prohibits, as well as review the Statute?s available safe harbors. It will also show how violation of the AKS can raise FCA concerns, and it will provide an assessment of enforcement activities, showing how participants may be at risk. In addition, the session will review recent cases and show how they potentially impact participants.
We will provide an in-depth review of the AKS, focusing on what is prohibited under the Act and what the exceptions are. We will also review the case law, particularly the early case law that sets the stage and basis for how the courts interpret the law. Since one of the exceptions to enforcement under the Act is regulations promulgated by the Secretary, the "safe harbors ", payment practices that will not be subject to criminal prosecution and that will not provide a basis for civil monetary penalties or exclusion from the Medicare or Medicaid programs, we will examine these safe harbors, particularly those more frequently used, to show how protection from enforcement can be achieved. Specifically, we will review the investment, space and equipment rental, personal services/management contracts, and physician recruitment safe harbors.
In addition, we will discuss the OIG?s Joint Venture Advisory Opinion, where a hospital expands into a related service line by contracting with an existing provider of that service. The OIG has significant problems with such an arrangement. We will also discuss the recent advisory opinion by the OIG regarding Physician-Owned Entities. OIG views PODs as inherently suspect under the AKS because the opportunity for a referring physician to earn a profit, including through an investment in an entity for which he or she generates business, could constitute illegal remuneration under the AKS.
Finally, the webinar will review various cases to show how easy it is to run afoul of the Statute, and how the courts view compliance with it.  
Why should you attend this webinar?
This session is designed for healthcare executives, physicians and other healthcare providers who participate in and receive remuneration from Medicare, Medicaid, and other federal health care programs such as TriCare. Several recent cases bring home the realization that the Anti-Kickback Statute is alive, still with us and as viable as ever, and it makes activities that are common in other industries a crime.
As a health care executive, physician or other healthcare provider, you should be very concerned about the potential for the government to use the Anti-Kickback Statute as one of the prime methods for enforcing the federal fraud and abuse laws. It is also concerning that, along with Stark II (the federal physician anti-referral law), the Anti-Kickback Statute can be and is being used as the basis for an action brought under the Federal False Claims Act. In this webinar, you will learn about the elements of the Anti-Kickback Statute, along with the various exceptions and safe harbors that you can rely on for protection against enforcement under these laws. This is important because under recently enacted health care laws, enforcement and health care fraud task forces have been greatly enhanced. In addition, the Affordable Care Act (better known as Obamacare), the government has greatly enhanced enforcement resources. 
Two cases, The Christ Hospital case in Cincinnati, with a settlement in excess of $100 million and the Hardeman Memorial Hospital case in Texas, with a settlement of $398, 230.56 stand out. In addition, in the Hardeman case, the Texas federal court sentenced former CEO Angela Edwards to 2 ½ years in prison and ordered her to pay $370,657 in restitution. If that is not enough to get your attention, consider the recent cases finding that the "responsible corporate officer doctrine" allows the government to hold hospital CEOs and others directly responsible for the fraud. 
Attend this webinar and learn how to protect yourself and your organization.
Areas Covered in the Session:
  • Federal Civil Anti-Kickback Statute,
  • Safe Harbors providing protection under the AKS,
  • Enforcement activities involving the AKS, 
  • The OIG's Joint Venture Advisory Opinion,
  • The OIG's advisory opinion regarding Physician-Owned Entities, and
  • The anti-fraud provisions of the Affordable Care Act.
Who can Benefit:

  • Hospital executives, particularly CEOs, COOs, CFOs, CNOs, and CMOs
  • Nursing home executives
  • Physicians
  • Physician practice managers 
  • Other healthcare provider executives.
Compliance Key INC
  717-208-8666

Comments

Popular posts from this blog

Understanding Design Controls

Compliance Key INC  -  Medical Device Training Overview Design Controls are the processes used to design, develop, and manage medical devices that you manufacture. They are mandated by federal regulation, however, the regulations concerning design controls are vague in terms of the specific process steps required and the approaches that should be taken to achieve compliance should be developed. Knowing how the FDA both views and examines design controls is crucial to achieving compliance throughout the life of the medical devices you manufacture and is one of the most valuable compliance subject areas to explore. Noncompliance in design controls, which are consistently uncovered by the FDA during inspections and examinations, are concerned with the design control process that has been designed and applied and the documentation required to support each design control step. The specific sections of the regulations that apply to design controls include CFR 21 Part 820 Qua...

Essentials of Affirmative Action and OFCCP Compliance

Compliance Key INC  -  Human Resource Training Online                                                                  Janette Levey Frisch Janette Levey Frisch is Keynote Speaker at Compliance key Inc. She is founder of  The EmpLAWyerologist Firm, has over 20 years of legal experience, more than 10 of which she has spent in Employment Law. It was during her tenure as sole in-house counsel for a mid-size staffing company headquartered in Central New Jersey, with operations all over the continental US, that she truly developed her passion for Employment Law.   Webinar Id:   CICJE001  10.00 AM PT | 01.00 PM ET   01/09/2018  Duration: 90 mins  Overview If you are a federal contractor, having a firm grasp on the essentials ...

SOX Compliance: Accounts Receivable Risks and Controls

Overview The accounts receivable process includes the sub-cycles of acquiring and accepting customer orders; writing sales contracts; granting customer credit; shipping or otherwise delivering products or services; billing and recording sales and lease transactions; maintaining and monitoring accounts receivable; instituting effective collection procedures; recording and controlling cash receipts; establishing pricing and promotional activities; and properly valuing receivable balances. In management's selection of procedures and techniques of control, the degree of control implemented is a matter of reasonable business judgment. The common guideline used in determining the degree of internal controls implementation is that the cost of a control should not exceed the benefit derived. The Order to Cash Process (O2C) Process is comprised of several sub-processes that must have a foundation of internal controls for SOX 404 certification process. This webinar wil...