AHLA/HCCA conference update:

We recently attended the AHLA/HCCA 2011 Fraud and Compliance Forum, where we enjoyed a dynamic panel discussion about anti-fraud enforcement trends. The panelists included Thomas Corcoran, Esq., US Attorney, District of Maryland; Stephen Immelt, Esq. of Hogan Lovells LLP, and Susan Strawn, Executive Director of Taxpayers Against Fraud Education Fund, The False Claims Act Legal Center.

Hayes’ Robert Freedman asked the panelists, “What is your advice on conducting a self-assessment? Many healthcare organizations are reticent to do this because they fear the ensuing self-disclosure will draw the attention of federal regulators.”

All of the panelists were in strong agreement that it is in a healthcare organization’s best interest to continually perform self-audits, because it demonstrates good intention. Both attorneys and prosecutors agreed that intention is very important to the end result. The Department of Justice understands that mistakes are made, but it weighs heavily in the organization’s favor if it has a process to proactively find errors that bears fruit. If your organization does not have a process to find overpayments, it doesn’t look good. And it can be very costly. An organization can be fined up to $11,000 per claim for an overpayment that is found by an outside regulator – amounting to much more than the cost of refunding overpayments.