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2016 Compliance Institute presentations and handouts

Monday

Conference session handouts are organized by the day they were presented and sorted sequentially:

Sunday   |   Monday   |   Tuesday   |   Wednesday

Choose a session block

 General Sessions        100's        200's        300's        400's

All session presentations and handouts in one PDF with bookmarks
(very large file 110mb, please allow ample time to download. Right click, save target as..)


Did you miss a session you wanted to attend? Get a recording of a session you missed.

Attendee prices: Each session only $20 or get the whole conference for $499

(Online recordings, Attendee prices)


Track color key

General Compliance and Hot Topics

Long-Term Care

Privacy & Security

Physician Compliance

Compliance Lawyer

Auditing & Monitoring

Internal Audit

How to Succeed as a Compliance Professional

Quality of Care

Advanced Discussion Groups

Session

Title/Description

Speakers

General Session | 8:45 am - 9:15 am 


GS1

OIG Update

Presentation (2 slides/page)
Presentation (3 slides/page)

Daniel R. Levinson, Inspector General, Office of Inspector General, U.S. Department of Health and Human Services


General Session | 9:15 am - 9:45 am


GS2

DOJ Update

No presentation or handout available

Leslie Caldwell, Assistant Attorney General, Criminal Division, DOJ

General Session | 9:45 am - 10:15 am


GS3

When Bad Things Happen to Good Organizations: Compliance in Resilience and Recovery

No presentation or handout available

James Sheehan, Chief, Charities Bureau, NY Attorney General


Did you miss a session you wanted to attend? Get a recording of a session you missed.

Attendee prices: Each session only $20 or get the whole conference for $499

(Online recordings, Attendee prices)



Break Out Sessions | 11:00 am - 12:00 pm


101

General Compliance and Hot Topics

ICD-10, Six Months In: Impact. Obstacles. Response. Compliance?

  • Identify initial challenges and impactful responses that have evolved in compliance since implementation of ICD-10
  • Identify evolution of documentation-coding-billing interface dynamics since implementation of ICD-10
  • Interactive audience discussion of challenges (or responses) in clinical documentation & revenue cycle compliance experienced with the implementation of ICD-10

Presentation (2 slides/page)
Presentation (3 slides/page)

Bess Ann Bredemeyer, Senior Director Consulting, McKesson Business Performance Services

Cindy Cain, Director, Consulting, McKesson

Betty B. Bibbins, Founder, CEO & Executive Physician Educator, DocuComp LLC

Nicole Harper, Senior Director of Revenue Cycle Operations, East Region, Surgical Care Affiliates



102

General Compliance and Hot Topics

DOJ and OIG Focus on Physician Compensation

  • The DOJ and OIG are increasing scrutiny of physician compensation arrangements. The panelists will explore recent cases to understand risk factors that may lead to physician compensation as potentially improper under the law
  • Describe steps hospitals and physicians can take to protect themselves, including the use of written contracts, fair market value analysis and proper record keeping
  • Discuss the trends that DOJ and OIG have signaled for their enforcement priorities, including heightened risk of prosecution against individual physicians and administrators under the Stark and Anti-kickback laws

Presentation (2 slides/page)
Presentation (3 slides/page)

Winston Chan, Partner, Gibson, Dunn & Crutcher LLP

William J. Harrington, Partner, Goodwin Procter LLP

Jeffery Marcus, Founder, Marcus Neiman & Rashbaum LLP



103

Long-Term Care

Swapping, Kickback, Fair Market Value: Risks for a Post-Acute Provider

  • OIG resources for post-acute care compliance officers
  • Relationships between post-acute care providers and ancillary providers—what should compliance officers know about “swapping”?
  • Post-acute bundling and coordinated care arrangements—discussion of risks and possible solutions

Presentation (2 slides/page)
Presentation (3 slides/page)

Alan Schabes, Partner, Benesch, Friedlander, Coplan & Aronoff LLP

Shannon Drake, VP, Associate General Counsel, Kindred at Home

Amanda Copsey, Senior Counsel, Office of the Inspector General, US Department of Health and Human Services



104

Privacy & Security

HIPAA Enforcement

  • What are OCR’s HIPAA enforcement priorities?
  • What industry compliance issues does OCR continue to see when enforcing HIPAA?
  • What does OCR hope to address with a permanent HIPAA audit program?

