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Risk 133

Hour 1 Identify various types of billing irregularities and impact on healthcare expenditures. Distinguish upcoding from bundling within the context of irregular billing schemes. Demonstrate how and when exceeding a state’s scope of practice becomes “the unauthorized practice of medicine.” Explain the restrictions states’ scopes of practice place on healthcare providers’ authority to treat and diagnose patients. Discuss how invoicing unrendered medical services impacts third-party payers. Interpret chiropractic boards’ positions on testimonial advertising and how best to comply. Hour 2 Identify what constitute a false claim under the False Claims Act. Discriminate a kickback from a self-referral. Trace how anti-kickback legislation arose and examine its prohibitions. Explain the enactment of Stark legislation arising on the heels of anti-kickback bans. Assess providing nutritional counsel within the context of “the practice of medicine.” Evaluate identity theft and its impact on patients, providers and the cost of healthcare. Discriminate between illegal copayment waivers from proper hardship waivers. Discuss court cases instancing successful prosecution of healthcare fraud.
InstructorPeter Van Tyle, Esq
Subject BreakdownRisk 2
Total Credits2.00
FormatDistance - On-demand


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