Waiving patient cost share responsibilities, including deductibles, coinsurance, and cc payments, carries significant legal risks for healthcare professionals. Both Federal and commercial healthcare programs and plans impose civil and criminal liability in case 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 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.

Learning Objectives:

• Gain a comprehensive understanding of the hazards associated with waiving patient cost share responsibilities
• Learn why is waiving patient cost show responsibility so important
• Understand the Federal False Claims Act liability & penalties
• Know the Anti kick back liabilities and associated penalties
• Know the Impact of Federal health programs versus commercial health plans
• Health Plan sample language
• Learn how to analyze health plan documents relative to the prohibits of waiving patient cost share basis
• Know about professional courtesy, financial hardships, and prompt payment discounts and how to draft these documents compliantly
• The reasons why the routine waiving patient cost share is dangerous

Areas Covered in the Session:

• Importance of waiving patient cost show responsibility
• Federal False Claims Act liability & penalties
• Anti-kickback liabilities
• Federal health programs versus commercial health plans
• Health plan sample language
• Analysis of legal cases
• Professional courtesy
• Financial hardships
• 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
• Drafting 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
• Live Q&A session

Suggested Attendees:

• Healthcare CEOs
• Healthcare CFOs
• Healthcare COOs
• Healthcare Provider Revenue Cycle Staff
• Healthcare provider Office Managers and Billing Staff and Companies
• Healthcare Compliance Personnel
• Healthcare Attorneys
• Physicians
• Physician Assistants
• Nurse Practitioners
• Surgeons
• Hospitals and Other Facilities
• Insurance Companies
• Healthcare Consultants
• Practice Manager
• In and Out of Network Providers
• Medical Billing Companies
• Providers Office Staff
• Chief Compliance Officers
• Medical Providers
• Attorneys and Legal Staff
• Customer Service Managers
• Risk Managers