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Waiving patient cost share responsibilities, including deductibles, coinsurance, and co-payments, carries significant legal risks for healthcare professionals. Both Federal and commercial healthcare programs and plans impose civil and criminal liability in cases of non-compliance. It is essential for healthcare professionals to grasp the intricate legal framework, rules, and potential penalties associated with the waiver of patient cost share responsibilities.

In today's healthcare landscape, understanding these complex regulations is imperative to protect both patients and medical practices. Failure to comply can lead to severe consequences, including legal actions, fines, and damage to professional reputation. Healthcare professionals must navigate the fine line between providing financial assistance to patients in need and adhering to strict legal requirements.

This session by federal licensed attorney, Thomas J. Force, Esq. aims to shed light on these critical aspects. Thomas will delve into the nuances of the Federal False Claims Act and Anti-Kickback statutes, exploring their defined penalties and implications for healthcare providers. Additionally, he will discuss practical strategies for drafting policies that align with financial hardship, professional courtesy, and prompt payment, while staying within the bounds of the law.

Webinar Agenda
  • Why is waiving patient cost show responsibility so important.
  • Federal False Claims Act liability & penalties
  • Anti kick back liabilities
  • Impact of Federal health programs versus commercial health plans
  • Health Plan sample language
  • Analysis of legal cases
  • Professional courtesy, financial hardships, and prompt payment discounts
  • The reasons why the routine waiving patient cost share is dangerous
  • Federal False Claims Act defined with penalties
  • The Anti Kick Back statutes defined with penalties
  • How to draft a complaint financial hardship, professional courtesy and prompt payment policy
  • Analyze typical health plan documents relative to the prohibits of waiving patient cost share basis
Who Should Attend

Physicians, Revenue Cycle Managers, Physicians Assistants, Nurses, Physician/Hospitalist, Physician office managed by Biling Staff, healthcare attorneys, third party billing companies, Ambulatory Surgery centers & hospital revenue cycle staff

Thomas J. Force, Esq.

As a state and federally licensed attorney in both New Jersey and New York, Mr. Force has over 30 years of experience in the healthcare and insurance industries. His success as a Wall Street insurance litigator and his tenure as General Counsel for a New York-based Accident and Health Insurance Company where he served as Chief Compliance Officer propelled the founding of The Patriot Group. The Patriot Group is a full service revenue recovery company that provides billing, collections, and follow-up services as well as assistance with managed care appeals, managed care contracting, credentialing and compliance.

Mr. Force is nationally recognized as an expert in revenue collection techniques, managed care contracting and appeal strategies. Mr. Force remains an active member and frequent speaker on managed care and collection techniques for the Health Finance Management Association, the Suffolk County Bar Association, and other organizations. A United States Marine, Mr. Force received the prestigious Meritorious Mast Award for Leadership in 1987. Mr. Force is also co-Chairman of the Health and Hospital Committee of the Suffolk County Bar Association. He is co-founder of the Healthcare Reimbursement Attorneys Network, a national association of attorneys that represent physicians and hospital clients. Mr. Force also works closely with the American Medical Association and various state Medical Associations.

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