decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
False Claims Act / Minimizing burdens imposed on providers during investigations
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Article Overview
This article addresses guidance for U.S. Attorneys and Justice Department personnel on conducting fraud-related investigations and audits in a way that limits unnecessary operational and financial burden on providers. It is relevant to compliance professionals, legal teams, auditors, and healthcare organizations that may be subject to False Claims Act scrutiny or related review activities.
Why This Topic Matters
Providers can face significant disruption during audits and fraud investigations. Understanding the general approach described here helps organizations anticipate how enforcement activity may be managed and what operational concerns may be considered during review planning.
What You Will Learn
- The general purpose of guidance aimed at reducing disruption during investigations and audits
- How federal fraud enforcement activity can affect provider operations
- The kinds of provider concerns that may be considered when investigative plans are developed
- The relationship between diligence in fraud review and minimizing unnecessary burden
Who Should Read This
- Healthcare compliance professionals
- Healthcare attorneys
- Billing and coding auditors
- Provider leadership
- Revenue cycle teams
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