Understanding Health Care Fraud, Waste and Compliance Programs

Dec. 4
1 – 2 p.m. Central


The session will begin with a description of the federal and state agencies involved in enforcing fraud, waste and abuse against hospitals, including an overview of recent enforcement actions and settlements involving hospitals. The speaker will provide an introductory overview of the Stark Law, Anti-Kickback Statute, False Claims Act, federal Beneficiary Inducement prohibitions and Excluded Provider laws. The session will include examples of arrangements that could violate each of the laws to illustrate how these laws are applied in hospital operations. Finally, the session will address hospital compliance programs, including the federal guidance used by hospitals when developing compliance programs and best practices in establishing a compliance program and incorporating all aspects of hospital operations.

Who Should Attend?
This program is for all hospital boards, C-suite executives and legal staff

Alissa Smith, Partner, Dorsey & Whitney, LLP, Des Moines, Iowa

Alissa Smith represents health systems, hospitals, pharmacies, long-term care providers, home health agencies and medical practices as well as nonprofit and municipal organizations. Her transactional practice includes contracts, leases, mergers, acquisitions and joint ventures. Smith’s regulatory practice includes interpretation and application of state and federal fraud and abuse laws, Medicare and Medicaid rules, tax-exemption laws, HIPAA and privacy laws, EMTALA laws, licensing matters, employment laws, governmental audits and open records and open meetings matters. She also assists with corporate and health system governance issues, including the revision and negotiation of medical staff bylaws. Smith also assists with hospital-provider relations such as co-management arrangements, peer review investigations and medical staff fair hearings. She represents health care providers before the Iowa State Health Facilities Council in Certificate of Need hearings and represents hospitals in meaningful use audits. Smith is a partner in Dorsey & Whitney’s health group.


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