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Course Title: Reserve Cost Reports
Course Series: eComply Healthcare

Description:

In an effort to reduce costs and deter illegal conduct, all federal authorities with responsibilities for enforcing the rules of Medicare and other federally funded healthcare organizations are currently devoting many of their resources to the detection and punishment of false claims. Federal officials, who contend that hospitals frequently engage in illegal and improper reporting of reserve costs, have launched a high-profile enforcement effort to stem what they regard as a major area of healthcare fraud.

Officials of those hospitals whose reimbursement is a function of reserve costs must constantly exercise great vigilance and caution to avoid the dangerous consequences that may and likely will follow from a government accusation of improper reporting.

Hospital reporting of reserve costs has prompted multiple lawsuits and is intensely scrutinized by the Centers for Medicare and Medicaid Services (CMS) and the Office of the Inspector General (OIG). This course explains how improper reserve cost reports may constitute submission of a false claim.

At the end of this course, you will be able to:

1. State the elements of a false claim

2. Explain the relationship between reserve cost reporting and false claims

3. List examples of reserve cost reporting that may trigger false claims allegations

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