Healthcare Fraud and Abuse 2015 - ObamaCare Takes Aim at Healthcare Fraud and Abuse

Overview: This webinar will discuss the various anti-fraud and abuse provisions of the Affordable Care Act and will discuss the actions of that should be taken to minimize enforcement activities. Medicare it is a higher risk Federal program and has been designated as such by the GEN accountability office since 1990. Its vast size and complexity make it vulnerable to fraud, waste and abuse.
Lewis Morris, chief counsel to the Office of Inspector General, Department Of Health and Human Services, testifying before the Senate Finance Committee in 2009, stated, "Although we cannot measure the full extent of the health care fraud in Medicare and Medicaid, everywhere we look we continue to find fraud in these programs." Conservative estimates indicate that as much as $60 billion of total national health care spending is fraudulent. According to the New England Journal of Medicine, federal investigators have found that the Medicare System is being infiltrated by criminals and organized crime. However, fraud is not limited to the activities of organized crime.
In Morris’s testimony, he indicated, "Major corporations such as pharmaceutical and medical device manufacturers and institutions such as hospitals and nursing facilities have also committed fraud, sometimes on a grand scale." The Obama Administration has created a cabinet-level anti-fraud task force, overseen by the deputy attorney general and the deputy HHS’ secretary. This task force will oversee "strike force teams," composed of investigators from various federal agencies. The initial teams will be doubled and will target cities where healthcare fraud is rampant. Obamacare includes sweeping provisions to combat healthcare fraud and abuse. You should attend this webinar to learn about these provisions and how you can protect yourself and your organization.
Areas Covered in the Session:
More money to prevent and fight fraud
Hiring new agents and investigators
New task force
Better screening and compliance activities
Pre-enrolment screening program
Oversight of providers and suppliers
Moratorium to prevent new providers from joining program
Withholding payment where credible allegation of fraud made
New controls on high risk programs
Expand RAC program
Expand security bond program
Compliance programs required
Limits time for filing claims
New fines and penalties
Stronger civil and monetary penalties
Increase in sentencing guidelines for healthcare fraud
New fines and penalties for failure to return overpayments
Recapture fraudulent funds
New penalties for false claims
New penalties for marketing violations
Increased investigative power for nursing home fraud
Greater data sharing
Centralizes claims data
New data bank
Centralized data bank to identify "false front" providers
DOJ and OIG has greater access to CMS claims and payment data
Requires states to report additional Medicaid data
Requires faster sharing of terminated provider data with states
Actions that should be taken
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