Tuesday, December 2, 2014

Fraud and Abuse Prevention Toolkit

Dianne De La Mare


AHCA/NCAL is pleased to release the Fraud and Abuse Prevention Toolkit, posted on AHCA/NCAL website, which was prepared by Reed Smith attorneys, Susan Edwards and Carol Loepere. It was reviewed by AHCA’s Legal Committee and edited by AHCA Public Affairs staff, Tom Burke.

This Toolkit will help AHCA/NCAL membership untangle the complex web of federal and state agencies, regulations and laws related to fraud and abuse. Although the Toolkit focuses on nursing care centers (NCCs); much of the information within also applies to other settings, such as assisted living communities (ALCs) and centers for individuals with intellectual and developmental disabilities (ID/DD). In all of those settings, for example, the federal anti-kickback and Stark laws will apply (e.g., those laws are relevant to all health care programs including both the Medicare and Medicaid).

Please note, the Toolkit will help AHCA/NCAL membership better understand the legal environment they operate within.  However, it is not a Compliance Program or Compliance Plan. Instead, this Toolkit was specifically developed to help members improve their compliance with federal fraud and abuse laws and regulations.

To obtain a copy of the Toolkit go to http://www.ahcancal.org/facility_operations/integrity/Pages/default.aspx.

Please contact Dianne De La Mare at ddmare@ahca.org if you have any questions.

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