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Fraud, Abuse & Ethics [1HR]
[3108]
$30.00


[3108] Fraud, Abuse & Ethics
Provides a general overview of healthcare fraud & abuse laws with a practical understanding of how they work.

TAHC&H Faculty/Presenter: William Dombi

Presentation Info:

  • Presentation Date: November 14, 2017
  • TAHC&H Event: HCSSA Administrator Program | Houston

Subscription Type: Individual

Education-Training Credits:

  • TX HCSSA Administrator/Alternate Continuing Education
    • 1.00 Clock Hrs
  • Continuing Education for Nurses
    • 1.00 Contact Hr(s)
  • Social Worker
    • 1.00 CEU [Pending]

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][6]risk assessment and management

Program Description: Medicare certified home health agencies, private duty agencies and hospices are looking for ways to collaborate with other providers, including referral sources. While collaboration may address some difficult problems, the statute and rules regarding fraud and abuse still apply to all provider types. This program provides a general overview of healthcare fraud & abuse laws that affect providers including:

  • False Claims Act
  • Stark & Anti-Kickback Statutes

Statistics, investigations, and unethical conduct (including blatant overutilization) is discussed. The program also provides a fundamental understanding of these laws to Home Care administrators using real-life home care examples. These case studies include a range of situations in marketing, delivery of care, and referral arrangements. By discussing these laws in context of common scenarios, this presentation provides a practical understanding of how they work.

Program Learning Outcome:

  • Learners will actively engage in the activity and indicate an intent to change or enhance their practice by ensuring application of fraud and abuse surveillance within their agency to promote ethical standards of practice.

About the Presenter:
William Dombi, JD
is the Interim President of the National Association for Home Care & Hospice. Bill specializes in legal, legislative, and regulatory advocacy on behalf of patients and providers of home health and hospice care. With nearly 40 years of experience in health care law and policy, he has been involved in virtually all legislative and regulatory efforts affecting home care and hospice since 1975, including the expansion of the Medicare home health benefit in 1980, the formation of the hospice benefit in 1983, the institution on Medicare PPS for home health in 2000, and the national health care reform legislation in 2010. With litigation, Dombi was lead counsel in the landmark lawsuit that reformed the Medicare home health services benefit, challenges to HMO home care cutbacks for high-tech home care patients, lawsuits against Medicaid programs for inadequate payment rates, along with current lawsuits challenging the Medicare home health face-to-face encounter rule and the Department of labor changes to the overtime rules under the Fair labor Standards Act.

In addition to litigation, Bill offers extensive community and professional educational services through lectures, publications, teleconferences, and videos. He is the Editor and lead author of Home Care & Hospice Law: A Handbook for Executives, the only comprehensive legal treatise on the topic. His lectures include market trends in home care, compliance, risk management, patient rights, fraud and abuse, health care reimbursement, legislative and regulatory reforms, and legal issues in telehealth services.

CE Approval Statements:
· This program meets continuing education requirements for Administrators and Alternates under Texas HCSSA licensing regulations.
· Texas Association for Home Care & Hospice is an approved provider of continuing nursing education by the Texas Nurses Association - Approver, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.
· Texas Association for Home Care & Hospice is an approved provider of social work education by the Texas State Board of Social Work Examiners, approved provider #1230.

[3108] Fraud, Abuse & Ethics

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Subscription Type & Duration:
This product was added to our catalog on Friday 10 November, 2017.
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