In today’s aggressive regulatory and legal environment, chiropractors must remain vigilant to avoid becoming the target of insurance investigations, clawback demands, and fraud litigation. This course, presented by two leading healthcare attorneys, provides attendees with critical legal insights into the evolving strategies used by insurance companies in Florida to target healthcare providers. Attendees will learn how to identify red flags, avoid legal pitfalls, and protect their practices from unnecessary risk. Hour one will focus on the lifecycle of PIP fraudulent investigation, clawback claims and best practices to minimize exposure. Hour two will analyze recent “Right Spinal” case strictly prohibiting LMT’s from treating PIP patients, the legal principles behind the federal cases against chiropractors, and how laws such as Patient Brokering, and licensing restrictions are being applied to spine care delivery.
Learning Objectives
- Recognize key legal risks, including the “predetermined protocol” theory, that insurance companies use to build PIP fraud claims.
- Implement compliance-driven best practices to reduce the likelihood of being targeted by an insurance audit or clawback lawsuit.
- Interpret the current legal standards and recent court rulings, including the Right Spinal case, and apply these to staff utilization, patient brokering, and clinical protocols.
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