Presentation (2 slides/page)
Presentation (3 slides/page)

Iliana Peters, Senior Advisor for HIPAA Compliance and Enforcement, HHS Office for Civil Rights



105

Physician Compliance

Is Your Practice a Government Target? Pre-Audit Risk Assessment

  • See how CMS and private payers use advanced predictive analytics to identify high-risk physicians
  • Identify which codes and modifiers for which providers pose the greatest risk
  • Learn how to create an audit action plan for use in mitigating risk on the front end

Presentation (2 slides/page)
Presentation (3 slides/page)

Frank D. Cohen, Director of Analytics, Doctors Management LLC

 



106

Compliance Lawyer

Telehealth 202: Anatomy of a Hospital Telehealth Arrangement

  • Learn key legal, regulatory and business issues by examining an actual hospital telehealth arrangement
  • Explore specific contract terms and language, learning why they are used in compliant telehealth contracts
  • Obtain meaningful handouts and tools to incorporate into your company’s telehealth arrangements

Presentation (2 slides/page)
Presentation (3 slides/page)

Handout

Nathaniel M. Lacktman, Partner, Foley & Lardner LLP

Deborah A. Randall, Health Law and Telehealth Consultant, Deborah Randall Consulting



107

Auditing & Monitoring

Auditing, Monitoring and Validating: Leveraging Resources and Relationships to Assess and Reduce Risk

  • Understand the processes of auditing, monitoring and validation with a focus on the benefits and pitfalls of each activity
  • Apply principles of resource allocation based on assessed risks for both auditing and monitoring functions, based on the size of the organization
  • Real-time application of principles to develop a sample validation tool, a monitoring plan and the foundation of audit criteria, based on common inpatient and outpatient rules and protocols

Presentation (2 slides/page)
Presentation (3 slides/page)

Handout

Aurae Beidler, Director of Compliance/Assistant Professor, Pacific University

Monica R. Freedle, Hospital Compliance Program Manager, Kaiser Permanente Northwest



108

Internal Audit

How Can Compliance and Audit Work Together to Leverage Their Expertise

  • How to best use Subject Matter Experts in compliance to help audit
  • What areas can Subject Matter Experts be best leveraged
  • How it can work well and how it won’t

Presentation (2 slides/page)
Presentation (3 slides/page)

Marti Arvin, VP, Chief Compliance and Privacy Officer, Regional Care



109

How to Succeed as a Compliance Professional

Stuck in the Middle with You: How to Navigate the Politics of Healthcare

  • Learn how to strengthen your relationship with physicians and healthcare leaders
  • Strategies for negotiation and conflict resolution
  • Learn how to diplomatically communicate with physicians and healthcare leaders

Presentation (2 slides/page)
Presentation (3 slides/page)

Jay P. Anstine, Compliance Officer, Advanced Medical Imaging Consultants, P.C



110

General Compliance and Hot Topics

Top Five Hospice Risk Areas: What You Need to Know and Do Now

  • Examine current Federal and State enforcement trends affecting the hospice industry
  • Understand the focus of government enforcers will help providers prioritize their compliance program activities to audit and monitor high risk areas
  • Explore compliance and risk mitigation actions that hospice providers can take now to address these enforcement activities

Presentation (2 slides/page)
Presentation (3 slides/page)

Lynn Stange, Chief Compliance Officer, Nathan Adelson Hospice

Jason Christ, Member, Epstein Becker & Green PC

Serra Schlanger, Senior Associate, Epstein Becker & Green PC

Laura Ellis, Senior Counsel, Office of Inspector General, U.S. Department of Health and Human Services

           



111

General Compliance and Hot Topics

Telehealth and Multi-State Physician Licensure: Don’t Get Caught in the Tangled Web of Inconsistent and Troublesome State Physician Licensure Laws

  • Learn to identify similar provisions of telehealth state physician licensure laws and standards of practice
  • Understand common missteps in analyzing multistate physician licensure
  • How to create a detailed review process to navigate inconsistent state licensure laws and avoid getting caught in the tangled web

Presentation (2 slides/page)
Presentation (3 slides/page)

Handout 1
Handout 2

Marcie R. Swenson, Regional Compliance Officer, Intermountain Healthcare

Suzie Draper, VP Business Ethics & Compliance, Intermountain Healthcare

  



