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2016 Compliance Institute presentations and handouts

Sunday

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

Sunday   |   Monday   |   Tuesday   |   Wednesday

Choose a session block

Pre Conference AM                  Pre Conference PM

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

Pre Conference Morning Breakout Sessions | 9:00 am - 12:00 pm


P1

Industry Immersion

Large Hospital Systems

  • Learn how to benchmark your program against other large hospitals and health systems through use of polling software
  • Understand challenges relevant to large hospitals and large health systems
  • Engage in dialogue with your colleagues regarding operational solutions and best practices for large hospitals and health systems

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

John E. Steiner, Chief Compliance and Privacy Officer and Associate General Counsel, Cancer Treatment Centers of America

Suzie Draper, VP Business Ethics & Compliance, Intermountain Healthcare

Cheryl Wagonhurst, Owner, Law Office of Cheryl Wagonhurst


P2

General Compliance and Hot Topics

Compliance Program Start Up: What Are the Basics Needed for Your Infrastructure?

  • Describe the fundamental elements of a compliance program
  • Identify ways to leverage current resources
  • Provide tips on getting organization buy in

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

Sheryl Vacca, SVP/Chief Comp & Audit Officer, UC-California

Debbie Troklus, Managing Director, Aegis Compliance & Ethics Center


P3

Long-Term Care

Understanding PPS for the New Long-Term Care Compliance Officer and Those Who Want a Refresher

  • Review the ins and outs of PPS
  • Review scheduled & unscheduled assessment requirements and impact of late or missing assessments
  • Learn tools you can walk away and use to audit & monitor your PPS billings and documentation

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

Handout

Shawn M. Halcsik, VP of Compliance & Clinical Services, Evergreen Rehabilitation

Renee Kinder, Clinical Specialist, Evergreen Rehabilitation

 



P4

Privacy & Security

OCR HIPAA Audits-Phase 2: Preparing to Demonstrate Compliance

  • Practical Strategies and Tools when performing HIPAA Privacy reviews
  • Assembling the team for an OCR audit
  • Discuss approaches to demonstrating HIPAA compliance for an audit
Presentation (2 slides/page)
Presentation (3 slides/page)

Handout 1
Handout 2
Handout 3
Handout 4 (xlsx)

Catherine M. Boerner, President, Boerner Consulting LLC

R. Brett Short, Chief Compliance Officer, UK HealthCare/University of Kentucky

Sarah Radermacher, Privacy Manager, Fairview Health Services; Former Policy Analyst, Supervisory Investigator and Compliance Advisor, Office for Civil Rights, DHHS



P5

Physician Compliance

How Does Your Program Rate? Tried and True Principles of Compliance

  • Learn how to continually develop and promote your compliance program
  • Determine the likelihood of the impact of an external audit conducted at your facility
  • Learn to effectively utilize OIG directives, PEPPER and other tools to assess your risks and to enhance your audit plan development

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

Terri L. Gilbert, Senior Manager, Aegis Compliance & Ethics Center LLP

Lisa A. Taylor, Director and Chief Compliance Officer, UC Health



P6

Compliance Lawyer

False Claims Act Developments

  • Fundamentals of the False Claims Act’s liability, damages, procedure and whistleblower provisions from the viewpoint of the compliance official
  • Discussion of whistleblower, government and defense perspectives on the filing, investigation, litigation and settlement of qui tam cases
  • Review of recent important decisions by the federal and state courts with far-reaching implications for enforcement of the False Claims Act

Handout 1
Handout 2

Moderator:
John T. Boese, Counsel, Fried Frank Harris Shriver & Jacobson LLP

Gary Eiland, Partner, King & Spalding LLP

Michael Granston, Director, Commercial Litigation Branch, Fraud Section, Civil Division, US Department of Justice

Michael A. Morse, Partner, Pietragallo Gordon Alfano Bosick & Raspanti, LLP



P7

Auditing & Monitoring

How to Implement a Monitoring Program

  • Discuss strategies for implementing a monitoring program. For example, using the quality platform
  • Explore different areas to monitor in each hospital department and a physician practice
  • How to formulate a monitoring dashboard to senior management and audit committees

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

Kelly Nueske, Executive Consultant, Pinnacle Healthcare Consulting



P8

Internal Audit

Emerging Compliance Audit Issues

  • Review emerging compliance risk areas; understand regulatory requirements and lessons learned from recent settlements
  • Discuss auditing and monitoring techniques for each area
  • Review best practices and controls for compliance risk areas

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

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

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

Handout 1 (xls)
Handout 2 (xls)
Handout 3 (xls)
Handout 4
Handout 5
Handout 6
Handout 7
Handout 8
Handout 9
Handout 10
Handout 11
Handout 12
Handout 13
Handout 14

