Monday, June 12, 2017
10-10:30 a.m. ET; 7-7:30 a.m. PT
SPECIAL GUEST
Mary A. Inman, Esq.
Constantine Cannon, LLP, San Francisco
ALSO FEATURING
Duane Abbey, PhD, CFP; Janelle Ali-Dinar, PhD;
Nancy Beckley, MS, MBA, CHC; David Glaser, Esq.;
Ronald Hirsch, MD, FACP, CHCQM; and Edward Roche, PhD, JD
A major lawsuit against a Medicare Advantage Organization (MAO) was reported last week by RACmonitor, when the U.S. Department of Justice announced a $32.5 million settlement with Freedom Health Inc. and Optimum Healthcare, MAOs based in Tampa, Fla.
The reported settlement resolves allegations that the insurers violated the False Claims Act by engaging in illegal schemes to maximize their payment from the government in connection with their Medicare Advantage plans. The whistleblower complaint alleged that Freedom and Optimum gamed risk-adjustment frameworks used by the Centers for Medicare & Medicaid Services (CMS) to make extra payments to MAOs for sicker patients or patients with multiple chronic conditions. Reporting this major story will be Monitor Mondays’ special guest Mary Inman, partner in the whistleblower practice group at Constantine Cannon, LLP in its San Francisco office and one of the lead attorneys representing the whistleblower in this case.
The broadcast rundown also includes:
Register now for this news broadcast coming your way on Monday, June 12, 2017 at 10 a.m. ET.
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Dr. Ronald Hirsch dives into the basics of Medicare for clinicians to be successful as utilization review professionals. He’ll break down what Medicare does and doesn’t pay for, what services it provides and how hospitals get paid for providing those services – including both inpatient and outpatient. Learn how claims are prepared and how much patients must pay for their care. By attending our webcast, you will gain a new understanding of these issues and be better equipped to talk to patients, to their medical staff, and to their administrative team.
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