LEG06: Avoiding Government Enforcement Action: How DME Providers Can Stay Off the Radar and Out of Trouble
Session Description:
Federal enforcement actions targeting DME suppliers are intensifying: driven by questionable billing patterns, marketing relationships, and compliance gaps. This session features three nationally recognized attorneys who bring unique perspectives to help DME providers avoid becoming the next target.
This session is tailored to DME suppliers, compliance officers, billing staff, and business owners who want a proactive and realistic strategy to reduce risk and operate within legal boundaries.
Speakers:
- Courtney G. Tito, Esq., Shareholder at Buchanan Ingersoll & Rooney PC, is a reimbursement expert who will highlight billing practices that raise audit flags and lead to payment suspensions. She will provide guidance on audit avoidance and defensible billing strategies.
- Marissel Descalzo, Esq., Shareholder at Tache, Bronis and Descalzo, PA, is a white-collar defense attorney with deep experience in healthcare fraud investigations. She will offer insight into how federal agencies investigate DME providers and what triggers civil or criminal enforcement.
- Jacqueline Bain, Esq., Partner at Silverman Bain LLP, focuses on regulatory compliance and will cover key fraud and abuse laws, including the Anti-Kickback Statute and False Claims Act. She will explain how DME companies can structure operations and relationships to stay compliant.
Learning Objectives:
- Identify high-risk business practices under the Anti-Kickback Statute (AKS), Stark Law, and False Claims Act (FCA) that frequently lead to government scrutiny of DME providers.
- Evaluate common marketing and referral arrangements for potential compliance violations and learn how to restructure them to reduce regulatory risk.
- Detect billing patterns and documentation deficiencies that typically trigger audits by Medicare contractors and Unified Program Integrity Contractors (UPICs).
- Understand how federal agencies target DME providers using data analytics, whistleblower complaints, and industry alerts, and learn the warning signs of an impending investigation.
- Apply proactive compliance strategies to mitigate enforcement risk and maintain defensible business and billing practices in the DME space.
Speakers
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