The fraud and abuse enforcement landscape has changed dramatically with the passage of the Fraud Enforcement and Recovery Act (FERA), the American Recovery and Reinvestment Act (ARRA), and the Patient Protection and Affordable Care Act (PPACA). Significant increases in funding for investigations and enforcement activities, new tools for prosecuting health care providers, changes in enrollment standards for Medicare and Medicaid providers, and revisions to the statutory provisions regarding health care offenses have added to the compliance landmines that providers must navigate if they wish to participate in Federal health programs.

However, the news is not all bad. Along with these changes, Congress has granted HHS with the authority to compromise on an entity’s financial liability for violations of the physician self-referral law (commonly referred to as the Stark Law), opening up new avenues for providers to self-disclose noncompliance with the Stark Law’s referral and billing prohibitions.  

This webinar examines the new authorities, government initiatives for rooting out and addressing health care fraud and abuse, and the recently posted Stark Self-Referral Disclosure Protocol (SRDP). The speakers will discuss candidly the risks facing health care providers, recent governmental investigatory and prosecutorial activity, and whether and how to use the SRDP. In addition, the speakers will provide practical advice for designing and conducting internal investigations, dealing with government enforcement agencies, and implementing compliance policies and procedures. Finally, the speakers will update the participants regarding current Department of Justice initiatives related to alleged Medicare and Medicaid noncompliance that establishes a basis for a False Claims Act action.

Who Should Attend

• Hospitals
• Physicians and their staffs
• CFO, CEO
• Chief Compliance Officer
• Compliance Director
• Chief Risk Officer
• Director of Risk Management
• Director of Regulatory Affairs
• Hospital Legal/Regulatory Counsel
• VP/Director of Revenue Cycle

About the Presenter

Lisa Ohrin is a partner in the law firm of Katten Muchin Rosenman LLP. Ms. Ohrin has over 15 years of health law experience in a variety of settings and areas of concentration. Ms. Ohrin previously served as the Director of the Division of Technical Payment Policy with the Centers for Medicare and Medicaid Services (CMS) at the U.S. Department of Health and Human Services (HHS). In this capacity, Ms. Ohrin was responsible for handling a variety of statutory and regulatory payment issues, and for developing policy and regulations related to the physician self-referral law and the anti-markup payment limitation. She was one of the principal drafters of the Stark II Phase III regulations (and the subsequent revisions thereto).

Joshua Berman is a partner in the law firm of Katten Muchin Rosenman LLP. Mr. Berman represents numerous companies and individuals in connection with criminal and regulatory investigations undertaken by the U.S. Department of Justice (DOJ), U.S. Attorneys’ Offices throughout the country, both houses of Congress, states Attorneys General, the Securities and Exchange Commission (SEC), the Department of Health and Human Services Office of the Inspector General (HHS OIG), and other regulatory enforcement bodies. Mr. Berman regularly conducts sensitive internal investigations for major corporate clients in the United States and overseas, and has substantial experience handling Foreign Corrupt Practice Act (FCPA) and health care fraud and abuse matters throughout the world. He also focuses on high-stakes health care fraud and abuse qui tam matters. In addition, Mr. Berman has appellate litigation experience, having briefed and argued a number of cases before the United States Courts of Appeals for the Second, Fifth and Ninth Circuits.

Glen Donath is a partner in the law firm of Katten Muchin Rosenman LLP. Mr. Donath’s practice focuses on white collar criminal defense, governmental enforcement actions, internal investigations, health care fraud and abuse, corporate compliance and complex civil litigation. A highly regarded former federal prosecutor with extensive trial experience, Mr. Donath has successfully represented health care providers, financial institutions, investment funds, insurance companies and various other corporations in an array of complex civil and criminal proceedings, and has successfully defended many corporate officers in similar matters. He also regularly conducts internal investigations for corporations and other organizations. Mr. Donath previously served as a federal prosecutor for five years. As a Senior Assistant U.S. Attorney in the Fraud and Public Corruption Section of the U.S. Attorney’s Office for the District of Columbia, he conducted grand jury investigations and prosecuted cases involving a wide variety of white collar matters, including health care fraud, money laundering, mail and wire fraud, tax offenses, bankruptcy fraud and government corruption.

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