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Healthcare Enforcement Trends: 2017 in Review & What to Expect in 2018
February 28, 2018 @ 12:00 pm - 1:00 pmFree
Change is a predominant force in healthcare and healthcare organizations must plan for shifts within an ever changing regulatory environment. Given this current climate, it is important to understand that enforcement will continue to be a priority. This webinar presented by Attorney Matthew Fischer will cover the latest trends in criminal enforcement, administrative enforcement, and litigation under the False Claims Act. It is imperative to understand these changes to ensure compliance, mitigate risks, and protect your bottom lines.
Major areas to be discussed –
- DOJ Criminal Enforcement Actions: In July 2017, the DOJ announced the largest ever healthcare fraud enforcement action in its history. The DOJ brought charges against 412 individuals. This action was focused heavily on the distribution of medically unnecessary prescription drugs along with other theories of embezzlement, theft, and fraudulent billing.
- Enforcing Quality of Care Standards Using the False Claims Act (FCA): Included in its arsenal, DOJ is increasing scrutiny on nursing homes utilizing new theories under the FCA. These types of cases take two forms, worthless services and false certification cases. Both involve circumstances where some care was provided to a patient but the care was so poor that the services were essentially valueless.
- HHS Enforcement Activity: The amount of actions taken by HHS are up compared to 2016 (i.e., exclusions, civil monetary penalties, and corporate integrity agreements). HHS OIG focused exclusions on business owners and executives of pharmacies. Moratoria on certain providers continued in 2017 such as home health agencies and non-emergency ambulance providers.
- HHS Office of Civil Rights (OCR) / HIPAA Enforcement: The fines imposed by OCR in 2017 exceeded 2016. OCR has ramped up scrutiny of cybersecurity and providers’ responses to data breaches. As part of its efforts, OCR issued its first cyber-attack “quick-response” guidance in June 2017.