Fraud and Abuse

Overview

Healthcare is one of the most highly regulated industries and healthcare businesses and those who serve them face significant regulatory hurdles that have a substantial impact on day-to-day operations. Effective compliance with Federal and state fraud and abuse laws, including anti-kickback and anti-inducement laws, and provider referral prohibitions such as the Stark law, requires ongoing diligence.

Wortham LLP offers piece of mind for fraud and abuse compliance, including extensive experience evaluating new and existing transactions and relationships for compliance and developing and updating compliance programs and procedures that help to serve as guideposts for day-to-day operations.

For incisive strategic advice tailored to your specific business challenges, choose Wortham LLP.

Representative Matters

  • Analysis and guidance for fraud and abuse and fee-splitting implications of revenue cycle management services proposal compensated on a percentage basis.
  • Anti-kickback statute and Stark law analysis and guidance for hospital graduate medical education cost reimbursement to participating clinic sites.
  • Anti-kickback statute analysis and guidance for bundled discount on purchase of equipment and disposables.

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