Free Health Law Webinar–Steps to Take When a Fraud, Waste, or Abuse Issue is Discovered

It’s your last chance to register for the first free webinar in Wolters Kluwer Legal & Regulatory, U.S.’s four-part webinar series in partnership with Alston & Bird focusing on best practices for handling internal and external healthcare fraud and False Claims Act investigations.

“Steps to Take When a Fraud, Waste, or Abuse Issue Is Discovered”, will cover the essential elements of a comprehensive investigation plan that prudent organizations should develop as a first step when fraud, waste, or abuse is discovered. To register, visit the link below:
Steps to Take When a Fraud, Waste or Abuse Issue is Discovered
Thursday, November 1, 2018 at 3 PM EST
Moderator: Frank Sheeder, Partner at Alston & Bird
Featured speakers: Jason Popp, Partner, and Brad Smyer, Senior Associate at Alston & Bird

For information on the full webinar series, visit http://health.wolterskluwerlb.com/2018/10/wk-announces-free-webinar-series-on-healthcare-investigations/

WK Announces Free Webinar Series on Healthcare Investigations

Wolters Kluwer Legal & Regulatory U.S. announced that registration is open for a four-part webinar series in partnership with Alston & Bird focusing on best practices for handling internal and external healthcare fraud and False Claims Act investigations. This educational activity has been submitted to HCCA and is currently pending their review for continuing education.

Each webinar in the series will feature Alston & Bird attorneys covering topics such as handling fraud, waste, and abuse issues, dealing with internal and government investigations, and managing complainants and whistleblowers. These discussions will be based on real-life scenarios that participants will receive in advance, and will offer practical, actionable approaches to the most confounding challenges. The webinars will also include a demonstration of how compliance professionals can leverage Cheetah™, Wolters Kluwer’s intuitive legal research platform, to assist in mitigating risks and issues.

“Healthcare industry stakeholders need to be aware of the potential legal and regulatory compliance risks, costs, and disruptions that can potentially arise in an organization,” said Kristen Kaplan, Sr. Health Law Product Manager for Wolters Kluwer Legal & Regulatory U.S. “This webinar series will offer practical and actionable approaches to mitigating these issues.”

“Healthcare organizations face a challenging legal, regulatory, and enforcement environment,” said Frank Sheeder, Partner at Alston & Bird and Co-Chair of its Healthcare Litigation Team.  “We are pleased to partner with Wolters Kluwer on this webinar series to share our experiences and help their in-house counsel, compliance professionals, and reimbursement teams to better serve their organizations.”

The first webinar in the series, “Steps to Take When a Fraud, Waste, or Abuse Issue Is Discovered”, will cover the essential elements of a comprehensive investigation plan that prudent organizations should develop as a first step when fraud, waste, or abuse is discovered. To register, visit the link below:
Steps to Take When a Fraud, Waste or Abuse Issue is Discovered
Thursday, November 1, 2018 at 3 PM EST
Moderator: Frank Sheeder, Partner at Alston & Bird
Featured speakers: Jason Popp, Partner, and Brad Smyer, Senior Associate at Alston & Bird

The second webinar, “Internal and Government Investigation Strategies”, will discuss how companies can conduct cohesive internal investigations, what the government expects organizations to do and the investigative techniques that the government uses. To register, visit the link below:
Internal and Government Investigation Strategies 
Tuesday, December 4, 2018 at 2 PM EST
Moderator: Frank Sheeder, Partner at Alston & Bird
Featured speakers: Wade Miller, Partner, and Matt Dowell, Senior Associate at Alston & Bird

The third webinar is titled “Dealing with the Government, Complainants, and Whistleblowers”. It will explore the external and internal adversaries organizations face and participants will hear from a former United States Attorney about best practices for contending with them. To register, visit the link below:
Dealing with the Government, Complainants, and Whistleblowers 
Thursday, January 10, 2019 at 2 PM EST
Moderator: Frank Sheeder, Partner at Alston & Bird
Featured speakers: Former US Attorney Thomas Walker and Meredith Kingsley, Partners at Alston & Bird

