AHCA/NCAL Fraud and Abuse Prevention Toolkit

Esq. Stephen B. Hanse and Nancy Leveille in Clinical & Quality, Legal

AHCA/NCAL is pleased to release the Fraud and Abuse Prevention Toolkit (posted on AHCA/NCAL website), which was prepared by Reed Smith attorneys, Susan Edwards and Carol Loepere; reviewed by AHCA’s Legal Committee; and edited by AHCA Public Affairs staff, Tom Burke.  This Toolkit will help AHCA/NCAL membership untangle the complex web of federal and state agencies, regulations and laws related to fraud and abuse.  Although the Toolkit focuses on nursing care centers (NCCs); much of the information within also applies to other settings, such as assisted living communities (ALCs) and centers for individuals with intellectual and developmental disabilities (ID/DD).  In all of those settings, for example, the federal anti-kickback and Stark laws will apply (e.g., those laws are relevant to all health care programs including both the Medicare and Medicaid).  Please note, the Toolkit will help AHCA/NCAL membership better understand the legal environment they operate within; however, it is not a Compliance Program or Compliance Plan.  Instead, this Toolkit was specifically developed to help members improve their compliance with federal fraud and abuse laws and regulations.  To obtain a copy of the Toolkit go to http://www.ahcancal.org/facility_operations/integrity/Pages/default.aspx.  Please contact Dianne De La Mare at ddmare@ahca.org if you have any questions.


Stephen B. Hanse, Esq.
Vice President & Counsel, Governmental Affairs
518-462-4800 x26

Nancy Leveille, RN, MS
Sr. Director, Member Operational Support
518-462-4800 x20