112

General Compliance and Hot Topics

The Key Three: How Collaboration, Communication and Culture Solidify Compliance

  • Collaboration: More than working together; it’s about getting people to do what you need them to
  • Communication: Communicating effectively means learning common communication filters, barriers to listening and how assumptions cause miscommunication
  • Culture: Creating the ideal environment where titles don’t matter as much as integrity, expectations and openness

Presentation (2 slides/page)
Presentation (3 slides/page)

Jennifer L. Kennedy, Manager Corporate Compliance, Barber National Institute



AD1

Advanced Discussion Groups

Take a Swim in the Compliance Fish Tank

  • The audience will vote and select hot compliance topics for discussion
  • The audience will be divided into two groups, those inside the compliance fish tank and those outside the compliance fish tank
  • The group inside the compliance fish tank discusses the hot compliance topic for ten minutes followed by five minutes of questions by those outside the fish tank; the groups will then reverse roles and continually repeat the exercise until the session is completed    

No presentation or handout available

John Falcetano, Managing Director, Action Compliance Services



AD2

Advanced Discussion Groups

Examining Different Methods for Auditing Research Compliance

  • Review methods for how human subjects protection is audited
  • Explore processes for auditing clinical research billing
  • Learn about peer compliance program’s efforts to audit research compliance

No presentation or handout available

Ryan Meade, Director of Regulatory Compliance Studies, Loyola University Chicago School of Law


Did you miss a session you wanted to attend? Get a recording of a session you missed.

Attendee prices: Each session only $20 or get the whole conference for $499

(Online recordings, Attendee prices)




Break Out Sessions | 1:30 pm - 2:30 pm


201

General Compliance and Hot Topics

Develop an Internal Due Diligence Process and Integration Strategy

  • Discussion of compliance-related due diligence in hospital/physician mergers and acquisitions, with additional due diligence drill-down recommendations based on preliminary findings and the impact on compliance program integration
  • Develop a detailed due diligence checklist, attestation form, and interview questionnaire
  • Discuss strategies for integration and implementing a standard compliance program

Presentation (2 slides/page)
Presentation (3 slides/page)

Handout 1 (xlsx)
Handout 2

Andrei M. Costantino, VP of Integrity & Compliance, Trinity Health

 



202

General Compliance and Hot Topics

The Impact of Retail Health and Wellness

  • Consider various benefits for health care providers partnering with retail pharmacies, retail clinics, including care coordination, reduced healthcare delivery costs, better patient outcomes and reduced long-term costs
  • Outline measures taken by providers and retailers to engage patients/customers to take active part in their personal health decisions through a variety of means including financial incentives
  • Discuss trends around i) retail pharmacy, retail clinics and wellness promotion and ii) the ever-increasing scope of services at retail pharmacy, retail clinics that can lead to greater operational, financial and compliance risks and the impact for manage

Presentation (2 slides/page)
Presentation (3 slides/page)

Thomas Delegram, Director, Deloitte

Chris Kloc, Senior Director-Specialty Pharmacy, Giant Eagle



203

Long-Term Care

Social Media, Care Providers Texting: How Do You Protect PHI?

  • Explore the new types of privacy and security risks facing companies in the long term care industry with the rapid pace of technological change, including employee use of smart phones, notepads and laptops, text messaging, and the various forms of social media
  • Understand the HIPAA regulatory scheme, how it adapts to new technologies and social media, and pick up clues about what Congress and the regulators are thinking about and what actions they may take in the future
  • Receive practical advice about how to protect your residents’ PHI in the face of these changes by adapting your HIPAA policies and practices and human resources policies

Presentation (2 slides/page)
Presentation (3 slides/page)

Donna Thiel, VP & Chief Compliance Officer, Fortis Management Group, LLC

Craig Day, Of Counsel, Lane Powell

Sarah Swale, Shareholder, Lane Powell



204

Privacy & Security

#HIPAA: How Social Media Impacts HIPAA Compliance

  • Explore how social media and its popularity has evolved into a major communication channel that is used by a demographically diverse user base
  • Understand “why” and “how” social media sites provide an easy opportunity for impermissible disclosures to occur and the implications of how these may result in a breach
  • Consider the different options and strategies that HIPAA compliance professionals use when monitoring for possible postings that may represent an unauthorized use of PHI

Presentation (2 slides/page)
Presentation (3 slides/page)

Frank Ruelas, Facility Compliance Professional, St. Joseph’s Hospital and Medical Center, Dignity Health



205

Physician Compliance

Compliance Mistakes in the EMR—Those Things They Don’t Warn You About!

