Session Overview:

Navigating the complexities of waiving patient cost share responsibilities, such as deductibles, coinsurance, and copayments, is crucial for healthcare professionals. Improperly handling these waivers can lead to significant legal and financial repercussions under both commercial and federal healthcare programs. This session will provide an in-depth understanding of the laws, regulations, and potential penalties associated with waiving patient cost share responsibilities, helping you safeguard your practice against compliance risks.

Key Topics to be Covered:

• The importance of understanding patient cost share waivers.
• Liabilities and penalties under the Federal False Claims Act.
• Risks associated with the Anti-Kickback Statute.
• Guidelines on assessing financial hardship.
• Differentiating the impact on Medicare and other federal programs versus commercial health plans.
• Reviewing health plan contract language regarding waivers.
• Case studies and legal analysis.
• Discussion on professional courtesy, financial hardship exceptions, and prompt payment discounts.
• Circumstances where healthcare providers can legitimately waive or discount patient balances.

Who Should Attend:

This webinar is designed for a wide range of healthcare professionals, including physicians, physician assistants, office managers, revenue cycle managers, hospitalists, nurses, billing staff, staff from third-party billing companies, and revenue cycle staff in ambulatory surgery centers and hospitals.

Materials and References Provided:

• Comprehensive PowerPoint presentation
• Detailed discussions on relevant legal cases
• Examination of potential risks from payer scrutiny and whistleblowers
• Insights into why routine waivers of patient cost share can be legally dangerous