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Experience

Mr. Fitzgerald helps health care companies successfully overcome complex regulatory problems, including:

Government audits, investigations and litigation. Mr. Fitzgerald represents health care companies in response to a wide range of government audits and investigations, ranging from criminal and civil false claims investigations and litigation to appeals and strategic planning of Medicare Recovery Audit Contractor (RAC) audits. He has extensive experience with Medicare and Medicaid coverage and claims appeals.
Licensure and Certification. Mr. Fitzgerald helps health care companies successfully resolve issues with licensure applications, licensure denials, state and federal surveys, immediate jeopardy notices, licensure appeals, and general compliance with a wide variety of state licensure matters. His deep understanding of state licensure and Medicare reimbursement regulations allows him to help providers develop strategies to surmount licensure, billing and reimbursement issues.
Regulatory Compliance Counseling. Mr. Fitzgerald facilitates the structuring of prospective business arrangements in ways that minimize regulatory risk while maximizing business opportunities. This includes joint venture structuring, hospital-physician arrangements, and due diligence on regulatory issues.
Proactive Fraud and Abuse Problem Solving. Mr. Fitzgerald helps health care companies find creative solutions to a wide range of compliance dilemmas. He has conducted significant internal investigations related to allegations of regulatory violations. He has extensive experience with resolving coding and billing irregularities, including through the strategic use of voluntary disclosures and repayments. Mr. Fitzgerald assists providers in the ongoing operation of their corporate compliance programs. He assists providers with finding solutions to potential Stark Law noncompliance.

News

June 1, 2012	Consider the Submission of Imperfect Medicare Claims on a Case-by-Case Basis
April 19, 2012	Denver Shareholder To Present At National Health Care Compliance Conference
January 20, 2012	VIDEO - Hot Topics in Health Reform Discussed in Denver

Publications & Presentations

February 28, 2013	WEBINAR - Fraud and Abuse: A Year in Review
January 8, 2013	Fraud and Abuse: A Year in Review 2013 Health Care Regulatory Update
January 20, 2012	Hot Topics in Health Reform Video
2011	Fraud and Abuse Colorado Bar Association CLE
2011	Fraud and Abuse: A Year in Review 2011 Health Care Regulatory Update
2010	Recent Developments in Enforcement and the False Claims Act HCAA Rocky Mountain Conference
2010	Fraud & Abuse Upate: Legal Changes and Your Hospital's Compliance Program Colorado Hospital Association
2010	Mistakes Happen: The Nuts and Bolts of a Voluntary Medicare Repayment HCCA 14th Annual Compliance Institute
2010	Recent Developments in Voluntary Disclosure HCCA 14th Annual Compliance Institute
2010	Lessons Learned From the Integrated Delivery System Round Tables™ How to Avoid Key Pitfalls on the Path to IntegrationAn IDS Boot Camp
2010	Legal and Regulatory Update Integrated Delivery Round Table
2010	Fraud and Abuse: Year in Review Colorado Hospital Association Health Care Regulatory Update
2009	Healthcare Fraud Under Heightened Scrutiny: Effective Compliance Strategies in the Face of New Healthcare Fraud Initiatives Legal Publishing Group of Strafford Publications
2009	EMTALA: Compliance and the Anti-Kickback and Stark Laws HCCA Compliance Institute
2009	The EMTALA Rollback Continues: The Courts and Inpatients HCCA Compliance Today
2008	Fraud and Abuse - Year in Review Colorado Bar Association CLE
2008	What CMS Gives, the Courts Take Away: Patients in Ambulances and EMTALA HCCA Compliance Today
2008	EMTALA & You Exempla Good Samaritan Medical Center
2008	Outside-the-Box Compliance Initiatives HCCA's 12th Annual Compliance Institute
2008	Case Study: Compliance Investigations and Settlement Agreements HFMA Colorado Chapter, Compliance/Law Conference
2007	Companies Cannot Be Put in Jail, But They Can Be Executed TRENDS
2007	Reevaluating and Developing the Company's Compliance Program in Light of New Rules and Laws State False Claims Summit
2007	Re-Energizing Your Compliance Program: Preserving the Strength of Fraud Avoidance American Urological Association Practice Management Conference
2006	Medicare Exclusioin and Health Care Employers HCCA Compliance Today
2006	HIPAA Civil Enforcement Update HCAA Mountain Local Annual Conference
2006	Strategies for Resolving Billing Mistakes or Alleged Misconduct Colorado MGMA Annual Meeting
2006	Protecting Your Practice Against Embezzlement Colorado MGMA Annual Meeting
2005	Employer Beware: Hidden Risks of Medicare-Excluded Workers Denver Business Journal
2004	Importing Drugs from Canada is More Mirage than Miracle Denver Business Journal
2004	Representing Health Care Providers in Civil and Administrative Fraud and Abuse Matters Sponsored by the Colorado Bar Association and the CBA Health Law Section Defending Civil and Criminal Healthcare Investigations
2003	Responding to a Fraud and Abuse Investigation Health Care Compliance Association, Region VIII Compliance Conference
2003	Fixing Past Mistakes MGMA Connexion
2000	A Guide to Employee Interview Techniques for Healthcare Organizations in a Fraud Investigation Healthcare Fraud and Abuse Newsletter Co-Author

Podcasts

February 28, 2013

WEBINAR - Fraud and Abuse: A Year in Review

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T. Jeffrey Fitzgerald

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