  • EMR may not be the end all, be all, everyone thought it would be. How to ensure it is compliant!
  • How to handle the “issues” in the EMR when they are identified, and they will be!
  • Potential risks and how to be proactive and avoid them

Presentation (2 slides/page)
Presentation (3 slides/page)

Sandra K. Giangreco, Senior Associate, PricewaterhouseCoopers

Kimberly G. Huey, President, KGG Coding & Reimbursement Consulting



206

Compliance Lawyer

Physician Pharmacy Ventures: What Are They and What Are the Compliance Risks

  • What types of pharmacy arrangements are physicians entering into?
  • What are the key compliance issues associated with these ventures?
  • How can safe arrangements be structured?

Presentation (2 slides/page)
Presentation (3 slides/page)

Lester J. Perling, Partner, Broad and Cassel Erin Smith Aebel, Partner, Shumaker, Loop & Kendrick, LLP



207

Auditing & Monitoring

Don’t Let Auditors Cash In at Your Table: Effective & Efficient Billing Compliance Program Strategies

  • Perspectives regarding the top hospital and physician billing compliance risk areas that can and should be mined internally
  • Examples of risk-based auditing approaches and findings (i.e., use of PEPPER, evaluation of short stay data, drug unit billing, outlier payments, payments greater than charges)
  • Tips on managing the message: reporting of monitoring and auditing activities to senior leadership through dashboards and other formal and informal methods of communication

Presentation (2 slides/page)
Presentation (3 slides/page)

Tim Cleary, SVP Compliance, Internal Audit & Privacy, Health Quest Systems Inc

Dara Quinn, MHA, CHC, VP Compliance and Internal Audit, CarePoint Health

Gloria Jarmon, Deputy Inspector General for Audit Services, OIG-HHS



208

Internal Audit

Auditing the Two Midnight Rule: Midnight Madness or Moonlight Serenade

  • Understand CMS requirements for a valid hospital inpatient admission order
  • Identify the difference between an ED order and an admission order
  • Identify compliance risks associated with the two midnight rule and the barriers associated with implementation

Presentation (2 slides/page)
Presentation (3 slides/page)

Paul R. Belton, Vice President Corporate Compliance, Sharp HealthCare



209

How to Succeed as a Compliance Professional

What Employers Look for in a Compliance Professional

  • Key Attributes of the Successful Compliance Officer
  • The Employer’s Perspective
  • Interview Tips

Presentation (2 slides/page)
Presentation (3 slides/page)

Beth DeLair, President, Health Care Compliance Recruiting


210

General Compliance and Hot Topics

CERT: National Findings, Proper Medical Record Keeping and Tips to Prevent Medicare Recoupments

  • Learn about the CMS CERT Program and how it can effect reimbursement for Medicare providers
  • Become aware of the national impact and top trends identified through CERT reviews
  • Review specific scenarios identified as a CERT error and discover measures to prevent future CERT review findings

Presentation (2 slides/page)
Presentation (3 slides/page)

Becky Gunderson, Director of Part A Medical Review, Noridian Healthcare Solutions, LLC

Rachel Guy, CERT Team Leader, Noridian



211

General Compliance and Hot Topics

Compliance Is Ruff: A Dog’s Approach

  • Techniques used in the service dog training industry to gain compliance and correct unwanted behaviors
  • Methods utilized in the service dog training industry to work through challenging or difficult situations
  • How to apply these techniques and methods to enhance the effectiveness of a compliance program

Presentation (2 slides/page)
Presentation (3 slides/page)

Kimberly A. Lansford, Chief Compliance Officer, Shriners Hospitals for Children

Carol Lansford, Service Dog Trainer

Gabe II, Service Dog, Warrior Canine Connection



AD3

Advanced Discussion Groups

Pointers and Pitfalls in Managing Work-Life balance, Stress, and Burnout in the Compliance Profession

  • Raise awareness of work-life balance and burnout through interactive discussion with the participants attending this session
  • Discuss key findings from the 2012 survey that HCCA and SCCE conducted of its members which revealed that compliance professionals are under extreme stress and are at a significant risk of developing burnout
  • Through group discussion and interaction, we will introduce strategies to help to avoid burnout through practicing work-life balance as well as guidelines to facilitate early detection of burnout

