Last week, one of my clients got a letter from a state Attorney General. The letter requested information about two of the organization’s former employees. When the client forwarded me the letter, I suggested that I would call the author and confirm that my client wasn’t a target of the investigation. My client was nervous. “Won’t having a lawyer call on my behalf make me look guilty?” the client asked, continuing “Don’t only guilty people need lawyers?”
There is much to unpack there. I’ll start with a common adage: when a lawyer represents themselves, they have a fool for a client. Experience has taught that even lawyers benefit by bringing in another pair of eyes to handle problems. If lawyers shouldn’t represent themselves, it is extra clear that a non-lawyer shouldn’t.
There are many reasons for this. First, you don’t know what you don’t know. Again, a fresh pair of eyes can be helpful. But there are other benefits to having a lawyer make contact.
If you call an investigator, nothing will stop them from starting to interrogate you. They can ask anything they want. If you’re worried about how it will look having a lawyer call on your behalf, imagine how it will look if you try to shut down an agent’s questions – when, mid-call, you regret not engaging counsel. Worse yet, let’s say that you make some factual mistake during the call. You’re now on the hook for making a false statement during an investigation. Having a lawyer make the call on your behalf provides an inherent buffer, lowering the risk that the call takes an unexpected turn.
Second, I wouldn’t tie yourself in knots trying to determine whether a particular course of action looks guilty or not. After all, agents are well-aware of the fact that people think it makes them look bad to get a lawyer. The result could be some sort of psychological Catch-22: guilty people don’t retain counsel for fear of looking guilty. You may arouse suspicion by NOT engaging counsel. Don’t get trapped by mind games about appearances. Focus on substance.
But I really want to emphasize the strongest argument for engaging counsel. If you’ve ever watched a cop show or read a newspaper article about investigations, you know the length to which a government agent will go to try to keep someone from engaging counsel.
There is a reason for that.
People who have counsel are less likely to get convicted. Agents don’t want people to get counsel, because it makes their work more difficult. And that should tell you all you need to know. This point is illustrated brilliantly by a Gary Larson cartoon. The cartoon features a man talking to a shark in a boat, as other sharks circle hopefully. The shark says “I’ll tell my people you’re going to stay in the boat, but I warn you, they’re not gonna like it.”
It’s absolutely true that government agents will be annoyed at you for getting counsel. But the reason for their displeasure is that their job will be harder.
Larson’s The Far Side offers the perfect analogy. Would you rather jump in the water and have happy sharks (government agents), or stay in the boat – that is, engage counsel and refuse to talk, and annoy them? Personally, I am staying in the boat. Finally, the letter ends with the statement “Please note that the data regarding investigations is confidential, and I request that you treat this information accordingly.” Just a reminder that while the STATE may be required to keep the information confidential, YOU are not. The government’s request is just that: a request. That’s importantly distinguishable from a requirement.
Back in August, you may have heard my colleague Cate Brantley review the latest in a string of lawsuits over the legitimacy of the No
The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) has posted a report titled Additional Oversight of Remote Patient Monitoring
Please log in to your account to comment on this article.
Optimize your outpatient clinical documentation and gain comprehensive knowledge from foundational practices to advanced technologies, ensuring improved patient care and organizational and financial success. This webcast bundle provides a holistic approach to outpatient CDI, empowering you to implement best practices from the ground up and leverage advanced strategies for superior results. You will gain actionable insights to improve documentation quality, patient care, compliance, and financial outcomes.
Enhancing outpatient clinical documentation is crucial for maintaining accuracy, compliance, and proper reimbursement in today’s complex healthcare environment. This webcast, presented by industry expert Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, will provide you with actionable strategies to tackle complex challenges in outpatient documentation. You’ll learn how to craft detailed clinical narratives, utilize advanced EHR features, and implement accurate risk adjustment and HCC coding. The session also covers essential regulatory updates to keep your documentation practices compliant. Join us to gain the tools you need to improve documentation quality, support better patient care, and ensure financial integrity.
This webcast, presented by Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, a recognized expert with over 30 years of experience, offers essential strategies to improve outpatient clinical documentation integrity. You will learn how to enhance the accuracy and completeness of patient records by adopting best practices in coding and incorporating Social Determinants of Health (SDOH). The session also highlights the role of technology, such as EHRs and CDI software, in improving documentation quality. By attending, you will gain practical insights into ensuring precise and compliant documentation, supporting patient care, and optimizing reimbursement. This webcast is crucial for those looking to address documentation gaps and elevate their coding practices.
ICD10monitor has teamed up with renowned CDI expert Dr. Erica Remer to bring you an exclusive webcast on how to recognize sepsis, how to get providers to give documentation that will support sepsis, and how to educate to avert sepsis denials. Register now and become a crucial piece of the solution to standardizing sepsis clinical practice, documentation, and coding at your facility.
Dr. Ronald Hirsch provides critical details on the new Medicare Appeal Process for Status Changes for patients whose status changes during their hospital stay. He also delves into other scenarios of hospital patients receiving custodial care or medically unnecessary services where patient notifications may be needed along with the processes necessary to ensure compliance with state and federal guidance.
Healthcare organizations face complex regulatory requirements under the No Surprises Act and Price Transparency rules. These policies mandate extensive fee disclosures across settings, and confusion is widespread—many hospitals remain unaware they must post every contracted rate. Non-compliance could lead to costly penalties, financial loss, and legal risks. Join David M. Glaser Esq. as he shows you how to navigate these regulations effectively.
Protect your facility from unwanted audits! Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, and take a deep dive into both the CMS and AMA guidelines for reporting post operative pain blocks. You’ll learn how to determine if the nerve block is separately codable with real life examples for better understanding. Becky will also cover how to evaluate whether documentation supports medical necessity, offer recommendations for stronger documentation practices, and provide guidance on educating providers about documentation requirements. She’ll include a discussion of appropriate modifier and diagnosis coding assignment so that you can be confident that your billing of post operative pain blocks is fully supported and compliant.
During this RACmonitor webcast Dr. Ronald Hirsch spotlights the areas of the OIG’s Work Plan and the findings of their most recent audits that impact utilization review, case management, and audit staff. He also provides his common-sense interpretation of the prevailing regulations related to those target issues. You’ll walk away better equipped with strategies to put in place immediately to reduce your risk of paybacks, increased scrutiny, and criminal penalties.
Copyright © 2024 RACmonitor. Powered by MedLearn Media.
Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →
👻Spooky Sale is Back!👻 Get 31% off all three Medlearn brands, using code SPOOKY24.
