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Attorney Spotlight

How did a clerkship with Judge Merritt change the way Chris Climo approaches the practice of law? Find out more>

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Experience

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Experience Spotlight

Primary Care Providers Win Challenge of CMS Interpretation of Enhanced Payment Law

With the help and support of the Tennessee Medical Association, 21 Tennessee physicians of underserved communities joined together and retained Bass, Berry & Sims to file suit against the Centers for Medicare & Medicaid Services to stop improper collection efforts. Our team, led by David King, was successful in halting efforts to recoup TennCare payments that were used legitimately to expand services in communities that needed them. Read more

Tennessee Medical Association & Bass, Berry & Sims

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Thought Leadership

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Thought Leadership Spotlight

Download the Healthcare Fraud & Abuse Review 2017, authored by Bass, Berry & Sims

The Healthcare Fraud & Abuse Review 2017 details all healthcare-related False Claims Act settlements from last year, organized by particular sectors of the healthcare industry. In addition to reviewing all healthcare fraud-related settlements, the Review includes updates on enforcement-related litigation involving the Stark Law and Anti-Kickback Statute, and looks at the continued implications from the government's focus on enforcement efforts involving individual actors in connection with civil and criminal healthcare fraud investigations.

Click here to download the Review.

Aggressive False Claims Actions, Medical Necessity Determinations and Individual Liability Charges

Events

July 31, 2012

Bass, Berry & Sims healthcare fraud attorney, Anna Grizzle, will participate on the panel discussion, "Aggressive False Claims Actions, Medical Necessity Determinations and Individual Liability Charges" at the American Conference Institute's Advanced Forum on Healthcare Provider Disputes and Litigation on Tuesday, July 31. Assistant United States Attorney, Jeffrey W. Dickstein, will also participate in this panel discussion.

The topic of discussion will cover:

  • Minimizing your exposure to False Claims Act violations under Health Care Reform's expanded statute
  • Examining the key considerations, strategies and timing involved in the motion practice and procedural issues when it becomes necessary to litigate a FCA case
  • Ensuring diagnosis codes are properly submitted so that the provider is reimbursed for services offered
  • Reporting overpayments to the government within a defined period of time to avoid increased monetary penalties
  • Top 5 things to do now to diminish your risk of a government investigation
  • Developing a risk adjustment model that withstands government scrutiny billing, medical necessity, and other fraud.
  • Determining if a procedure was medically necessary and who authorized its performance
  • Mitigating the risks of billing for services not provided, billing for a level of service not provided, or miscoding a claim to obtain reimbursement
  • Conducting due diligence assessments to safeguard the provider against anti-kickback and Stark Law violations Individual Accountability
  • Working through available defenses to a Park charge
  • Insulating yourself from liability in the government's pursuit of individual providers for health care fraud
  • Preparing for the government’s increased focus on provider activity
  • Ensuring that service was provided within Medicare guidelines
  • Learning how to cope with corporate life under the government's microscope
  • Representing yourself accurately and producing documents to avoid false claims or obstruction of justice allegations
Download Document - ACI Healthcare Provider Disputes and Litigation Conference Brochure

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