“Lessons Learned That We Hope Not to See Repeated” will discuss some of the most notorious investigation failures that have occurred in healthcare organizations, and the speakers will offer advice on how to avoid pitfalls. To register, visit the link below:
Lessons Learned that We Hope Not to See Repeated 
Wednesday, February 6, 2019 at 2 PM EST
Featured speakers: Frank Sheeder and Mitch Mitchelson, Partners at Alston & Bird

About Alston & Bird
Alston & Bird is a leading national and international law firm. The firm’s core practice areas are complex litigation, corporate, intellectual property and tax, with national industry practices that include healthcare, life sciences, financial services, technology, manufacturing, and energy. The firm has built a reputation as one of the country’s best employers, appearing on Fortune magazine’s “100 Best Companies to Work For” list for 19 consecutive years, an unprecedented accomplishment among law firms in the United States. The firm has offices in Atlanta, Beijing, Brussels, Charlotte, Dallas, Los Angeles, New York, Raleigh, San Francisco, Silicon Valley, and Washington, D.C.

For more information about Alston & Bird, visit www.alston.com, follow us on FacebookTwitter, and LinkedIn.

About Wolters Kluwer Legal & Regulatory U.S.
Wolters Kluwer Legal & Regulatory U.S. is part of Wolters Kluwer N.V. (AEX: WKL), a global leader in information, software solutions and services for professionals in the health, tax and accounting, risk and compliance, finance and legal sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with specialized technology and services.

Wolters Kluwer reported 2017 annual revenues of €4.4 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

For more information about Wolters Kluwer Legal & Regulatory U.S., visit www.WoltersKluwerLR.com, follow us on FacebookTwitter and LinkedIn.

Maximum sentence for head of Houston Medicare fraud scheme

Medicare losses of nearly $7 million were acknowledged by two individuals involved in a scheme to defraud the program. They were sentenced to federal prison and ordered to pay restitution, according to the Department of Justice (DOJ). The scheme involved “so-called diagnostic testing labs” in the Houston area which paid Medicaid beneficiaries for use of their Medicare numbers to fraudulently bill Medicare.

A man from California formed 11 diagnostic testing clinics in the Houston area that were used to fraudulently bill Medicare for services and tests that were either not performed or not medically necessary. Co-conspirators were instructed to order ultrasounds, allergy tests, and pulmonary function tests for every beneficiary and to include poor circulation, shortness of breath, heart problems, and allergies on their charts. The other sentenced individual, a woman from Houston, acted as a marketer at seven of the clinics to recruit and pay the Medicare beneficiaries. Marketers were paid $80 to $100 cash, with part of the amount going to the beneficiary and the rest being kept by the marketer. When the first clinic was put under pre-payment review and payments slowed down, the owner recruited others to open new clinics and new bank accounts in their names.

The owner was sentenced to the statutory maximum of 10 years. The marketer was sentenced to 37 months in prison. Two other co-conspirators previously pleaded guilty and are awaiting sentencing.

Home health owner/operator pleads guilty to Texas-sized Medicaid fraud

Billed as the largest provider attendant services (PAS) fraud in Texas history, the owner/operator of five Houston-area home health agencies pleaded guilty in a $17 million fraud conspiracy case, the last conspirator in the scheme to plead guilty. The owner/operator pleaded guilty to two counts of conspiring to defraud Medicare and the Texas Medicaid-funded home and community-based service and primary home care programs and one count of conspiring to launder money. His sentencing is scheduled for June 22, 2017.

The owner/operator, whose co-conspirators included his daughter and other family members, admitted to the following:

1. obtaining patients for the home health agencies by paying illegal kickbacks to patient recruiters and office employees;
2. paying cash, checks, Western Union, and Moneygram funds to Medicare and Medicaid patients for receiving services from the home health agencies in exchange for using their Medicare and Medicaid numbers to bill for home health and PAS services;
3. paying patients for recruiting other Medicaid and Medicaid patients to the home health agencies;
4. paying physicians illegal kickbacks for referring and certifying Medicare and Medicaid patients for home health and PAS services; and
5. using fraudulently-obtained money from Medicare and Medicaid to pay the illegal kickbacks to promote the conspiracies and to ensure that they would continue.

Over $17 million in fraudulent claims were submitted to Medicare and Medicaid and the conspirators received approximately $16 million in payments from the programs.