2020 Virtual Compliance Institute (CI)

Medical Necessity & The False Claims Act: An Ever-Moving Target

  • Medical Necessity & The False Claims Act: An Ever-Moving Target

    Christopher A. Melton, Partner, Wyatt, Tarrant & Combs LLP. Rosalind Cordini, Senior Vice President/Director of Coding & Compliance Services, Coker Group.

    March 31, 2020

    • The current way the False Claims Act is being used in litigation, with a focus on whether a doctor’s certification that a procedure is reasonable and necessary matches up with the government’s definition of the phrase

    • Understand current False Claims Act case law for what must be alleged in order to deem medical necessity of a procedure/service false, and learn from examples of recent FCA cases that are being filed

    • Gain insight on various court decisions regarding the government’s burden in these cases, along with tangible advice on how to make sure that medical necessity is justified

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The Society of Corporate Compliance and Ethics (SCCE) is a non-profit, member-based professional association. SCCE supports our members' work with education, news, and discussion forums. We are a community of leaders, defining and shaping the corporate compliance environment across a wide range of industries and geographic regions. In developing and maintaining effective ethics and compliance programs, our members strengthen and protect their companies.

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About HCCA

The Health Care Compliance Association (HCCA), is a 501(c)6 non-profit, member-based professional association. HCCA was established in 1996 and is headquartered in Minneapolis, MN. We provide training, certification, and other resources to over 10,000 members. Our members include compliance officers and staff from a wide range of organizations, including hospitals, research facilities, clinics and technology service providers.

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