Physicians in the Crosshairs: A Review of Recent Compliance Enforcement against Physicians

Strengthen Your Compliance & Protect Your Medical Practice from Settlements & Enforcement

There has been a noticeable uptick in settlements and enforcement against individual physicians, ever since the U.S. Department of Justice (DOJ) issued the Yates’ Memo for stronger enforcement against individuals. As a physician, you cannot afford to ignore the compliance risk you may face – because the settlements and enforcement against your practice can be very costly.

Join this session, where healthcare reimbursement and compliance expert C. J. Wolf, MD, M.Ed. will discuss in detail these recent enforcement actions – and show you how to prevent them by strengthening your organization’s compliance program. You will learn how to assess your compliance program’s effectiveness, access resources to check your practice’s billing compliance, and which tools to use to identify questionable financial relationships.

You will also learn about the current environment of compliance risk your medical practice is exposed to – especially over the last two years – due to the DOJ’s increased focus on individual physician accountability.

After attending the webinar, you will be armed with the tools, knowledge and methods to prevent settlements and enforcement against your practice.

Session Highlights

The session will cover useful topics, such as:

• High level overview of the Yates’ Memo, it’s purpose and the effect it has on physician practices
• Summary of a recent physician settlement case because of medical billing practices
• Summary of a recent physician settlement case because of financial relationships with vendors and business partners
• How to strengthen your medical billing compliance program
• How to strengthen your financial relationships compliance program

Session Objectives

After attending the session, you will be able to:

• Assess your compliance program’s effectiveness
• Access resources to check your practice’s billing compliance
• Learn what tools are helpful in identifying questionable financial relationships that raise red flags
• Prevent settlements and enforcement against your practice

Session Agenda

• Memo highlights
• Cardiovascular practice settlement
• CPT codes 11043 and 28002
• Dermagraft
• Advanced pain management
• Attorney general sessions
• Lessons for compliance programs
• Local coverage determination
• 60-day overpayment rule
• Lookback period
• Statistical sampling
• Proactive and reactive audits
• Effective compliance programs
• Auditing & documentation

Who Should Attend

• Compliance officers
• Billing staff and coders
• Compliance auditors
• Physicians

Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

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