Lobbying Affiliate: MML&K Government Solutions

Fraud, Waste and Abuse

especially in healthcare law, prevention can be the best medicine.

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Overview

Keeping Healthcare Providers Compliant

The regulatory environment for healthcare providers has never before been such a minefield. While the Stark law, the Anti-Kickback Statute and the False Claims Act have been around for years, healthcare reform and other changes in law and policy have found new uses for these laws to police every step of the practice of healthcare. Numerous advisory opinions, corporate integrity agreements, Department of Justice correspondence, court rulings and settlements against providers now attest that it is no longer enough to operate and act in good faith.  Regulators may hold providers to standards that they are often not even aware of. 

Laws and regulations meant to curb fraud, waste and abuse are now increasingly used to scrutinize good faith day-to-day transactions. Even a small oversight from a strenuously conscientious provider can become an overpayment, potentially subject to False Claims Act liability. With a look-back period of six years under the Affordable Care Act’s 60-day rule, these issues can accumulate and bankrupt a practice.  Additionally, increasing warnings of fraud in provider agreements from the U.S. Department of Health and Human Services Office of the Inspector General signal an increased scrutiny on agreements that actually operate in furtherance of the ACA’s aims of patient-centered comprehensive care.

That’s why the attorneys at McBrayer scrutinize every law, regulation, policy, work plan, guidance, agency interpretation or trend to stay abreast of how enforcement actions will affect healthcare providers. We continually improve our knowledge of healthcare compliance to assist providers with keeping their practice compliant. No matter what agency is looking in your direction, we have your back.

Take the First Step to Success

For more information about our services and how our lawyers can help you navigate the challenges facing healthcare providers and industry participants, contact the McBrayer firm. Our attorneys serve healthcare clients throughout Kentucky from our offices in Louisville, Lexington, Frankfort, Greenup and Washington, D.C.

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