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Overpayment Recoveries by Health Insurers: Bringing and Defending Claims, Evaluating Merits, Scope of Recovery

Recording of a 90-minute CLE video webinar with Q&A

This program is included with the Strafford CLE Pass. Click for more information.
This program is included with the Strafford All-Access Pass. Click for more information.

Conducted on Thursday, October 6, 2022

Recorded event now available

or call 1-800-926-7926

This CLE course will guide counsel to healthcare insurers and providers on bringing and defending overpayment recovery claims. The panel will provide practical insight from both plan and provider perspectives on implementing and dealing with health insurer audits, overpayment demands, and recoveries.

Description

The government has focused on fighting healthcare fraud and abuse and pursuing overpayments. They are not alone in this endeavor. Health plans are also tasked with combating fraud and abuse (by contract or by their own initiative). The result is that health insurers have become increasingly more active in investigating potential provider fraud and abuse and seeking the recovery of overpayments from healthcare providers.

Both health insurers and providers must understand the regulatory framework under which claims for overpayments are brought. Further, counsel to providers should evaluate the merits of the claims and be prepared to challenge them.

Listen as our authoritative panel of healthcare attorneys provides practical insight from both plan and provider perspectives on implementing and dealing with overpayment demands and recoveries.

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Outline

  1. Regulatory framework
  2. Key considerations
    1. Basis for recovery
    2. Merits of claim
    3. Scope of recovery
  3. Best practices
    1. For healthcare providers
    2. For health insurers

Benefits

The panel will review the following important issues:

  • Hot trends in fraud and abuse (what are health insurers looking at), recent recovery actions and settlements, including lessons learned
  • Key considerations when determining to bring recovery claims and defending against such claims
  • Best practices for challenging health insurer audits, sampling, and extrapolation evidence

Faculty

Greenberg, David
David S. Greenberg
Partner
ArentFox Schiff

Mr. Greenberg advises health care companies, including providers and suppliers, through an exceedingly...  |  Read More

Hamilton, Steven D.
Steven D. Hamilton
Partner
Reed Smith

Mr. Hamilton is an seasoned trial lawyer who focuses his practice on healthcare litigation and regulatory issues. As an...  |  Read More

Access Anytime, Anywhere

Strafford will process CLE credit for one person on each recording. All formats include course handouts.

To find out which recorded format will provide the best CLE option, select your state:

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