Payment, Enforcement, and Compliance Committee

The Payment, Enforcement and Compliance Committee monitors trends and practices in reimbursement, billing, collection and provider audits under Medicare, Medicaid and other federal and state health care programs. The Committee tracks developments related to reimbursement and payment policies of managed care and commercial payors including the changing face of health care delivery and reimbursement, the restructuring and management of risk-sharing arrangements, valued-based purchasing, bundled payments and ACOs. The Committee’s focus includes compliance, quality of care, false claims, kickback and Stark Law issues, as well as fraud and abuse prevention, investigations and prosecutions, arising as a result of changing health delivery systems and payment initiatives.