BarbriSFCourseDetails

Course Details

This CLE course will provide guidance to healthcare counsel for withstanding heightened regulatory scrutiny and increased enforcement activity targeting home health operations. The panel will discuss steps home health agencies can take to minimize the risk of fraud and abuse investigations.

Faculty

Description

In recent years, there has been a substantial increase in the availability and severity of sanctions, including civil monetary penalties, that may be imposed by CMS on home health agencies with survey deficiencies. The Office of Inspector General (OIG) has also identified particular areas within the home health industry that are vulnerable to fraud and abuse. Moreover, the roll out of the new Patient-Driven Groupings Model (PGDM) payment system for home health agencies will present new liabilities for home health agencies, as there are sure to be audits verifying compliance.

Healthcare counsel should monitor the areas of home health operations that are currently targeted for enforcement, evaluate their clients' potential risks, and assist with developing effective compliance measures.

Listen as our authoritative panel examines these changes in the home health industry and discusses best practices to ensure compliance with federal fraud and abuse laws and minimize the likelihood of government investigations.

Outline

  1. Survey readiness and process
  2. OIG work plan focus
  3. PDGM compliance
  4. Recent cases and lessons learned

Benefits

The panel will review these and other key questions:

  • What does CMS survey data show about surveyor focus areas?
  • How did the revisions to State Operations Manual, Appendix Q alter the immediate jeopardy process?
  • What areas of home health operations are more susceptible to potential fraud and abuse violations?
  • What are the risks to agencies whose utilization patterns change under PDGM?
  • What lessons can be learned from recent actions and settlements for mitigating risk?