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1. Rules institutional providers, particularly hospitals, must follow regarding billing federal programs such as Medicare and Medicaid 2. Issues that an institutional provider may encounter


1. Rules institutional providers, particularly hospitals, must follow regarding billing federal programs such as Medicare and Medicaid

2. Issues that an institutional provider may encounter with respect to Medicare/Medicaid standards and billing compliance that could lead to adverse consequences if not addressed.

3. Who is subject to the federal False Claims Act, and what conduct does it prohibit. Key principles of compliance?

4. Is the court likely to regard any hospital billed amount as reasonable and thus enforceable?

5. How do doctor/billing and financial incentive payments create conflicts of interest, and what is the extent to which those conflicts are legally permissible?

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