The False Claims Act: Government Enforcement Trends & Compliance Best Practices Related to Medical Necessity, Coding & Billing

Health care organizations continue to face an increasing number of federal government enforcement actions premised on allegations that facility and professional services billed to government health care programs were not medically necessary, not documented appropriately or failed to meet complicated coding and billing rules. Listen along as Hall Render attorneys Ben Fee, Katherine Kuchan, Scott Taebel and Lori Wink discuss recent trends in federal False Claims Act enforcement, including government initiatives and self-disclosures based on medical necessity, coding and billing compliance issues and how organizations can identify and mitigate risk in this high stakes enforcement climate. Topics covered will include:

  • Recent FCA enforcement, settlement and self-disclosure trends;
  • Compliance risks related to medical necessity and electronic health record documentation;
  • Issues surrounding accurate coding for both facility and professional coding, including providing appropriate clinical supervision; and
  • Strategies to identify compliance and mitigate enforcement risk.

The session focuses on the roles of senior leadership, the in-house legal department, compliance and outside counsel in conducting compliance reviews and corrective action planning and recap key trends and developments in recent health care fraud and abuse, compliance and government enforcement. Viewers will leave the webinar with knowledge of how these trends and changes will impact health care organizations and their contracting and compliance efforts.