erin muellenberg, jd, CPCS, cpmsm

With concerns about the next upcoming survey or the general meeting around the corner, the False Claims Act is low on the priority list. However, the False Claims Act is one of the areas of highest exposure for any hospital. Everything from meeting the regulatory requirements, Conditions of Participation and medical necessity for procedures are all areas that the MSP is the first to encounter. This session reviews the origin of the False Claims Act and how hospitals have been found liable for the acts of medical staff members and will include cases of liability. We will specifically discuss red flags that can be identified by the MSP and the role of the compliance officer and how to avoid the multi-million dollar payback by your organization. 

Objectives:

• Participants will be able to state the origin of the False Claims Act
• Participants will be able to identify one way the MSP can avoid being the source of False Claims Act liability
• Participants will be able to state the role of Conditions of Participation in the False Claims Act

Have you ever breathed a sigh of relief when the problem practitioner turns in his/her resignation? And then the affiliation letters start coming in….there have been no formal actions but there have been plenty of little problems. What do you tell the next hospital? This session will discuss the legal and ethical obligations of information sharing and work through the practitioners that are in the “gray zone.” 

Objectives:

• Participants will be able to identify one way to advise the medical staff leadserthip on affiliation responses
• Participants will be able to identify when to require more information from the institution that sends the benign affiliation letter
• Participants will be able to identify one law that provides immunity for responses