No presentation or handout available

Robert Ossoff, Maness Professor of Laryngology and Voice, Vanderbilt University Medical Center

Shawn DeGroot, Global BPM Compliance Officer, Navigant



AD4

Advanced Discussion Groups

The Partnership of Risk and Compliance

  • Discuss the primary differences between the roles of risk and compliance
  • Identify the key areas where risk and compliance can gain synergies in their functional activities, e.g.: risk assessments, planning, training, communications, auditing and monitoring, etc.
  • Discuss metrics for identifying return on investment for this partnership

No presentation or handout available

Sheryl Vacca, SVP/Chief Compliance & Audit Officer, University of California



AD5

Advanced Discussion Groups

Privacy Officer & Researcher: The Reluctant Partnership

  • What are the differences in HIPAA requirements in the research world?
  • What are the HIPAA requirements that are the same as in the clinical world, but still a challenge for researchers and their covered entities?
  • How does a privacy officer become their researchers’ best friend? 

No presentation or handout available

Joan Podleski, Compliance Professional




Break Out Sessions | 3:00 pm - 4:00 pm



301

General Compliance and Hot Topics

The 340B Mega-Wait is Over—Now What?

  • Review and summarize HRSA’s “340B Program Omnibus Guidelines” (also referred to as the “Mega-Guidance”), including key topics addressed in the guidance
  • Understand and clarify the implications of the megaguidance for 340B stakeholders, including impacts and common challenges
  • Learn leading practices and tactics for operationalizing and complying with the 340B mega-guidance, including monitoring and auditing techniques

Presentation (2 slides/page)
Presentation (3 slides/page)

Karolyn Woo-Miles, Principal, Deloitte & Touche LLP

Anne S. Daly, Senior Director of Compliance, Banner Health

Emily Cook, Partner, McDermott Will & Emery



302

General Compliance and Hot Topics

Institutional Review Boards and Beyond: Understanding Research Compliance as a Non-Scientist

  • Legislation such as the PPACA has created a drive for new evidence-based medical standards at the same time as research is becoming easier to conduct through new tools such as Apple’s ResearchKit
  • Patient privacy standards, billing and coding requirements and technological security protocols only become more complex when research is being conducted in a health care facility.
  • Understanding the complexities of medical research and its compliance requirements will help the general compliance practitioner be a better partner with their organization’s Research Department and participate in Institutional Review Board activities

Presentation (2 slides/page)
Presentation (3 slides/page)

Angela I. Gamalski, Juris Doctor Candidate, Michigan State University College of Law

Alfred M. Pheley, Director of Research, Allegiance Health



303

Long-Term Care

OIG Compliance Expectations for the SNFs and Boards: Lessons Learned from Recent CIAs

  • Explore recent OIG reports and guidance about effective board governance, including compliance training and oversight to identify opportunities for improving Boards’ understanding of the government’s expectations
  • Analyze recent SNF corporate integrity agreements (CIAs) and develop strategies for using CIAs as tools for facility risk assessments and compliance monitoring
  • Assess the need to develop a Board training and education plan

Presentation (2 slides/page)
Presentation (3 slides/page)

Paula G. Sanders, Principal and Healthcare Chair, Post & Schell, P.C.

Cynthia Haines, Principal, Post & Schell, PC

Felicia Heimer, Senior Counsel, Office of Inspector General, U.S. Department of Health and Human Services



304

Privacy & Security

How to Socially Engineer Healthcare: Understand Why Our Natural Tendency to Trust Others Can Get Us into Trouble!

  • The methods social engineers use to manipulate workforce members, gain access to restricted areas, and steal patient records
  • Hear uncomfortably true stories of successful social engineering attempts, such as impersonating staff, sweet-talking workforce members, climbing through a trash compactor, and dumpster diving
  • Learn to spot the signs of a successful social engineer, how to adequately train staff in the spirit of professional skepticism, and ultimately protect patient information

Presentation (2 slides/page)
Presentation (3 slides/page)

Brand Barney, Security Analyst, Security Metrics

 



305

Physician Compliance

NPP: Scope of Practice & Operational Implications

  • Types of Non-Physician Providers, scope of practice, and limitation
  • Medicare, PPACA, and current trends in patient access expansion
  • Risk management and framework of effective controls, while running business and properly billing

Presentation (2 slides/page)
Presentation (3 slides/page)

