Avoiding Government Scrutiny on Issues of Medical Necessity

In this 90-minute CLE program, experts panelists will discuss issues surrounding compliance with Medicare's "reasonable and necessary" standard. The issue of medical necessity has become increasingly important for health care providers in recent years due to government prosecutions concerning this issue under the False Claims Act. The panelists will give a brief history of the issue and summarize the disputes which most commonly occur between the government and providers. They will discuss hot issues in DOJ enforcement, including elective procedures, patient classification and billing practices for surgical specialties. They will also address ways that clients can avoid adverse actions through training for billing personnel and building successful compliance programs. In addition to John, panelists include Kirk Ogrosky, former head of health care fraud enforcement in the Criminal Division of the United States Department of Justice, and other experienced practitioners.

Additional details of the program are included in the attached brochure below.

Panelists:

Mary Beth Fortugno, Member, Bass Berry & Sims, PLC, Nashville, TN

Kirk Ogrosky, Partner, Arnold & Porter LLP, Washington, DC

Joseph T. Van Leer, Associate, Polsinelli LLP, Chicago, IL

Moderator: John E. Steiner, Jr., Chief COompliance Officer, Cancer Treatment Centers of America, Schaumburg, IL