A Master Class in Hospital Reimbursement Compliance

Foley Partner Janice Anderson spoke on the first of six Web conferences as part of the Health Care Compliance Association’s (HCCA) A Master Class in Hospital Reimbursement Compliance on March 4, 2008. Moderated by Foley Partner Lawrence Vernaglia.

Ms. Anderson spoke with Doug Nock, CMS on “CMA Data Mining Implications.” The government is becoming ever more sophisticated about how it mines data to identify compliance failures at hospitals and other providers. These providers and their compliance, reimbursement and legal staffs need to become equally proficient in order to be able to respond to inquiries, investigations and audits. Moreover, being able to run similar information internally, and before an official inquiry is made, presents significant benefits to a hospital. This presentation will address the various sources of data available to CMS and other regulators, how CMS and other regulators use this data to promote the integrity of the Medicare program, where hospitals can find the data, and how they can use it to promote compliance and avoid costly enforcement actions.