From Prevention to Prosecution: Understanding and Responding to Enforcement Trends in the Health Care Industry

Join lawyers from Ballard Spahr's Health Care Industry Team as we explore the most recent trends in health care enforcement, steps to follow if fraud is uncovered, and how to remain compliant and prevent repercussions in the future.

Below are descriptions of each program and a registration link. We hope you will join us!

Part 1: The Era of Enforcement: Trends in Health Care Enforcement and Tips for Avoiding DOJ’s Crosshairs
Thursday, June 13, 2024
Watch recording here.

Part 2: Code Blue: Emergency Measures for Handling Whistleblower Complaints + Conducting Investigations
Thursday, June 27, 2024
Watch recording here.

Part 3: Coding Compliance: Common Pitfalls and Best Practices for Physicians
Thursday, July 18, 2024
12:00 – 1:00 PM ET
Watch recording here.

Part 1: The Era of Enforcement: Trends in Health Care Enforcement and Tips for Avoiding DOJ’s Crosshairs

Kicking off our webinar series are Beth Moskow-Schnoll and Matt Kussmaul who will delve into multiple facets of health care enforcement, starting with an exploration of the evolving trends and potential impacts associated with the integration of AI in this domain. They will then shift focus to specific areas of enforcement concern, such as combating telehealth-related fraud, addressing issues within Medicare Advantage, regulating nursing and long-term care facilities, and monitoring private equity investment in health care. Attendees will gain insights into the implications of the newly-formed DOJ Antitrust Division’s Task Force on Health Care Monopolies and Collusion (read our recent alert). And finally, a comprehensive case study will be presented, offering valuable takeaways from a recent health care fraud trial, providing attendees with practical knowledge to navigate the intricacies of regulatory compliance in the health care sector.

Part 2: Code Blue: Emergency Measures for Handling Whistleblower Complaints + Conducting Investigations

With the advent of the new whistleblower pilot policy issued by the Department of Justice that provides whistleblowers with financial incentives to report criminal actions, health care clients need to reexamine their whistleblower policies and how they investigate matters. Our white collar partners, Jim Mitchell and Celia Cohen, will discuss this new policy and the implications of it. They will also discuss best practices for handling investigations that relate to both potential criminal actions, as well as civil False Claims Act matters.

Part 3: Coding Compliance: Common Pitfalls and Best Practices for Physicians

Most physicians don’t become doctors because they want to learn the details of medical billing, but billing is the key to getting paid, and errors are not uncommon. When services are paid for by government health care programs, those errors can be costly and may even lead to a criminal investigation of the matter. Phil Legendy, Jim Mitchell, and David Goroff will discuss the government’s primary tools for enforcing billing issues, review examples of common pitfalls in physician offices, and discuss best practices to reduce risk.