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

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Presentation on theme: "Current Top 10 List JAMES G. SHEEHAN Associate United States Attorney"— Presentation transcript:

1 Current Top 10 List JAMES G. SHEEHAN Associate United States Attorney
615 Chestnut Street Suite 1250 Philadelphia, PA Phone: Fax:

2 QUI TAM RELATORS

3 2.PRESCRIPTION DRUGS

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

5 4.EXPERIMENTAL DEVICE AND PROCEDURE CLAIMS

6 5.DRG UPCODING

7 6.CREDENTIALING OF PHYSICIANS AND OTHER HEALTH WORKERS

8 OUTLIER PAYMENTS

9 8.QUALITY OF CARE/ MEDICAL ERROR ISSUES

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

11 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.

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