Debi Weatherford, Executive Director, Internal Audit, Piedmont Healthcare

Debra Muscio, SVP, Chief Audit, Ethics & Compliance Officer, Community Medical Centers



P9

How to Succeed as a Compliance Professional

Compliance Strategies for Effectiveness

  • Discuss the best practice methods to advance the compliance program through strategic planning and partnership
  • Provide well defined documents including committee charters, work plans and risk assessment tools
  • Engage the participants in a discussion regarding alignment with corporate strategy through dashboards and scorecards

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

Handout 1
Handout 2
Handout 3
Handout 4
Handout 5
Handout 6
Handout 7 (xls)
Handout 8
Handout 9

Handout 10
Handout 11
Handout 12 (xls)
Handout 13 (xls)
Handout 14
Handout 15
Handout 16
Handout 17

Deann M. Baker, Sutter Care at Home Compliance Officer, Sutter Health

Dwight Claustre, Director, AEGIS Compliance & Ethics Center, LLP

Shawn Y. DeGroot, Global BPM, Compliance Officer, Navigant



P10

Quality of Care

Value Based Payments and Compliance: Responding to the Government’s Focus on Quality of Care and Medical Necessity

  • CMS’ move to quality based payments presents new enforcement risks for providers. Learn the legal theories the government pursues in quality of care and medical necessity investigations and the defenses
  • available to providers caught up in this effort
  • Quality reporting requirements such as the Physician Quality Reporting System (PQRS) result in both incentive payments and adjustments based on quality. How can the compliance department utilize these
  • measurements? Can these lead to FCA exposure?
  • How can the compliance department factor quality and medical necessity into a fraud and abuse program? The EHR, and a move to ICD-10, offer new roadmaps to the enforcers; how can compliance address these risks?

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

George B. Breen, Shareholder, Epstein Becker & Green PC

Jeffrey Dickstein, Partner, Phillips and Cohen LLP

Lisa Melamed, VP of Corporate Compliance and Compliance Officer, Laser Spine Institute

Ryan Haggerty, Senior Manager, Deloitte



P11

General Compliance and Hot Topics

Tackling the Risk Assessment

  • Understanding regulatory expectations
  • Developing enhanced protocols
  • Avoiding unnecessary exposure

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

Sara Kay Wheeler, Partner, King & Spalding

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

Charles Overstreet, Sr Managing Director, FTI Consulting Health Solutions, Brentwood, TN



P12

General Compliance and Hot Topics

Developing the Framework of your Compliance Program: Policies & Procedures

  • Interactive session on how to develop policies and procedures
  • What policies, procedure and guidelines do you need for your Compliance Program
  • Ideas for managing the policies procedures and guidelines for your Compliance Program and your entire organization

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

Lea Fourkiller, Ethics & Compliance Professional, Fourkiller Enterprises, LLC

Brenda Tunstill, Corporate Compliance Officer, Jordan Valley Health Center

Teri Morris, Director of Quality/ Compliance, Cherokee Indian Hospital



P13

Industry Immersion

Laboratory Compliance: Maintaining Compliance in an Uncertain and Changing Environment

  • Compliance issues facing today’s laboratories including topics such as lab developed tests (LDTs), point of care testing, off-label use of laboratory instruments, provider orders, custom panels, and CLIA
  • documentation requirements
  • Recent initiatives related to enforcement of legal and regulatory authorities, including increased use of private contractors, criminal proceedings, reverse false claims (failure to return overpayments),
  • pursuit of physician participants in alleged unlawful arrangements, and related protective strategies
  • Practices that can result in imposition of sanctions, steps to limit related legal and regulatory risk, and responding to unlawful competitor activities

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

Handout 1
Handout 2
Handout 3
Handout 4
Handout 5
Handout 6
Handout 7
Handout 8
Handout 9
Handout 10
Handout 11

Robert E. Mazer, Principal, Ober|Kaler

Tim Murray, Director Laboratory Compliance, Corporate Responsibility, Catholic Health Initiatives

Andrea Treese Berlin, Senior Counsel, Office of Inspector General-U.S. Department of Health and Human Services



P14

Industry Immersion

Striving to Be “Fraud‑Free Audit Ready” in a Managed Care Environment

  • What are you currently looking at for a Managed Care Plan as your dashboards and scorecards to be Fraud-Free Audit Ready? What should you be looking at if you’re not already doing so?
  • How do your FDRs fit into the picture? What are the best practices for FDRs to assure they are part of the program? Do you measure the same or different elements?
  • What happens during an actual CMS Medicare Advantage audit? How do you prepare before the audit happens to accomplish a successful outcome?

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

Caron Cullen, President, Positive Compliance Outcomes, Inc.

