Medicare audit requests on the rise: How to justify the medical necessity of your lab’s testing
How to Protect Your Lab from Costly and Time-Consuming Government Investigations and Qui Tam Lawsuits—and What to Do If the Government Does Come Calling
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If you missed the webinar from Pathology Webinars on “How to Protect Your Lab from Costly and Time-Consuming Government Investigations and Qui Tam Lawsuits—and What to Do If the Government Does Come Calling,” you still have a chance to purchase the CD of this event.
The number of fraud and compliance investigations continues to grow. And with an increase in False Claims Act whistleblower investigations, state and federal agencies are getting inside information on the activities of targeted providers, making it likely that more and more laboratories—including yours—could come under their scrutiny.
And if all that wasn’t bad enough, CMS and the government are now cracking down on the need for testing, and making your lab responsible for proof of medical necessity. You can’t just rely on the orders you get from the doctor. Increasingly, labs are being asked to exercise independent judgment on whether the testing you’re doing is excessive or not.
As these and other rules continue to change, and the government’s focus on laboratory activities increases, it’s critical that you have a thorough understanding of your lab’s potential vulnerabilities, and what you can do to keep your laboratory or pathology group from becoming a target of an investigation that could cost you millions and jeopardize your participation in federal healthcare programs.
False Claims Act “qui tam” lawsuits are often brought by competitors or current or former employees who stand to gain significantly if a government agency is successful at proving its case. These whistleblowers get a percentage of any funds the laboratory pays the government to settle its claim. And the amounts can be substantial, which is why whistleblowers will do a lot to help the government.
So what can your laboratory or pathology practice do now to avoid a possible government investigation? How can you ensure a culture of compliance in your laboratory? And if you are investigated, what should you do when the government comes knocking?
Get answers to these questions and more when you purchase the CD of the latest webinar from Pathology Webinars “How to Protect Your Lab from Costly and Time-Consuming Government Investigations and Qui Tam Lawsuits—and What to Do If the Government Does Come Calling” that originally aired on March 24, 2016. Richard Blake and Bruce Reinhart, both from McDonald Hopkins, will provide you with an inside look at how the government investigates cases against pathologists and laboratories, and what you can do to avoid being targeted by government agencies or qui tam whistleblowers who have a very personal stake in the outcome. You’ll also get information on a case pending before the U.S. Supreme Court that could severely limit healthcare qui tam cases, including the ramifications any judgment could have on your laboratory.
As former Assistant United States Attorneys who prosecuted healthcare fraud cases and who now represent pathologists and laboratories in criminal and civil investigations, both speakers can provide a unique perspective along with practical advice on how to avoid being targeted and what to do in the event that your laboratory or pathology group is investigated.
If you’re a laboratory director, business manager, compliance officer, or pathologist—anyone who needs to ensure their lab’s compliance and avoid or reduce possible penalties—you’ll want to order this recording.
Distinguished Presenters
Richard H. Blake is a Member and Co-Chair of McDonald Hopkins’ Government Compliance, Investigations, and White Collar Defense Practice Group. His background includes more than 25 years of investigative and litigation experience in both government and private practice where he represents clients in a wide range of government investigations, prosecutions, and commercial litigation matters.
After almost 20 years as an Assistant United States Attorney with the Department of Justice and a Senior Enforcement Attorney with the Department of Treasury, Mr. Blake now represents clients in all levels of criminal, civil, and administrative matters, including criminal grand jury investigations; qui tam whistleblower and False Claims Act matters; SEC and state securities investigations; FCPA, data breach, and HIPAA violations; and complex commercial litigation matters.
Mr. Blake has successfully represented clients in cases involving allegations of healthcare fraud, environmental law violations, banking and securities fraud, public corruption, tax fraud, government procurement fraud and mortgage fraud. He has also assisted clients in conducting internal investigations for them, including those for laboratories, hospitals, pharmacies, individual healthcare providers, financial institutions, insurance providers, and governmental entities.
Mr. Blake was the first federal prosecutor hired by the Justice Department to exclusively prosecute federal qui tam and civil false claims cases in the Northern District of Ohio, where he specialized in healthcare and defense procurement fraud prosecutions. As an Assistant United States Attorney, he also worked in the Organized Crime Strike Force and Economic Crimes Unit.
Bruce E. Reinhart is Co-Chair of McDonald Hopkins’ Government Compliance, Investigations, and White Collar Defense Practice Group. He is also a trial attorney and former federal prosecutor.
Mr. Reinhart defends corporations and individuals in federal criminal investigations and regulatory enforcement matters. His clients have included numerous pathology and toxicology labs in qui tam and other government enforcement matters. He conducts internal investigations and provides compliance counseling for businesses of all sizes in a wide range of industries. Mr. Reinhart also represents corporations and individuals in asset forfeiture proceedings, including, in one case, successfully reacquiring more than $1 million in property for a Fortune 500 company.
Mr. Reinhart’s experience includes having served as an Assistant United States Attorney in the Southern District of Florida for more than 11 years, as Senior Policy Advisor to the Undersecretary for Enforcement at the U.S. Treasury Department, and as a trial attorney in the Public Integrity Section of the U.S. Department of Justice.
Mr. Reinhart received his law degree cum laude from the University of Pennsylvania in 1987 and his undergraduate degree cum laude from Princeton University in 1984.
Here is just some of what you’ll learn when you purchase the CD of this in-depth 90-minute conference:
- How to create an effective compliance program that will pass government scrutiny.
- The areas of concern that government regulators are focusing on—and how to find and fix them in your laboratory.
- How to provide proof of medical necessity to ensure Medicare pays all your claims.
- Recent legal developments, including a case before the U.S. Supreme Court that could severely limit healthcare qui tam cases.
- How to prepare for an audit or government subpoena.
- The actions that you and your laboratory should take as soon as you’re contacted by the government.
- How to avoid being named in a qui tam whistleblower lawsuit—and what you should do if you are.
