Vernaglia Comments on Hospital Compliance and Audit Themes, Landscape for 2018

08 January 2018 Report on Medicare Compliance News
Partner Larry Vernaglia was quoted in a Report on Medicare Compliance article, “Expect Steady Audits, Enforcement; Pay Squeeze, Fewer Rules Raise Ante for CCOs,” discussing how compliance officers are planning to handle their risk assessments this year.

Vernaglia explained that compliance officers may see variations this year on themes under the False Claims Act that allege Stark Law violations. He also explained the impact of the updated Medicare physician fee schedule regulation is mostly being felt in fewer “innocent inadvertent errors that result in Stark penalties or self-disclosures.”

Vernaglia later said that hospital compliance is “a tough environment. It’s why hospitals are affiliating with larger, safer hospitals. [However,] the FTC is pushing back on hospital mergers as more hospitals merge every year, so we get this interesting storm of fee-for-service reimbursement cuts, continued need to move to a value-based payment environment, and compliance challenges when they try to escape to form larger systems better able to weather this storm.”

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