Current Top 10 List JAMES G. SHEEHAN Associate United States Attorney

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Presentation transcript:

Current Top 10 List JAMES G. SHEEHAN Associate United States Attorney 615 Chestnut Street Suite 1250 Philadelphia, PA 19106 Phone: 215-861-8301 Fax: 215-861-8647 E-mail:Jim.Sheehan@USDOJ.gov

QUI TAM RELATORS

2.PRESCRIPTION DRUGS

THE RELATIONSHIP BETWEEN MANAGED CARE PLANS, AND HOSPITALS AND PHYSICIANS - FRAUD ISSUES.

4.EXPERIMENTAL DEVICE AND PROCEDURE CLAIMS

5.DRG UPCODING

6.CREDENTIALING OF PHYSICIANS AND OTHER HEALTH WORKERS

OUTLIER PAYMENTS

8.QUALITY OF CARE/ MEDICAL ERROR ISSUES

MONITORING, NEGOTIATION RELATING TO COMPLIANCE, VOLUNTARY DISCLOSURES AND CORPORATE INTEGRITY PLANS.

10. PHYSICIANS BILLING FOR SERVICES PROVIDED BY RESIDENTS AND OTHERS AND PHYSICIAN UPCODING * The opinions expressed are personal to the author, and are not officially endorsed or authorized by the Department of Justice.