Regina F. Gurvich



306

Compliance Lawyer

Protection and the Advice of Counsel: Fact or Fiction

  • What is the “advice of counsel” defense?
  • What are the risks in asserting “advice of counsel”? What does it protect?
  • Relationship to attorney-client privilege and work product protection

Presentation (2 slides/page)
Presentation (3 slides/page)

Kevin McAnaney , Attorney, Law Office of Kevin G. McAnaney

James Sheehan, Chief, Charities Bureau, NY Attorney General



307

Auditing & Monitoring

Immediately Address IT Access Compliance Challenges with These Techniques, Using Tools You Already Have

  • The healthcare industry must comply with IT regulations or risk a material weakness at audit or loss of valuable and confidential patient information
  • A review of the top IT access compliance issues for healthcare such as least privileges, dormant accounts, and excessive access
  • Walk away with tools and techniques you and your organization can utilize with software you already have to address these compliance challenges 

Presentation (2 slides/page)
Presentation (3 slides/page)

John Vastano, CSO, Veriphyr, Inc.

Alan Norquist, CEO & Founder, Veriphyr, Inc.



308

Internal Audit

DIY EMTALA Auditing

  • Conduct your own internal audit of EMTALA policies, procedures and processes in your Emergency Department to insure you are following all EMTALA requirements
  • Develop a partnership between Internal Audit, Compliance, the ED, Patient Registration, and Health Information Management in order to achieve the best compliance
  • Avoid common pitfalls in EMTALA preparedness

Presentation (2 slides/page)
Presentation (3 slides/page)

Handout 1
Handout 2
Handout 3

Robert Brown, Director of Compliance, University of Washington



309

How to Succeed as a Compliance Professional

Navigating Your Opportunities as a Compliance Professional

  • Broadening your horizons as a healthcare compliance professional
  • Identifying the range of diverse career opportunities available to compliance professionals
  • Maximizing your current role and evaluating potential opportunities

Presentation (2 slides/page)
Presentation (3 slides/page)

Joel Dziengielewski, Director, Navigant

Robert A. Hussar, Counsel, Manatt, Phelps and Phillips

 



310

General Compliance and Hot Topics

The Golden Triangle between Patient Access, HIM and Business Office

  • Faulty information creates incorrect data and redundant master person index entries. Claims are rejected and bad debt write-offs climb. Furthermore, the data correction and cleanup process is costly and labor intensive
  • This session highlights Mercy Health’s journey towards stronger data integrity through a focused patient identity theft initiative
  • Speakers also outline new steps for patient verification, clinical confirmation and behindthe-scenes data correction. Specific roles for each stakeholder are assessed and best practices discussed across all three areas: patient access, HIM, and business office

Presentation (2 slides/page)
Presentation (3 slides/page)

Elizabeth Delahoussaye, Senior VP of Privacy and Compliance of Provider Operations, IOD Incorporated

 



311

General Compliance and Hot Topics

Emerging Challenges in mHealth: Keeping Information Safe & Secure

  • Emerging trends in Mobile Health technology and the opportunity to engage patients by communicating with healthcare providers, researchers, and IOT (Internet of Things) vendors
  • This Presentation will explore the regulatory approach taken by the FDA, FTC, & OCR to safeguard sensitive data and consumers’ expectations in their use of mHealth
  • How mHealth technologies and changing marketplace dynamics are impacted by regulatory requirements to protect patient information

Presentation 1 (2 slides/page)
Presentation 1 (3 slides/page)

Presentation 2 (2 slides/page)
Presentation 2 (3 slides/page)

Handout 1
Handout 2
Handout 3

David Holtzman, VP Compliance, CynergisTek, Inc.

Web Hull, Privacy, Data Protection, & Compliance Advisor, Global Privacy and Compliance



AD6

Advanced Discussion Groups

 Legal Counsel and Compliance Relationship

  • Identify when legal counsel should be considered to respond to compliance and privacy issues
  • Explore the factors, benefits and challenges to using legal counsel
  • Learn from experiences of other participants how to use legal counsel effectively

No presentation or handout available

Darrell Contreras, Chief Compliance Officer, Millennium Health


AD7

Advanced Discussion Groups

Strategies for Managing Potential Overpayments and Compliance with the 60-Day Rule

  • Discuss 60-day rule developments, including CMS’s rulemaking and enforcement developments
  • Explore compliance challenges for providers attempting to navigate the 60-day rule in the face of real-world obstacles
  • Share practical strategies for meeting these challenges, including approaches to monitoring and reporting potential overpayments

