Health care executives and board members must understand the risks and opportunities in the emerging era of quality of care. New quality-based payment systems are paying only for high-quality services, denying payment for certain errors and routine quality failures, and offering extra incentive payments for outstanding quality. At the same time, the Centers for Medicare & Medicaid Services (CMS) and the American Health Care Association (AHCA) have increased public reporting of private quality of care data, which is intended to make for better-informed and savvy consumers. Furthermore, the OIG and the U.S. Department of Justice are using the False Claims Act to enforce quality of care failures, holding individual high-ranking executives and physicians individually responsible.
This session provided an opportunity for executives to learn how these issues impact Florida health care businesses and how to recognize potential obstacles.
Foley Partner Janice A. Anderson is a member of the Health Care Industry Team and has 25 years of experience focusing on health regulatory and compliance issues. Prior to joining Foley, Ms. Anderson was General Counsel, Vice President, and Corporate Compliance Officer for Borgess Health, a three-hospital regional health system in Michigan.
Foley Senior Counsel Tina E. Dunsford is a member of the firm's Health Care Industry Team. Ms. Dunsford advises clients on managed care contracting, medical staff issues, compliance, fraud and abuse matters, and physician contracting arrangements. She also advises health care clients with focused litigation involving regulatory, fraud and abuse, and qui tam matters.
Foley Associate Nathaniel M. Lacktman is a Certified Compliance and Ethics Professional (CCEP). He is a member of the firm's Health Care Industry Team and White Collar Defense & Corporate Compliance Practice. Mr. Lacktman practices health care litigation and has experience in matters involving medical staff peer review, qui tam actions, and the False Claims Act as well as external investigations, long-term care, and defense against enforcement actions by state and federal regulators.
For questions concerning this event, contact Karen Keene at kkeene foley.com or 407.244.3258.