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The Straight and Narrow Bottom Line: Law and Ethics Related to Third-Party Payment
NOTE: This is a prerecorded presentation that originally took place at the Addiction eXecutive’s Industry Summit (AXIS) on March 6th, 2018.
This presentation – led by an experienced health care attorney who advises addiction treatment programs and urine drug testing laboratories – will include an overview of laws, regulations, policies, and ethics related to payment from private and public third-parties. The discussion will touch on the Federal Anti-Kickback Statute, state anti-kickback and fee-splitting statutes, the criminal health care fraud statute, False Claims Act, and the Affordable Care Act. This presentation will provide a timely discussion of the legal issues regarding the utilization of, and billing for, urine drug testing, including billing fraud and pass-through billing arrangements with clinical laboratories; collecting insurance payments made directly to patients; assignment of benefits; insurance enrollment; and copayment collection. Applying his practical experience and recent case law, enforcement trends, and legislation, the presenter will provide attendees with an understanding of how treatment programs and laboratories can comply with relevant laws and regulations, obtain reasonable payment, and ensure that safeguards are in place to protect the safety of patients and prevent civil and criminal liability.
Presenter Michael C. Barnes, Esq, is the managing partner at DCBA Law & Policy in Washington, DC. He has served as a strategic advisor to executives at multinational corporations, primary legal counsel to national health care service providers, and compliance officer for multi-state providers of behavioral health care. Mr. Barnes has authored more than 10 scholarly articles, presents frequently at conferences nationwide, and performs legal analysis for radio and TV networks, including CNN, HLN, and FOX News. Mr. Barnes is also the executive director of the Center for Lawful Access and Abuse Deterrence (CLAAD), a national non-profit working to reduce prescription drug abuse. He previously served as confidential counsel in the White House Office of National Drug Control Policy.