Enforcement actions and investigations targeting weight loss providers and clinics

Abstract:

In recent years, semaglutide medications have dominated weight loss headlines. Not surprisingly many weight loss providers and clinics have refocused their approaches, incorporating these drugs into patient treatment regimens. Unfortunately, the popularity of these drugs has led to a number of bad practices, ranging from overutilization to poor compounding practices. Insurance companies auditing claims for reimbursement have identified documentation deficiencies, improper coding practices, and incidents of outright fraud. During this presentation, we will discuss the current enforcement environment and discuss ways that weight loss providers and clinics can reduce their level of regulatory risk.

Audience take away notes:

• Participants will be able to discuss the various types of government investigations and prosecutions currently being pursued by Federal/State prosecutors and agency officials targeting weight loss providers and clinics.
• Participants will learn about specific government initiatives focusing on the ordering of GLP-1 receptor agonist drugs.
• Participants will be able to demonstrate steps that they can take to reduce their practice’s level of risk and increase its compliance with regulatory requirements.
• Participants will be able to discuss how to best respond if they are audited or investigated by law enforcement in connection with their GLP-1 ordering and prescribing practices.

Biography:

Mr. Liles’ background is rather unique. In addition to a law degree, he holds an MBA and an MS in Health Care Administration. Robert has worked on the provider side (in hospital administration), as a Federal prosecutor and now represents physician practices around the country in connection with Medicare / Medicaid and private payor audits and investigations. While working as a Federal prosecutor, he was asked to serve as the country’s first National Health Care Fraud Coordinator for the DOJ’s, Executive Office for U.S. Attorneys. Since entering private practice, Robert has continued to build on his health care background and experience.