Sean McKenna on Medical Necessity & Quality of Care Compliance [Podcast]

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medical necessity

Ahead of HCCA’s Healthcare Enforcement Compliance Institute, speaker Sean McKenna and host Kortney Nordrum discuss the importance of medical necessity and quality of care compliance, including:

  • What an effective healthcare compliance program look like;
  • The history of medical necessity compliance and the changes under the ACA;
  • Quality of care benchmarks;
  • How compliance programs help eliminate quality of care enforcement concerns;
  • Criminal and civil liabilities for quality of care and necessity issues (including the importance of understanding kickbacks);
  • Who the DOJ actually indicts;
  • The importance of documentation and peer review standards;
  • Recent compliance concerns; and
  • Sean’s best advice to measure your program’s effectiveness.

Sean McKenna ia a shareholder in Greenberg Traurig’s Dallas office. Sean focuses his practice on healthcare enforcement and regulatory issues, representing individuals and providers under civil or administrative investigation by the Department of Justice, Offices of Inspector General, and Attorneys’ General Medicaid Fraud Control Units, as well as in criminal investigations and matters involving the United States and State Attorneys General. As a former ten-year Assistant United States Attorney, Associate Counsel to the Inspector General and General Counsel for the U.S. Department of Health and Human Services, Sean focuses his practice on matters involving the health care industry and regularly represents clients before Medicare, Medicaid and commercial contractors. Sean’s work includes assisting clients with internal investigations and compliance reviews, as well as advising on compliance with state and federal fraud and abuse rules. He is a frequent invited speaker at national, regional, and local conference.

Sean has been Vice-Chair of the ABA Health Law Section’s Membership Committee and a member of the State Bar of Texas’s Health Law Section Council since 2013. He was honored in 2015 and 2016 to be named a Best Lawyer in America, Healthcare Litigation, and Texas SuperLawyer for healthcare in 2016.

For more information on HCCA’s Healthcare Enforcement Compliance Institute, click here.