Presenters:
Robert W. Liles, JD, MBA, MS, CPC and Ashley Morgan, JD, CPC, CMCO, CMRS
Description:
Mere mistakes, simple negligence and accidents that lead to the submission of incorrect or false information in a claim is not a crime but can lead to the assessment of an overpayment. Unfortunately, the government may contend that the submission of false information is not a mere mistake but rather constitutes fraud. The falsification of medical records is increasingly cited as the basis (in whole or in part) in the prosecution of physicians and administrative personnel in a wide variety of healthcare fraud cases. In this session, we will examine a number of these cases and discuss the conduct that led to the government enforcement action. Participants will also learn options for addressing records that appear to be incorrect or intentionally falsified.
Attendees will be able to:
• Discuss the various types of government investigations and prosecutions currently being pursued by Federal and State prosecutors around the country.
• Demonstrate steps that they can take to reduce their practice’s level of risk and increase its compliance with regulatory requirements.
• Discuss how to best respond if they identify incorrect or false statements made in previously submitted and paid claims.