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Quality Fraud: What’s That?

Alice G. Gosfield
Date & Time: All Days
Duration: 60 Minutes
Category: Healthcare
Type: Recorded Webinar

Description

Quality Fraud is a global phenomenon that has existed for a long time and increases daily; it is a deliberate act that causes a business or economy to suffer damages, often in monetary losses or otherwise.

Quality Fraud remains a significant concern across industries worldwide. Quality Fraud refers to the misrepresentation or falsification of the quality of a product or service. It involves deceitful practices to make something appear to meet higher quality standards than it does. This can apply various methods such as manipulating test results, using materials while claiming higher quality, or falsifying certifications.

The webinar will focus on maximizing profits or gaining a competitive advantage, but it damages consumer trust, harms brand reputation, and can lead to legal consequences. It destroys trust between consumers and producers, undermines the integrity of industries, and can have severe consequences for both businesses and consumers.

Session Highlights:

  • To understand potential liabilities under rules about quality and performance.
  • To understand how to revise compliance programs to address these issues proactively.
  • The webinar will discuss conditions of participation and the new risks associated with medical necessity.
  • Participants will be updated regarding quality reporting and pay for performance issues.
  • The webinar will explore value-based arrangements and other forms of quality failures.
  • Attendees will explore government guidance and practical steps.
  • The webinar will discuss penalties, including exclusions, sanctions, quality-based civil money penalties, quality-based corporate integrity agreements, false claims liability, and case law.

Why Should You Attend:

In the manufacturing industry, nothing is more important than delivering high-quality products to your customers. But unfortunately, quality inspection fraud is on the rise. Quality Fraud undermines the integrity of products and services, eroding trust between consumers and businesses. Addressing this issue requires collective action, including proactive measures to prevent fraudulent practices and educate consumers. By Fostering a culture of transparency and accountability, we aim to uphold genuine quality standards and safeguard consumer welfare and trust.

Who Should Attend:

  • Compliance officers
  • Chief medical officers
  • Group Administrators
  • Practice managers
  • Legal Counsel
  • C-suite leadership of healthcare providers

Price Details

Speaker Profile : Alice G. Gosfield

Ms. Gosfield served as Chairman of the Board of Directors of the National Committee for Quality Assurance, reelected to serve five terms from 1998 through 2002. She served on the Board for twelve years from1992 through 2003. In the public policy arena, she has served on four committees of the Institute of Medicine of the National Academy of Sciences studying issues involving utilization management and clinical practice guidelines and has served as an advisor to the Agency for Health Care Policy and Research in both evaluating one of their first three clinical practice guidelines and in developing methodologies to translate guidelines into medical review criteria, performance measures and standards of quality.She was the first Chairman of the Board of PROMETHEUS Payment®, Inc. a not-for-profit, national, multi-stakeholder project to develop a new provider payment model (PROMETHEUS Payment®) that bases provider payment on the cost of delivering guidelines based care as measured in a comprehensive scorecard. She was the first Chairman of the Board of the Health Care Incentives Improvement Institute, Inc (HCI3) a not for profit organization which is the merger of Bridges to Excellence and PROMETHEUS Payment®.She has been called on by the Congressional Budget Office, the General Accounting Office, the Robert Wood Johnson Foundation, the Federal Agency for Healthcare Research and Quality, the Joint Commission, and others to advise on issues pertaining to Medicare reimbursement, medical evidence, legislation dealing with medical necessity in managed care and tort reform. Ms. Gosfield served as President of the American Health Lawyers Association (formerly the National Health Lawyers Association), from 1992-1993 and chaired their Physician and Physician Organizations Institute from 2001 through 2006.