Health Care Chair Paula Sanders and White Collar Principal Barbara Rowland Co-Present at AHCA/NCAL Annual Convention on Oct. 8
October 8, 2014
On October 8, 2014, Health Care Practice Group Chair Paula G. Sanders and Internal Investigations & White Collar Defense Principal Barbara Rowland co-presented, "Medicare and Medicaid Audits and Investigations" at the American Health Care Association (AHCA)/National Center of Assisted Living (NCAL) 63rd Annual Convention and Expo in Washington, D.C.
The presentation examined how audits conducted by the Centers for Medicare & Medicaid Services (CMS) and CMS contractors can lead to further and more extensive investigations from federal government agencies, including the Office of Inspector General (OIG), US Department of Justice (DOJ) or the Federal Bureau of Investigation (FBI). As the government continues to fight health care fraud and abuse, long term care providers and their employees must be prepared for these audits and investigations; which can in turn lead to prosecution. If a government investigative agent presents a search warrant, subpoena, investigative demand, authorized investigative demand or other legal document; providers must understand the best practices and procedures for interacting with those agents.
In their presentation, Ms. Sanders and Ms. Rowland explored:
- Why audits occur and when you should conduct an internal audit
- How to respond to an audit and how to remediate any potential issues found during an internal or external audit
- What entities or agencies may audit or investigate your facility and what each entity does
- What to do when an agent presents a search warrant, subpoena, investigative demand or other legal document