Health Care Regulatory Matters
Detecting and preventing healthcare fraud and abuse has received increased focus and priority from federal and state law enforcement since the enactment of the Medicare and Medicaid programs on July 30, 1965. Government investigators, auditors and prosecutors are committed to the financial integrity of these programs and have developed sophisticated strategies to detect and prosecute improprieties, including the Health Care Fraud Prevention and Enforcement Action Team (HEAT) and its Medicare Fraud Strike Force Teams.
Providers develop plans to ensure that their companies are compliant with laws, rules, regulations and good business practices, and to protect themselves from an appearance of impropriety and mitigate their liability and exposure. An effective compliance program established and implemented in accordance with the Federal Sentencing Guidelines is a key to strengthening provider integrity.
Health care regulatory matters include the following:
- Corporate compliance
- Government audits and investigations
- Provider self disclosures
- Qui tam (whistle blower) matters
- Corporate integrity agreements
Health care regulatory matters services help managers manage risk, detect errors, report detected errors, react and respond to third party audits and investigations, implement remedial steps to respond to investigations and fix broken systems, processes, procedures and controls. I have over 30 years diversified health care experience as a professional advisor, an auditor with a Big Four public accounting firm, working for a health care provider and a government regulator.
Health care regulatory matter services include the following:
- Investigation, verification and quantification of errors
- Audit and investigation representation
- Systems and internal control improvements
- Corporate compliance program assessment
Related services include the following:
Contact Ralph P. Perrino, CPA, LLC for more information on litigation consulting services.