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CodeProU: Essentials of HH & Hospice Coding in ICD-10-CM | LEVEL 1
CodeProU: Essentials of HH & Hospice Coding in ICD-10-CM | LEVEL 1
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Fraud & Compliance: A Changing World for Hospice
[2432]
$45.00


[2432] Fraud & Compliance: A Changing World for Hospice

Summary: Hospice relationships draw increased focus to prevent fraud.

HCSSA Topic(s) Addressed:

  • §97.259[d][1]information regarding fraud and abuse detection and prevention
  • §97.259[d][4]agency responsibilities
  • §97.260[a][9]community resources
  • §97.260[a][10]marketing

Faculty: Berliner, Marie

Program Description: Regulations are tightening in the hospice industry both as a constraint against fraud and as a focus on improved quality of care. As new relationships link hospices together with entities such as nursing homes, assisted living facilities and accountable care organizations, the compliance focus and governance of hospices must also adapt. In this program Marie discusses significant hospice fraud cases in the last year while also presenting Congressional actions and OIG Work Plan initiatives addressing fraud, reimbursement changes, and reporting practices as they affect fraud enforcement.

Program Objectives: Upon completion of this program, the viewer will be able to:

  • Discuss perspectives and objectives of Congress, CMS and OIG in implementing hospice quality and cost controls
  • Explain interplay among OIG reports, Work Plans, and CMS Regulations
  • Highlight concerns over nursing facility relationships, use of GIP services, CHC marketing, and duplicate billings
  • Explain data collection measures and relationship to cost containment
  • Review lawsuits filed under the False Claims Act by individual citizens and the Department of Justice
  • Evaluate patterns of behavior common to enforcement actions (aggressive marketing, CHC services, terminal illness criteria and discharge criteria
  • Explain proposal to give qui tam relators a greater share of recovery.

About the Presenter: Marie Berliner, JD, Senior Counsel at Joy & Young, LLP has been counseling healthcare providers, including home health agencies, hospices, physicians and hospitals, in all aspects of administrative and regulatory compliance, since 1988. Her practice focuses on Medicare reimbursement, fraud and abuse, physician self-referrals (“Stark law”), licensure and certification, and other administrative and regulatory healthcare matters. She has also been a regular speaker (2004-2013) on Medicare issues to TAHC&H, The Texas and New Mexico Hospice Organization, and the University of Texas’ Annual Health Law Conference, and has presented numerous administrator training seminars to home health and hospice providers on select federal and state laws.
Ms. Berliner is licensed to practice in Texas as well as Maryland, and the District of Columbia.

Education-Training Credits:

  • 1.50 Hr(s) HCSSA Administrator/Alternate

[2432] Fraud & Compliance: A Changing World for Hospice

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This product was added to our catalog on Friday 14 June, 2013.
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