No presentation or handout available

Sara Kay Wheeler, Partner, King & Spalding



AD8

Advanced Discussion Groups

Accountable Care Organizations: Compliance Readiness

  • The Role/Scope of the Compliance Officer in an ACO
  • Compliance Framework to Support the Evolving Model
  • Governance Challenges and Opportunities

No presentation or handout available

Jenny O’Brien, UnitedHealthcare Chief Compliance Officer, UnitedHealthcare

Rebekah Latchis, Corporate Responsibility, Bon Secours Health System


Did you miss a session you wanted to attend? Get a recording of a session you missed.

Attendee prices: Each session only $20 or get the whole conference for $499

(Online recordings, Attendee prices)




Break Out Sessions | 4:30 pm - 5:30 pm


401

General Compliance and Hot Topics

Are You Doing What You Said You Would Do? Assessing Whether Your Compliance Program Meets Federal Medicare Managed Care Contract Standards

  • Learn about the Medicare managed care program compliance program requirements for “first tier” and “downstream” and “related” entities
  • Understand the potential impact of noncompliance with contractual provisions
  • Gain insights for effectively negotiating compliance program provisions in managed care agreements

Presentation (2 slides/page)
Presentation (3 slides/page)

Handout 1
Handout 2

Heather Fields, Shareholder, Chair - Hospital/Health Systems Practice, Reinhart Boerner Van Deuren s.c.

Catherine M. Boerner, President, Boerner Consulting LLC

Jenny M. O’Brien, UnitedHealthcare Chief Compliance Officer, UnitedHealthcare



402

General Compliance and Hot Topics

Compliance in the Country: Considerations for Critical Access and Rural Hospitals

  • Interactive discussion about unique compliance challenges in rural and Critical Access Hospitals
  • Address supervision of outpatient services, specialty clinic considerations, and emergency room transfer concerns proactively to avoid False Claims Act, Stark, and EMTALA liability
  • Practical guidance and innovative ideas for compliance program implementation and improvement with limited resources

Presentation (2 slides/page)
Presentation (3 slides/page)

Tomi Hagan, Senior Consultant, Compliance, Quorum Health Resources



403

Long-Term Care

Legal, Clinical, and Operational Issues Associated With Post-Acute Care Partnerships

  • Address legal considerations and traps for the unwary in establishing post-acute care partnerships
  • Best practices on how the compliance program of the post-acute care provider should interact with its potential partners
  • How a post-acute care provider can establish quality metrics for ACO participation and bundled payment initiatives

Presentation (2 slides/page)
Presentation (3 slides/page)

Todd J. Selby, Attorney/Shareholder, Hall

Render Killian Heath & Lyman P.C.

Becky Smith, VP of Compliance, Golden Living

Amy L. Brantley, Chief Compliance Officer, Golden Living



404

Privacy & Security

Text Message Programs in a Health Care Setting: There’s More to It than HIPAA

  • What are the key compliance issues to consider when communicating with patients by text message?
  • How has the Telephone Consumer Protection Act (TCPA) landscape changed in the last year?
  • How does the TCPA address communications permitted under HIPAA?

Presentation (2 slides/page)
Presentation (3 slides/page)

Laura I. Asbury, Director – Privacy Compliance, Walmart Stores

Elizabeth Johnson, Partner, Wyrick Robins

 

 



405

Physician Compliance

Creating or Enhancing Your Internal Departmental Audits

  • How to get buy in from reluctant managers and supervisors
  • The components that demonstrate a comprehensive departmental review
  • The find it, fix it challenge

Presentation (2 slides/page)
Presentation (3 slides/page)

Handout 1
Handout 2 (xls)

Glena Jarboe, Compliance Manager, University of Kentucky

Catherine Masoud, External Affairs Compliance Manager, UK HealthCare, Office of Corp Compliance



 406

Compliance Lawyer

Federal Administrative Sanctions: Exclusion and Civil Money Penalties

  • OIG priorities
  • OIG exclusions and CMPs—enforcement initiatives: summary of settlements and proposed changes to exclusion and CMP rules
  • CMS revocations—different rules, similar effect

Presentation (2 slides/page)
Presentation (3 slides/page)

Julie Kass, Principal, OBER|KALER

Robert Penezic, Deputy Branch Chief, Office of Inspector General-U.S. Department of Health and Human Services



