Build Up Your Hospice's Defenses: Breaking Down Key Trends in Recent Government False Claims Act and Whistleblower Cases

Wednesday, April 20, 2016: 1:30 PM-4:30 PM
National Harbor 5 (Gaylord National Resort and Convention Center) - 3rd Level
Meg Pekarske, JD, Reinhart Boerner Van Deuren S.C., Madison, WI, Judi Lund Person, MPH, National Hospice and Palliative Care Organization, Alexandria, VA, Brooke Bumpers, JD, National Hospice and Palliative Care Organization, Little Rock, AR and Bryan Nowicki, JD, Reinhart Boerner Van Deuren S.c., Madison, WI
As demonstrated by the growing number of high profile hospice prosecutions and settlements, the Office of Inspector General and Department of Justice are actively investigating, initiating and intervening in more hospice False Claims Act (FCA) cases.  These cases often stem from whistleblowers who are incentivized by the potential for financial rewards to make allegations against hospices.  Participants will learn about the types of allegations made against hospices and how they extend beyond eligibility to the anti-kickback statute and related issues such as compensation, relationships with referral sources and the failure to make repayments.  Presenters will provide an overview of the FCA, along with the implications of these cases for hospices.  Participants will learn tips for identifying and avoiding issues that could implicate the FCA and how to apply these strategies to manage complaints and potential whistleblowers.

Learning Objectives:
1. Understand overview of recent cases and outcomes
2. Identify strategies to address risk areas and "plus factors" ranging from conducting focused pre-billing reviews to monitoring key hospice relationships, including physicians, nursing homes, and assisted living facilities
3. Understand the emerging enforcement issues in hospice and tips for avoiding scrutiny, including managing internal and external complaints and potential whistleblowers and proactively addressing other risk areas

CE/CME: Nurse, Physician and Social Worker