Fraud & Abuse, Stark & Anti-Kickback Issues
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.
Overview:
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
Learning Objectives:
- 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:
- Physicians
- PAs/APNs
- Practice Managers
- Health Care Providers
- Pharmaceutical Representatives
- Billing & Coding Professionals
- Financial Managers/Advisors
- Compliance Officers
Speaker Profile
Clients seek her expertise when reviewing employment agreements, commercial leases, formation of new businesses and medical practices, separation from and sale of businesses and medical practices, business structuring, commercial and residential real estate transactions, 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.
Ms. Campanella is a nationally respected regulatory compliance specialist who dedicates herself to educating professionals nationwide on issues of business transactions and regulatory compliance.
Ms. Campanella graduated Magna Cum Laude from Seton Hall University with a Masters in Healthcare Administration in 2012 and earned her Juris Doctor from Seton Hall Law in 2005. In 2002, she graduated with Honors from Union College with a Bachelor of Arts in History. She is also a member of the American College of Healthcare Executives (New Jersey Chapter), the American Health Lawyers Association, and the New York City Bar Association.
Ms. Campanella has been admitted to practice law in New Jersey and United States District Court for the District of New Jersey since 2006, the District of Columbia since 2013, New York since 2013, Pennsylvania since 2017 and Vermont since 2018.
Ms. Campanella was recognized by New Jersey Super LawyersTM as a Rising Star in 2014, 2015, 2017, 2018, 2019 and 2020, a “Best of Bergen” attorney by Bergen Magazine in 2017, 2018 & 2019, an “Awesome Attorney” by South Jersey Magazine in 2019, and is recognized by AVVO as a Clients’ Choice Attorney in 2016, 2017, 2018 & 2019 with an AVVO rating of “10 out of 10”.* Her additional certifications include earning the status of Certified HIPAA Administrator from the HIPAA Academy and she is a Fellow in the American College of Healthcare Executives. Ms. Campanella is also an Adjunct Professor at the Seton Hall University School of Health and Medical Sciences.