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The Federal False Claims Act: Enforcement and Recent Updates – Recorded Webinar + Presentation
Recorded Webinar
The session will provide an overview of the Federal Civil False Claims Act (FCA) and how it works. It will also provide an assessment of enforcement activities, showing how healthcare providers may be at risk. In addition, the session will review recent cases and show how they potentially impact healthcare providers.
We will start with a review of the Federal False Claims Act and discuss how it works and how it is being used to fight health care fraud. We will discuss how the various health care fraud task forces use the Federal False Claims Act and its whistleblower provisions
to identify and prosecute health care fraud. The webinar will take the Federal False Claims Act apart and show step by step how an action is filed, how the government responds and how the courts interpret various elements of the Act. We will discuss proof, damages under the Act and how the whistleblower is rewarded for bringing a successful case.
The session will also provide an overview of the Anti-Kickback Statute (AKS) and review what it prohibits, as well as a general review the AKS available safe harbors. It will also show how violation of the AKS can raise FCA concerns, and it will provide an assessment of enforcement activities, showing how participants may be at risk. In addition, the session will review recent cases and show how they potentially impact participants.
We will provide an in-depth review of the AKS, focusing on what is prohibited under the Act and what the exceptions are. We will also review the case law, particularly the early case law that sets the stage and basis for how the courts interpret the law.
We will also review the changes made to both the False Claims Act and the AntiKickback Statute made by the Affordable Care Act.
Finally, the webinar will review various cases to show how easy it is to run afoul of the Statute, and how the courts view compliance with it. In addition, we will discuss the latest updates to both the False Claims Act and the Anti-Kickback Statute.
Recent cases and/or enforcement actions involving the FCA raise serious concerns regarding compliance issues with hospital, physician practices and other healthcare entities. Recoveries under the FCA are at an all-time high, and the percentage of actions involving healthcare organizations has been increasing at exponential rates.
This session is designed for healthcare executives, attorneys and consultants who advise health care executives and others who want to learn about the False Claims Act. The health care executive, physician or other health care provider, should be very concerned about the potential for enforcement actions under the FCA. This is important because under recently enacted health care laws, enforcement and health care fraud task forces have been greatly enhanced. Recovery under the FCA last year resulted in over $3.1 billion being recovered for the federal government, $24.2 billion since the law was revised to make it more relator friendly in 1986.
In FY 2020, the Department of Justice (DOJ) opened 1,148 new criminal health care fraud investigations. Federal prosecutors filed criminal charges in 412 cases involving 679 defendants. A total of 440 defendants were convicted of health care fraud related crimes during the year. Also, in FY 2020, DOJ opened 1,079 new civil health care fraud investigations and had 1,498 civil health care fraud matters pending at the end of the fiscal year. Federal Bureau of Investigation (FBI) investigative efforts resulted in over 407 operational disruptions of criminal fraud organizations and the dismantlement of the criminal hierarchy of more than 101 health care fraud criminal enterprises. In FY 2020, investigations conducted by HHS’s Office of Inspector General (HHS-OIG) resulted in 578 criminal actions against individuals or entities that engaged in crimes related to Medicare and Medicaid, and 781 civil actions, which include false claims and unjust-enrichment lawsuits filed in federal district court, civil monetary penalties (CMP) settlements, and administrative recoveries related to provider selfdisclosure matters. HHS-OIG also excluded 2,148 individuals and entities from participation in Medicare, Medicaid, and other federal health care programs.
Since 1986, whistleblowers have been awarded nearly $4 billion and whistleblowers are where a majority of the FCA suits originate. Several recent cases involving healthcare providers have resulted in huge settlements. If that is not enough to get your attention, consider the recent cases finding that the “responsible corporate officer doctrine” allows the government to hold hospital CEOs and others directly responsible for the fraud. In a recent case, executives paid $1 million to settle allegations of fraud and were excluded from participation in federal health care programs. You will want to attend this webinar to learn how to protect your healthcare providers.
