Overview: The session will provide an overview of medical necessity, particularly for the point of view of billing medical necessity as opposed to clinical medical necessity. We will address what providers and hospitals can do to try to stem this enforcement effort and how compliance programs should be adapted to address this risk area. We will address how historic fraud and abuse detection efforts are changing and review what the future holds for fraud detection and enforcement. We will discuss how companies/hospitals should self assess medical necessity activity. We will address who is accountable for the medical decisions of physicians and what should be done to fulfill that responsibility. We will provide insight into measurement tools that allow hospitals to evaluate and/or challenge the medical decisions of the medical staff. We will also discuss how hospitals can self assess medical necessity activity. The roll of peer review and due diligence reviews will be reviewed.Finally, the webinar will review some of the high-profile cases and how the government is approaching its enforcement activities.