Heathcare Fraud & Abuse, Stark and Anti-Kickback Issues
CMS finalized a number of significant changes to the Stark Law, now that these changes have gone into effect. Health care organizations should be monitoring and auditing their existing arrangements to ensure they are compliant with Stark’s technical requirements and key tenets of defensibility (e.g., fair market value, commercial reasonableness, and not taking into account designated health service referrals) in case their physician arrangements are ever challenged. Healthcare reform has invigorated the government’s focus on healthcare fraud, including enforcement of the Stark Law. Improper design and implementation of physician arrangements can result in penalties, denial of payments, and exclusion from federal health care programs. Thus, ensuring Stark Law compliance will be critical for medical groups, hospitals and health systems looking to manage areas of enterprise risk.
The Anti-Kickback Statute(AKS) provides that the offer or payment, as well as the solicitation or receipt, of “any remuneration” in exchange for referrals of any good, facility, service, or item for which payment may be made in whole or in part under Medicare/Medicaid is prohibited.
The expert Gina L. Campanella, Esq., FACHE, will provide an overview of the Federal Stark and Anti-Kickback laws and regulations including the source and purpose of these laws; and then go through several common examples of the most frequent scenarios that get physicians in trouble under these laws.
- Develop and understanding of the basics of the federal laws prohibiting healthcare fraud
- Understand Federal Stark Law
- Understand Anti-Kickback Statute
- Learn to recognize and eliminate “red flags”
- Understand common scenarios that are considered fraud and how to modify these scenarios to be compliant
- How to be compliant with these Fraud & Abuse, Stark and Anti-Kickback Statute
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
- Q&A Session
- Healthcare Executives
- Chief Operation Officers
- Chief Finance Officer
- Chief Medical Officers
- Compliance Officers
- Practice Managers
- Healthcare Providers
- Billing and Coding Professionals
- Healthcare Attorneys
About The Presenter:
Gina L. Campanella, Esq., FACHE focuses on healthcare regulatory and transactional matters federally and in New Jersey, New York and Pennsylvania. Ms. Campanella has assisted clients with transactional services and regulatory compliance consulting, as well as general counsel services to small practices and large societies and medical groups alike. Clients also seek her expertise when reviewing employment agreements, formation of new practices, separation from and sale of practices, business structuring, 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 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. Ms. Campanella lectures nationally on issues of health care law and compliance for events and organizations such as: the New Jersey Association of Osteopathic Physicians and Surgeons, the Atlantic Regional Osteopathic Conference, the New Jersey Chapter of the American College of Emergency Physicians, the New Jersey Podiatric Medical Society, the Health Care Compliance Association, the New Jersey Medical Group Management Association, the New York Medical Group management Association, Columbia University Medical School, the Advanced Emergency & Acute Care Medicine CME Conference, the CentraState Medical Center Practice Managers Group, Bassett Medical Center Medical Staff, the New Jersey State Society of Physician Assistants, and Skillacquire.
Ms. Campanella has been admitted to practice law in the State of New Jersey and United States District Court for the District of New Jersey since 2006, the District of Columbia since 2013, the State of New York since 2013 and the State of Pennsylvania since 2017. Ms. Campanella was recognized by New Jersey Super LawyersTM as a Rising Star in 2014, 2015, 2017 and 2018, a “Best of Bergen” attorney by Bergen Magazine in 2017, and is recognized by AVVO as a Clients’ Choice Attorney in 2016, 2017 and 2018 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.
You will receive an email with login information and handouts (presentation slides) that you can print and share to all participants at your location.
Operating System: Windows any version preferably above Windows Vista & Mac any version above OS X 10.6
Internet Speed: Preferably above 1 MBPS
Headset: Any decent headset and microphone which can be used to talk and hear clearly
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Toll-Free No: 1-302-444-0162