Spotlight on Healthcare and Pharma

Part II: Countering Compliance Uncertainty in the Telehealth Rules and Managing Post-Pandemic Telehealth Fraud Risks

January 24, 2024 10:15am

Jacob Foster
Principal Assistant Chief, National Rapid Response Strike Force, Fraud Section, Criminal Division
U.S. Department of Justice

Jolie Apicella
Wiggin & Dana LLP
Former Chief, Civil Health Care Fraud, USAO, Eastern District of NY

Eric Triana
Chief Compliance Officer
Former Deputy Assistant Administrator, Diversion Control Division, DEA

Jonathan M. Phillips
Partner | Co-chair FCA/Qui Tam Defense Practice Group
Gibson, Dunn & Crutcher LLP
Former AUSA, Fraud Section, Civil Division, USDOJ

Medicare providers can continue to provide telehealth at home until December 31, 2024, but complacency in reviewing potential FCA or AKS risks can be costly as DOJ remains committed to combatting telemedicine fraud post-pandemic. In this session, topics of discussion will include:

  • Exploring the enforcement trends of the DOJ’s nationwide coordinated law enforcement action to combat telemedicine, laboratory and durable equipment (DME) fraud
  • Untangling HHS-OIG’s special fraud alert regarding telehealth arrangements
    • Establishing clear procedures to comply with the alert towards mitigating potential FCA and AKS risks
  • Clarifying what CMS’s proposed changes to Medicare telehealth policies mean for your company and how to streamline the changes in your practice