David Crawford, Assistant Vice President, Special Investigations & Corporate Compliance, Affinity Health Plan

Virgilio Florentino, Principal, Compliance Strategies

Jenny Fong, Chief Compliance Officer, Compliance Strategies


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)




Pre Conference Afternoon Breakout Sessions | 1:30 pm - 4:30 pm



P15

Industry Immersion

The Journey of a Thousand Miles Begins With a Single Step

  • Focus on the elements needed to get started on a successful quality improvement project; learn how to define and scope a problem and methods of obtaining sound and reliable measurement
  • Elements of efficiently setting up a quality improvement project will be explored using both data/examples from a speaker’s completed project and information particular to participants’ home organizations
  • Come prepared with the information needed to begin working on your own quality problem during the session. Leave with a well define plan for taking action upon your return home

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

Handout 1

Kristine Koontz, Quality Management Director, Keystone Human Services Inc.

Amy Short, Project Director, Ohio Valley Sickle Cell Network



P16

General Compliance and Hot Topics

STRESS Makes You Distracted, Distraught, Dumb & Dead!

  • How stress affects YOU emotionally, physically & cognitively
  • Your stress: Identifying its origins & developmental processes
  • Realistically managing stress: It’s not just fixed with a day at the spa

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

Debra Hinson, Chief Research and Associate Compliance Officer, Columbus Regional Health

Albert Eaton, Director of Behavioral Science, Family Medicine Residency, Midtown Medical Center



P17

Long-Term Care

The Mystery of Repayment

  • How and when to make a repayment
  • Calculation of a repayment
  • Understand the perils of not getting it right

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

Bill Ulrich, President, Consolidated Billing Services Inc.

Barbara Duffy, Shareholder, Lane Powell

Deborah Nedelcove, VP Risk Mgmt/Chief Compliance and Privacy Officer, Avamere Health Services, LLC

Harold Malkin, Deputy Civil Chief/Chief, Affirmative Civil Enforcement (ACE) Unit, United States Attorney’s Office



P18

Privacy & Security

Hacked and Attacked: Lessons Learned from Recent Healthcare Breaches

  • Understand the newest threats to healthcare data and how organizations can take action by adjusting their security, privacy, and compliance efforts
  • Evaluate the latest cyber-attacks in healthcare to better understand and learn how to navigate the legal and regulatory complexities surrounding HIPAA privacy and security incidents and data breaches
  • Learn best practice strategies for pre- and postbreach planning procedures and processes as all organizations will experience a breach

No presentation or handout available

Sean Hoar, Partner, Davis Wright Tremaine

Douglas G. Pollack, Chief Strategy Officer, ID Experts

Mac McMillan, CEO, CynergisTek Inc.



P19

Physician Compliance

The Top Ten Risks Of Physician Compliance

  • What are the top ten risks in physician compliance? Find out from an analysis of compliance investigations and physicians
  • How can we reach, engage, and educate our physicians? A physician/attorney and compliance officer approach
  • Crisis points in physician education: proactive recognition and action to avoid compliance failures

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

D. Scott Jones, Senior VP, Risk Management & Corp Compliance, HPIX

Richard E. Moses, Physician/Attorney



P20

Compliance Lawyer

Anatomy of a False Claims Act Case: Investigation, Litigation, Negotiation, Resolution

  • The Investigation Phase: subpoenas, witness interviews and more
  • The Litigation Phase: discovery and motions practice
  • The Resolution Phase: settlements, CIAs and relator issues

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

Craig Holden, Chairman & COO, Ober|Kaler

Robert DeConti, Assistant Inspector General for Legal Affairs, Office of Inspector General-U.S. Department of Health and Human Services

Laura Laemmle-Weidenfeld, JD, Partner, JonesDay

Marlan Wilbanks, Senior Partner, Wilbanks & Bridges, LLP

Robert McAuliffe, Senior Trial Counsel, United States Department of Justice Civil Division



P21

Auditing & Monitoring

Part D Data Monitoring Techniques to Prevent Compliance Findings

  • Describe the Part D data streams that CMS expects plans to monitor including the new areas added to the 2015 CMS audit protocols: Medication Therapy Management and Provider Network Adequacy
  • Describe CMS’ expectations around oversight and monitoring of the first tier, downstream and related entity data
  • Describe the most efficient methods of identifying, fixing and assuring data issues do not reoccur

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

Babette Edgar, Principal, BluePeak Advisors

Sherry Pound, Principal, BluePeak Advisors



P22

Internal Audit

Next Generation Healthcare Internal Audit: Approach and Application

  • Discuss the rapid evolution of healthcare and the need for internal audit to extend into more strategic areas
  • Learn the top risk areas based on hundreds of risks evaluated across CHAN Healthcare and provide key takeaways for internal auditors to increase the value provided through the risk assessment process
  • Take a deeper dive into the key risk area of physician compensation, including Relative Value Unit (RVU) computations, complex arrangements and incentive compensation

