Health Care Regulatory Solutions
The health care regulatory matters cited below are generalized to preserve the nature and confidentiality of the subject matters of these services and illustrate the types of matters resolved. Matters include:
Corporate compliance programs: Developed, implemented and assessed the corporate compliance programs of health care providers.
Government audits and investigations: Procedures to respond to federal government, states attorneys general and other third party audits and investigations. Steps generally included analysis and investigation of allegations, error estimate, if any, and recommendations of process and procedure corrections to reduce errors in the future.
Provider self disclosures: Estimates of the value of non-compliance to federal health insurance plans in connection with provider self disclosures to the Assistant Inspector General for Investigative Operations of the Office of the Special Prosecutor for matters related to inappropriate billing practices and contractual relationships with referral sources.
Qui tam cases: Procedures in response to “whistle blower” allegation, and generally included analysis and investigation of allegations, error estimate, if any, and recommendations of process and procedure corrections to reduce errors in the future.
Compliance to corporate integrity agreements: System, process and procedure improvements and analysis and investigation for providers to demonstrate compliance to the corporate integrity agreements.