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Navigate Medicare's Medical Necessity Compliance Requirements and Minimize Your RAC and Federal Audit Exposures

Session #: 81809-xh
Presenter(s): Robert Corrato, John Joseph
Session Length: 1hr. 45 min.
Event: HFMA 2008 Audio Webcast
Date: 3-20-08

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Is Your Hospital Preserving the Integrity of the Medicare Trust Fund? Are You Prepared to Enter the "Era of Medical Necessity Audits?" And Defend Your Hospital Before the RACs, OIG, & Justice Department?

Join Dr. Robert Corrato, President & CEO of Executive Health Resources and John Joseph, Partner at Post & Schell and former Assistant United States Attorney to learn about Medicare's Medical Necessity compliance requirements and related risks, ways to minimize your RAC and Federal audit exposures, and understand best practices developed in response to the recent landmark $26M hospital settlement with the Justice Department for allegations of medically unnecessary inpatient admissions.

The Office of Inspector General (OIG) recently stated to the Department of Health and Human Services (HHS) that its #2 management and performance challenge facing HHS is the "Integrity of Medicare Payments." Are you certain that your hospital is in compliance with federal law that mandates certain Utilization Management practices as a condition of participation in the Medicare program? Have you fully implemented the federal medical necessity requirements necessary to ensure the integrity of your Medicare payments? Would a "peek under the covers" show fragmented processes and Medicare payment errors, or, worse yet, would the phrase "reckless disregard" be applicable? Will the dawn of the "Era of Medicare Medical Necessity Audits," led by RAC denials and recoupments, have major negative impact on your federal compliance, past quality of earnings, organizational value and creditworthiness?



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