ObamaCare Takes Aim at Healthcare Fraud and Abuse 2015

Key Topics

• Better screening and compliance activities
  • Oversight of providers and suppliers
  • Pre-enrolment screening program
  • Withholding payment where credible allegation of fraud made
  • Moratorium to prevent new providers from joining program
  • Expand RAC program
  • New controls on high risk programs
  • Compliance programs required
  • Expand security bond program
  • Limits time for filing claims
• More money to prevent and fight fraud
  • New task force
  • Hiring new agents and investigators
• Greater data sharing
  • New data bank
  • Centralizes claims data
  • DOJ and OIG has greater access to CMS claims and payment data
  • Centralized data bank to identify "false front" providers
  • Requires faster sharing of terminated provider data with states
  • Requires states to report additional Medicaid data
• New fines and penalties
  • Increase in sentencing guidelines for healthcare fraud
  • Stronger civil and monetary penalties
  • Recapture fraudulent funds
  • New fines and penalties for failure to return overpayments
  • New penalties for marketing violations
  • New penalties for false claims
  • Increased investigative power for nursing home fraud

Who should Attend

Senior attendees from:

• Chief Operating Officers
• Chief Executive Officers
• Hospital Corporate Counsel
• Corporate Compliance Officers
• Physician Practice Managers
• Chief Financial Officers