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

Jerry E. Lear, Sr Vice President, CHAN Healthcare



P23

How to Succeed as a Compliance Professional

Investigative Strategies: From Bootcamp to Minefields

  • Basic overview of investigations, investigative techniques and strategies for Compliance Professionals
  • Conducting an effective internal investigation: Avoiding the minefields
  • National Labor Relations Act (NLRA) considerations when complying with US Sentencing Guidelines for criminal conduct. Case review and considerations for both union and non-union employers during
    investigations

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

Steven R. Baruch, Service Area Compliance Director, Dignity Health

Lisa Barnett Sween, Shareholder, Jackson Lewis P.C.

Mark Ross, Shareholder, Jackson Lewis P.C.



P24

Quality of Care

Integrating Quality, Compliance, & Clinical Teams: Successful Approaches to Optimize Compliance and Patient SafetyIntegrating Quality, Compliance, & Clinical Teams: Successful Approaches to Optimize Compliance and Patient Safety

  • Aligning Quality, Compliance, and Clinical Teams to improve outcomes
  • Improving compliance and clinical metrics using quality tools and audit programs
  • Creating awareness and communicating outcomes to senior leadership, the board, and throughout your organization

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

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

Lynn H. Grieves, Chief Compliance Officer, CHOC Children’s

Caroline Steele, Director Clinical Nutrition and Lactation, CHOC Children’s

Valerie J. Campbell, Senior Director of Compliance, Westchester Medical Center

Sharon M. Marino, Senior Director of Compliance, Westchester Medical Center



P25

General Compliance and Hot Topics

Advanced Audit & Facilitation Workshop for Part A and B Providers and Suppliers

  • Important strategic considerations and practical advice for engaging in the new Part A and Part B Settlement Conference Facilitation (SCF) Pilot
  • Discussion of Medicare audit contractors and appeals processes, including important strategic approaches
  • Current and proposed reform initiatives to reduce the audit and appeals backlog, including Office of Medicare Hearings and Appeals (OMHA) reforms, RAC reforms, and pending legislative reforms

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

Andrew Wachler, Managing Partner, Wachler & Associates, P.C.



P26

Industry Immersion

Don’t Gamble with your DMEPOS Business; Compliance Tips and Tactics to Help Beat the Dealer

  • The Auditors are coming; Practical tips for dealing with the trouble spots in RAC and pre-payment audits, including helpful audit tools and internal controls to prepare for the audit onslaught and for working with payers
  • The Enforcers are here—learn about recent civil and criminal healthcare fraud enforcement involving DMEPOS manufacturers and suppliers, including OIG’s enforcement of the CMP laws and its exclusion authority.
  • Understand how the government’s quality care emphasis and its focus on overpayments impacts your compliance program
  • How to avoid the hot pockets and still grow your business; direct to beneficiary marketing, lead generation services and working with codes specific to orthotics, and ventilators

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

Handout 1 (xls)
Handout 2
Handout 3
Handout 4

Wayne H. van Halem, President, The van Halem Group – A Division of VGM Group, Inc.

George B. Breen, Shareholder, Epstein Becker & Green, PC

Karen Johnson, Corporate Compliance Specialist, Sanford Health

Ruth Krueger, Enterprise Compliance Program Manager, Sanford Health



P27

Industry Immersion

And the Beat Goes On… AMC Compliance in a Complex Regulatory Environment

  • Gain insight into current regulatory risk areas facing AMC’s nationally
  • Identify key mitigation strategies for your institution on high risk compliance areas
  • Join discussion during Q&A on career growth in the AMC setting

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

Moderator:
Lynda Hilliard, Principal, Hilliard Compliance Consulting, LLC

Deborah Grimes, Chief Compliance Officer, UAB Hospital

David Lane, Deputy Compliance Officer, University of California

R. Brett Short, Chief Compliance Officer, UK Health Care, University of Kentucky



P28

Industry Immersion

Research Compliance

  • Advanced governance and staffing models for Research Compliance and strategies for alignment with Administration, the Board and Investigators
  • Analysis of critical research risk areas for 2016: What’s new from the enforcers and applicable agencies (OHRP, ORI, FDA, OIG, DOJ, CMS)
  • Cutting edge risk assessment and auditing and monitoring techniques and risk areas to be covered in 2016 and beyond

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

F. Lisa Murtha, Senior Managing Director, FTI Consulting

Ryan D. Meade, Director, Regulatory Compliance Studies, Beazley Institute for Health Law and Policy, 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)