Venue: Recorded Webinar
Pivot Tables are one of Excel’s most powerful and misunderstood tools but once you know how to use them, they can transform how you analyse and report on data. In just a few clicks, you can summarise thousands of rows into meaningful, dynamic reports - no formulas required. This session will show you how to quickly create and customise Pivot Tables to reveal trends, answer questions, and support better decision-making. You’ll also discover how to turn your Pivot Table into a visual dashboard using built-in charting tools, slicers, and layout options. If you've ever looked at a Pivot Table and thought, “I should really learn that”, this is your moment. Why you should attend Manually building summaries and reports from Excel data is time-consuming and error-prone. Pivot Tables eliminate the guesswork, automate the process, and give you instant insights. This session is perfect if you want to save time, reduce complexity, and finally get confident with one of Excel’s most powerful (but underused) features. Topics covered How to structure your source data for best results Creating Pivot Tables in just a few clicks Summarising data with totals, counts, and percentages Formatting your Pivot Table for clarity and impact Sorting and filtering with built-in tools and slicers Visualising data using Pivot Charts Understanding and using (or avoiding) GETPIVOTDATA Who should attend This session is for anyone who wants to level up their Excel skills and gain confidence with Pivot Tables. It’s ideal for professionals in admin, finance, HR, operations, or anyone who builds regular reports. You should be comfortable with basic Excel tasks like entering data, using copy/paste, and applying simple formatting. The training is delivered using Excel for Windows (Microsoft 365), but most techniques also apply to earlier versions and Excel for Mac.
Whether your employer is a clinic, a hospital, home health, or long term care; whether you are an MD, RN, an occupational therapist, a receptionist, or in the C-Suite, approximately 5% - 10% of your patients may be gay, lesbian, or bisexual. Additional patients may be transgender, intersex, or questioning their gender identity or sexual orientation. The healthcare needs of GLBT patients may appear to be the same as other patients’, but institutionalized heterosexism in healthcare is a real barrier to quality care. Healthcare providers acknowledge they are serving more GLBT patients, and that they want to provide quality GLBT care, but aren’t sure how to best create and implement the policies, procedures, and practices to ensure best patient outcomes. GLBT patients face a multitude of barriers to equitable care such as: refusals of care, delayed or substandard care, mistreatment, inequitable policies and practices, end-of-life issues, and limits on visitation. The challenges begin from the beginning of the health professionals’ relationship with their GLBT patient—starting from asking them to identify if they are male or female, married or single, on their intake form. Objectives To list relevant laws, regulations and standards required for health equity and patient-centered care of GLBT patients To identify key policy, procedure and practice issues related to GLBT patients and their families to incorporate into already existing policies, procedures and practices To discuss opportunities to collect GLBT – relevant data and information during the healthcare encounter To identify or revise strategic community outreach efforts to the GLBT population To name a variety of resources Who should Attend? HR Management Nurses Other Health Professionals
Everyone makes decisions, but of course some decisions are more important and complex than others. Whether it is a decision about what to wear to work to deciding on a merger, the decision making process is generally the same. Most decision making by management is convoluted with much fuzziness and backtracking. Research suggests that managers put little thought into the decision making process such as—analysis of the risk, what values are poignant, the alternatives evaluated, quantitative and qualitative data, identifying the stakeholders, bias, and the impact of the decision on the system, to name a few. Decision making is the basic foundation of the process of management. Yet most management training and development tactics ignore this essential skill. Learning Objectives To examine the “act of choice” To analyze roadblocks to effective decision making To discuss 10 decision making/problem solving tools To list the various models of decision making Analyze how managers make decisions Who should Attend? HR Management Any Employee
It is our nature to think—we all do it, obviously. However, a good share of our thinking is biased, distorted, or incomplete. Critical thinking is an essential skill for both managers and employees. Few of us are effective critical thinkers though research suggests that leaders believe they think quite well. Critical thinking ensures we pose the right questions, view others’ viewpoints with merit, and challenge assumptions in strategic thinking, decision making and problem solving. Non-critical thinkers shoot down ideas before they are understood, or take action based on faulty assumptions resulting in a business disaster. Teams, as well as individuals, must learn to think critically which requires a work atmosphere that is conducive to challenging others’ perspectives. Critical thinking enables teams to develop positive insights and ideas that lead to effective action. It focuses on reframing and rethinking issues so that the right problems are addressed, and requires challenging conventional wisdom. Using the process of critical thinking leads to reasoned conclusions, better decisions, fewer mistakes, and improves collaboration among team members. Learning Objectives Define critical thinking List characteristics of critical thinkers Examine the critical thinking process Explore the elements of reasoning Discuss critical thinking techniques Identify organizational, team, and individual critical thinking barriers Who should Attend? HR Management Any Employee