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.
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Thomas J. Force, ESQ., is a state and federally licensed attorney with over 34 years of experience in the healthcare and insurance industries. As a former U.S. Marine and a successful Wall Street insurance litigator, Mr. Force served as General Counsel for a New York-based Accident and Health Insurance Company, where he also served as Chief Compliance Officer. These experiences led to the founding of The Patriot Group.
