Life after Medistat: Fraud and Compliance Lessons from the largest Medicare Fraud Case to Date

Event Information
Product Format
Prerecorded Event
60 Minutes
Product Description

Texas Doctor Accused Of Largest Medicare, Medicaid Fraud- Here Is A Lesson To Take From The Scam!

As healthcare fraud enforcement continues, the cases get larger and larger. Looking at these healthcare fraud cases can help providers to identify fraud and compliance issues in their operations and in their market. Providers need to stay abreast of enforcement and related trends in order to keep their compliance efforts up to speed.  More and more providers are getting caught up in audits and related Medicare fraud cases enforcement activities. Know what the risks are and what the government is looking at before they show up at your door.  

Join expert speaker Robert W. Markette, Jr., who will discuss the Medistat case as it has developed. What is the government alleging? Who did they arrest? How far afield did they look? You will see that the government is aware of a number of problems in the home health arena and is cracking down on them.  Agencies that were not indicted directly in the Medistat case still saw their payments suspended under the new “credible allegation of fraud” suspension. Merely being affiliated with a provider that is engaged in wrongdoing can lead to a suspension, regardless of whether or not you engaged in any wrongdoing.

Highlights of the session:

  • MEDISTAT: What happened?
  • Collateral Damage 
  • Can providers/agencies be suspended even if they were unaware of the fraud?
  • The specific scheme the government is prosecuting
  • Why you need to engage in compliance activities related to medical necessity, homebound status, etc.
  • Why the physician order/certification is not protection.
  • How you can monitor the referrals you receive
  • What do you do when you identify a fraud
  • What is the scope of the government’s authority to suspend payments
  • What other sanctions might you face for similar violations?
  • Physician orders do not eliminate your compliance obligations.
  • Complaint Process
  • Recruiting Patients - What to look out for
  • Ways the government can discover fraud.
  • Key areas to evaluate:
            1. Intake

            2. Internal Reporting

            3. Education

            4. Auditing
  • And much more...


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About Our Speaker

Robert W. Markette - Home Care Expert

For more than a decade, Robert W. Markette, Jr., CHC, has focused his practice on representing home health, hospice, private duty and DME providers in all aspects of their operations. With more than a decade of experience in working with these industries, Robert has developed a reputation for understanding the operational, compliance and legal/regulatory issues facing homecare providers.

In representing the homecare industry, Robert...   More Info
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