Updates on Fraud Investigations against Healthcare Providers

Event Information
Product Format
Prerecorded Event
60 minutes
Product Description

Avoiding Allegations of Fraudulent Activities through Current Best Practices


Fraud Investigations are increasing from both governmental agencies and insurance special investigation units. Medical providers need to use best practices to avoid even the appearance of fraud. Once suspected, fraud allegations can put your practice on the radar for years and can be difficult to resolve or lead to large recriminations, fines, and even license revocation or suspension. This likely could result in significant lost revenue and bankruptcy.

This session by expert speaker Thomas J. Force, Esq., will categorize the most common fraud actions brought against healthcare providers and include recommendations to avoid audits. Thomas will analyze recent court cases, fraud allegations, findings of fraud, and SIU investigations into fraud. You will receive strategies and techniques for avoiding those practices that may lead to fraud allegations. Additionally, Thomas will reveal current best practices that you can implement in your organization.

Session Highlights:

  • Summary of developments in fraud investigations
  • Review of recent fraud cases
  • Techniques to avoid allegations of fraudulent activity
  • Overview of state and federal anti-fraud laws
  • Current best practices
  • Steps to take if fraudulent practices are suspected

Session Agenda

  • What is fraud?
  • Major federal laws
  • False Claims Act
  • Anti-Kickback Statute
  • Physícal Self-Referral Law
  • What is DHS?
  • Exclusion Statute
  • State laws
  • How is fraud detected?
  • Major area—Durable medical equipment
  • Recent cases and investigations
  • Common types of fraud by dishonest providers
  • Self-audits
  • Coding/ billing problems
  • EHR system

Who should attend?

  • Out-of-Network Healthcare Providers including revenue recovery and billing staffs, especially
    • Ambulatory Surgery Centers
    • Surgical Centers
    • Hospitals
  • Chiropractors
  • Consultants
  • Attorneys

Order Below or Call 1-866-458-2965 Today

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About Our Speaker

Thomas Force - Compliance Coding Expert

Thomas J. Force, Esq. is a licensed attorney since 1994 in both state and federal courts in New Jersey and New York, with 27 years of experience in the healthcare and insurance industries. He is the president and founder of The Patriot Group, a full-service healthcare physician advocacy and revenue recovery company providing billing, appeals, collections and follow-up services for healthcare. Thomas is also the former CEO, general...   More Info
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