Program Integrity Provisions of the PPACA

Meeting the New Requirements for Compliance, Disclosure, Transparency and Quality of Care

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

Conducted on Thursday, February 17, 2011
Recorded event now available

This CLE webinar will provide guidance to healthcare counsel on complying with the program integrity provisions of the PPACA. The panel will outline immediate updates needed to providers' policies and practices to avoid government enforcement actions and increased liability exposure.


The Patient Protection and Affordable Care Act of 2010 (PPACA) contains several significant new requirements related to program integrity that require immediate attention and action by healthcare providers and their counsel.

The program integrity provisions set forth new expectations for healthcare entities in the areas of regulatory compliance, disclosure, transparency, and quality of care. The enforcement provisions accompanying the program integrity requirements significantly increase providers' liability exposure.

To ensure compliance with the PPACA and avoid civil and criminal penalties, counsel to hospitals and providers must understand the full impact of the new program integrity provisions on business operations and advise their clients to immediately update and enhance their policies and practices.

Listen as our authoritative panel of healthcare attorneys discusses recent developments related to program integrity and explains steps hospitals and providers should take now to ensure compliance with the program integrity provisions of the PPACA.


  1. Overview of new program integrity provisions
    1. Regulatory compliance
    2. Disclosure
    3. Transparency
    4. Quality of care
  2. CMS’s recent program integrity initiatives
    1. Legislation (new and proposed)
    2. MICs, RACs and ZPICs
    3. Medicaid Integrity Program
  3. Steps to minimize liability exposure


The panel will review these and other key questions:

  • What changes do the program integrity provisions make to the Stark law related to physician-owned hospitals, disclosure requirements for the IOAS exception, and the Stark self-disclosure protocol?
  • What are the new provider and supplier enrollment requirements?
  • What is the new deadline for reporting and returning overpayments?
  • What are the significant False Claims Act changes in the new law, including changes to the public disclosure bar?


Linda A. Baumann, Partner
Arent Fox, Washington, D.C.

She concentrates her practice on healthcare regulatory and transactional matters with particular focus on fraud and abuse, reimbursement and implementation of Medicare’s new Part D benefit. She has handled government investigations, implemented corporate compliance programs, served as outside regulatory counsel, and conducted due diligence in connection with acquisitions and financing.

Lisa A. Estrada, Partner
Arent Fox, Washington, D.C.

She represents institutional healthcare providers and suppliers in government enforcement actions and investigations, cases under the False Claims Act and administrative litigation. Through this work, she has gained a solid understanding of healthcare fraud and abuse issues and frequently counsels a broad range of health industry clients on compliance matters.


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Customer Reviews

Very good and concise CLE.

Anthony DiSandro

Stevens & Lee

The teleconference addressed a highly relevant topic that recurs in my practice. The subject matter was very timely and informative.

Saleem Moghal

Paul Hastings Janofsky & Walker

I really appreciated the detailed answers of the speakers during question and answer session.

Amy Berret

Kean Miller

The program's structure and organization was very logical and easy to follow.

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Kevin Wolf

Ruder Ware

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Health Law Advisory Board

Lowell C. Brown


Arent Fox

Jennifer L. Evans



Ryan S. Johnson


Fredrikson & Byron

Gina M. Kastel


Faegre Baker Daniels

Karen S. Lovitch


Mintz, Levin, Cohn, Ferris, Glovsky and Popeo

David A. Manko


Proskauer Rose

John J. Miles

Senior Counsel

Baker Donelson

C. Elizabeth O'Keeffe


Wyatt, Tarrant & Combs

J. Peter Rich


McDermott Will & Emery

Donald H. Romano

Of Counsel

Foley & Lardner

Judith A. Waltz


Foley & Lardner

John R. Washlick


Buchanan Ingersoll & Rooney

Jesse A. Witten


Drinker Biddle & Reath

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