Pharmacies are facing a growing number of audits. Payors are often employing a variety of techniques, including invoice audits, desk audits, regulatory audits, and mining protocols. Here, Wilentz’s Angelo Cifaldi and Satish Poondi discuss the impact of audit results, including the recoupment of millions of dollars and the potential impact on the licensure of the pharmacy. Additionally, they address the importance of pharmacies' understanding the anatomy of an audit, their legal rights, and how to minimize potential liability. Case studies in the field are also discussed.
I. Define the terms Fraud, Waste, and Abuse
II. Describe common audit techniques
III. Understand key components of compliance programs
IV. Discuss common legal issues that arise in responding to an audit
Satish Poondi is an associate at the law firm of Wilentz, Goldman & Spitzer, P.A. and a member of its Mass Tort/Class Action Team. Mr. Poondi is also a registered pharmacist, completing the Doctor of Pharmacy program at Rutgers University.
Mr. Poondi is active in the field of pharmacy academia. He is an advisor to multiple pharmacy organizations and a guest lecturer at the Ernest Mario School of Pharmacy at Rutgers University. Mr. Poondi regularly presents continuing education seminars relating to important pharmaceutical legal issues for programs sponsored by academic institutions, professional organizations, and retail chains. He routinely represents healthcare professionals before licensing boards, such as the New Jersey Board of Pharmacy, New Jersey Medicaid, Medicare, the Drug Enforcement Administration, the Office for Civil Rights, and many other regulatory agencies, as well as third party insurance companies. Additionally, he routinely provides guidance on the regulatory responsibilities associated with the sale and purchase of pharmacies. His clients include independent pharmacies, pharmacists, pharmacy technicians, retail chains, wholesalers, hospitals, and compounding pharmacies.
In addition to his administrative law practice, Mr. Poondi also represents patients who were injured by pharmaceutical products against large pharmaceutical companies. Presently he is representing:
Mr. Poondi also represents clients with lung cancer and mesothelioma caused by their exposure to asbestos.
Mr. Poondi is also an active member of the community. He is the Director of Legislative Affairs for the Asian American Retailers Association and Director of Communications for the Indian Business Association. He previously served on the Mayor’s Advisory Committee on Community Relations for the township of Edison. In addition, Mr. Poondi is on the Executive Board of various Middlesex County based community associations.
Angelo Cifaldi is a shareholder with Wilentz, Goldman and Spitzer P.A., where he is Co-chair of the Mass Tort/Class Action Team, a member of the management committee and the firm’s Vice President. He has been with the firm since he graduated cum laude from Seton Hall Law School in 1984. Before law school he graduated from Rutgers College of Pharmacy with high honors in 1981 and became a licensed pharmacist in New Jersey, a license that he still maintains. Mr. Cifaldi has two primary areas of practice: mass tort litigation and pharmacy administrative law.
During the past 30 years, Mr. Cifaldi, in conjunction with his Mass Tort/Class Action Team, has collected over one billion dollars for his clients. Mr. Cifaldi has successfully represented clients who have been the victims of asbestos exposure, including asbestosis, lung cancer and mesothelioma, defective prescription drugs and medical devices, chemical exposure, and environmental pollution, including ground water and air contamination.
Notably, Mr. Cifaldi has been on the forefront of asbestos and environmental litigation, and has achieved several successful single case recoveries. He achieved $38.5 million and $17.5 million resolutions for the victims of a ground water contamination. He has also handled various pro bono matters, the most notable being the representation of widows and relatives of the 9/11 terrorist attack on the World Trade Center.
As to his pharmacy administration practice Mr. Cifaldi represent hundreds of pharmacies, pharmacists, pharmacy technicians, wholesalers, and other healthcare providers in New Jersey, New York and Pennsylvania. He is considered a leading authority on pharmacy law in New Jersey and has handled numerous matters and hearings before the New Jersey Board of Pharmacy, DEA, FDA, Medicare and New Jersey Medicaid.
Mr. Cifaldi is also an adjunct associate professor of Pharmacy Law and Bioethics at Rutgers College of Pharmacy. He has been teaching Pharmacy Law at the school for over 25 years. In addition Mr. Cifaldi presents numerous continuing education seminars on pharmacy law related issue for groups such as Rutgers University, New Jersey Pharmaceutical Association, Garden State Pharmacy Owners Association, Indo American Pharmaceutical Society, New York State Department of Health-AIDS Institute, New Jersey Institute of Continuing Legal Education and others.
Mr. Cifaldi is also involved in civic activities as the chairman for the North Haledon Recreation Commission. He has held that position since 1983. He serves as the regional vice president of the American Amateur Baseball Congress. He also coaches a team of college and ex professional baseball players (over 25 years) in the Met League, a summer baseball league in Northern New Jersey. He is a former Councilman and Council President of the Borough of North Haledon and continues to be active politically in Passaic County.
I think this is excellent and I expect to review it soon to be certain all of the information is absorbed. These lawyers know their subject very well.
This was a very interesting seminar.
like the two person format - one adding to the other's statements
great course, learned a lot
Very good and comprehensive presentation.
Really good course
This course was quite informative and both speakers were experts in the subject matters.
Really insightful presentation.
Good basic information on Medicare and Medicaid
Good speakers and info.