Compliance & Fraud/Abuse Prevention & Defense

In light of the ever-increasing scrutiny from federal and state regulators, institutional providers and healthcare professionals must assure that their operations are consistent with law and regulation. The development of stringent, complex, and sometimes conflicting laws and regulations governing healthcare make proactive steps, such as the adoption of compliance plans, essential to all healthcare providers.

The firm assists its healthcare clients in developing compliance programs appropriate to their operations. Compliance programs consist of a number of elements, including, but not limited to, standards of conduct, education and training, periodic audits, and appropriate response to audit exceptions. Each element must address the standards applicable to the particular healthcare provider, including such topics as Medicare and Medicaid billing, Medicare provider participation requirements, and health information privacy and security standards.