407

Auditing & Monitoring

Post-Audit Extrapolation Mitigation

  • Learn the ins and outs of extrapolation and how payers use this technique to increase audit recoveries
  • Learn about the importance of a statistically valid random sample when it comes to extrapolation
  • Identify when the results are biased against you and learn how to defend yourself when this happens

Presentation (2 slides/page)
Presentation (3 slides/page)

Frank D. Cohen, Director of Analytics, Doctors Management LLC



408

Internal Audit

Leveraging Internal Audit and Corporate Compliance for Effective Risk Management

  • Learn how Cleveland Clinic structured its Integrity Office to leverage Internal Audit and Corporate Compliance resources
  • Gain insight on how the Clinic developed its approach to risk management, involving both Internal Audit and Corporate Compliance resources
  • Understand how the three lines of defense model can be used to manage risks across your enterprise

Presentation (2 slides/page)
Presentation (3 slides/page)

Donald A. Sinko, Chief Integrity Officer, Cleveland Clinic



409

How to Succeed as a Compliance Professional

Program Effectiveness 201: Using Key Performance Indicators for Measurement

  • Review elements of an effective Compliance Program
  • Discuss measurement tools
  • Identify key Program indicators as guidelines for improvement

Presentation (2 slides/page)
Presentation (3 slides/page)

Handout 1
Handout 2 (xls)
Handout 3

 

Ruth Krueger, Enterprise Compliance Program Manager, Sanford Health

Cindy J. Matson, VP Health Services Compliance, Sanford Health

 



410

General Compliance and Hot Topics

Peer Review Is a Compliance Issue: Medical Necessity, Quality & False Claims Act Liability

  • A hospital’s governing body has ultimate responsibility for the care provided-- and for not billing for medically unnecessary services
  • Peer review and compliance processes must be coordinated
  • Active government enforcement activity has resulted in substantial payments by multiple hospitals, and some criminal convictions

Presentation (2 slides/page)
Presentation (3 slides/page)

Terri Keville, Partner, Davis Wright Tremaine LLP

Terence Ou, Executive Director, Compliance, Huntington Hospital



411

General Compliance and Hot Topics

Communicating with Regulators and Enforcement: Avoiding Pitfalls

  • Healthcare companies do their best to avoid receiving a regulatory inquiry or a request for more information, or worse, a subpoena. Management knows all too well the consequences these types of requests can have on their reputation, bottom line, and their time
  • Get a view into the panelists’ day-to-day work as regulators and enforcement officials through entertaining personal stories of real case studies
  • Explore questions that every payer and provider will be interested in

No presentation or handout available

James J. Rough, Associate Director, Navigant Consulting, Inc

Cynthia Santana, Supervising Special Agent, Healthcare, Federal Bureau of Investigation, Las Vegas Office

Shaun Bowen, Deputy Chief Investigator, State of Nevada, Office of the Attorney General

Crane Pomerantz, Deputy Chief-White Collar Unit, Criminal Health Care Fraud Coordinator, US Attorney’s Office, District of Nevada



AD9

Advanced Discussion Groups

Program Operational Components: Monitoring and Safeguards

  • Discussion of the routine monitoring processes of your Compliance Program
  • Share ideas on how to identify and develop program safeguards
  • Come prepared to share your most effective compliance tools

No presentation or handout available

Al Josephs, Senior Director, Compliance Operations, Tenet Healthcare Corporation

Jawanna King, Regional Compliance Director, Tenet Healthcare Corporation



AD10

Advanced Discussion Groups

Compliance and Quality: Complement or Antagonist

  • Discuss methods to collaborate together for improved outcomes
  • Is there a productive tension between the two functions
  • Strategize on ways to improve communication and collaboration

No presentation or handout available

Lynda Hilliard, Healthcare Compliance Professional, Hilliard Compliance Consulting



AD1b/repeat

Advanced Discussion Groups

Take a Swim in the Compliance Fish Tank

  • The audience will vote and select hot compliance topics for discussion
  • The audience will be divided into two groups, those inside the compliance fish tank and those outside the compliance fish tank
  • The group inside the compliance fish tank discusses the hot compliance topic for ten minutes followed by five minutes of questions by those outside the fish tank; the groups will then reverse roles and continually repeat the exercise until the session is completed

No presentation or handout available

John Falcetano, Managing Director, Action Compliance Services


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