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2016 Compliance Institute presentations and handouts

Wednesday

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

Sunday      Monday      Tuesday      Wednesday

Choose a session block

 Post Conference Early Sessions                 Post Conference Late Sessions

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

Post Conference Breakout Sessions | 8:00 AM - 9:45 AM


W1

General Compliance and Hot Topics

Managed Care: Hot Legal Topics

  • Provider Networks: Lessons Learned from Michigan and Beyond
  • Exchanges: Compliance Challenges and Concerns Post King v. Burwell
  • Member Rewards and Incentives: What’s a MCO to do?

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

Jennifer A. Kildea Dewane, Deputy General Counsel, CareSource

Jeffrey E. McFadden, Partner, Stradley Ronon Stevens & Young, LLP

Mark Chilson, EVP General Counsel, CareSource



W2

General Compliance and Hot Topics

Provider Based Status: A Compliance Department Case Study and Lessons Learned

  • Summarize the legal requirements under Medicare’s provider-based regulations
  • Assess how the provider-based regulations impact billing to Medicare and other payors
  • Discuss a case study that resulted in a provider-based self-disclosure and processes that were implemented to ensure that all provider-based requirements are being met

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

Leia C. Olsen, Attorney, Hall Render Killian Heath & Lyman P.C.

Anne Wolanski, VP Quality Services and Risk Management/CRO, Lourdes Hospital



W3

General Compliance and Hot Topics

Effective Compliance: Lessons Learned from the Past and Preparing for the Future

  • Discuss new and expanded tools and technology to detect and prevent fraud, waste and abuse. Learn how to utilize Data Analytics to identify opportunities for improvement in your organization
  • Learn tips to ensure your organization’s effective compliance with applicable rules and regulations. Hear from the former Chief Compliance Officer at two different organizations under unique CIA obligations and its’ impact upon the compliance culture
  • Hear from a former federal prosecutor and OIG Attorney, experienced compliance official and veteran consultant regarding the best practices to implement and the essential steps to take to avoid and/or mitigate the possibility of an enforcement action

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

Bret S. Bissey, Senior VP Compliance Services, MediTract, Inc.

Sean McKenna, Partner, Haynes and Boone, LLP

Kenneth Zeko, Senior Vice President, CHAN Healthcare




W4

Privacy & Security

Privacy Officer Roundtable: Part I

  • Interactive discussion of challenges in applying the Breach Notification Rule risk assessment
  • Discussion of how covered entities are managing their business associate contracting and due diligence
  • Attendees will share what remains their biggest challenges three years after the effective date of the HIPAA Omnibus Rule and what practices have helped address these challenges

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

Adam Greene, Partner, Davis Wright Tremaine, LLP

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



W5

Physician Compliance

Physician Arrangement Integrity Panel: Avoiding Stark Law Technical Violations

  • Physician Arrangements: recent Stark law technical violations and suggestions for avoiding; lessons learned from recent OIG settlements; and tips for arrangement structure
  • Operationally and financially managing day-today compliance on the complex agreements, from the physician submitting time through payment processes. Best practices for operationally and financially managing agreements. Tips to ensure successful management
  • Learn from a progressive health system’s steps to drive consistency and processes related to managing physician arrangements, Amita Health, Chicago, IL. The steps the compliance leader followed to standardize and streamline current processes

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

Handout 1 (xls)
Handout 2

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

Jerry Burgess, Chief Corporate Responsibility Officer, Amita Health

Gail Peace, President, Ludi



W6

Compliance Lawyer

Enforcement and Compliance: Strategies for Organization Counsel and Compliance Professionals

  • Responses to reports of non-compliance and misconduct
  • Managing the risk and effective compliance programs
  • Internal investigations and self-disclosure

Handout

Moderator:
Gabriel Imperato, Managing Partner, Broad and Cassel

Richard Westling, Partner, Waller Lansden Dortch & Davis, LLP

Lesley Ann Skillen, Attorney, Getnick & Getnick LLP

Daniel Roach, General Counsel and Chief Compliance Officer, Optum360



W7

Auditing & Monitoring

Rolling the Dice on Physician Activity Monitoring? Use Effective Monitoring Tools to Ensure Compliance

  • This workshop will teach how to implement procedures to assure physician activities implicating remuneration are effectively monitored and controlled
  • Review examples of audit and monitoring tools related to physician activity: payments, timekeeping validation, activity concordance with job, and aging payments and submissions
  • Through case studies, understand when to take action, how to report and how to educate stakeholders to own responsibility for effective controls

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

Handout 1
Handout 2
Handout 3

Matthew R. Grosvenor, Partner, Bennett Thrasher LLP

Elizabeth Johnson, VP and Chief Compliance Officer, The Christ Hospital Health System

Elizabeth A. Mills, Compliance Counsel, The Christ Hospital



W8

Internal Audit

Auditing Emerging Compliance Risk Areas

  • Review emerging compliance risk areas
  • Discuss auditing techniques for each area
  • Review best practices and controls

 

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


           


W9

How to Succeed as a Compliance Professional

Stay On Target: Managing Auditors, Consultants, Lawyers and Experts

  • Practical criteria for deciding when to use outside expertise, how to select an expert and how to manage everyone’s expectations
  • Strategies for addressing dysfunction or unexpected process issues that can arise over the course of an engagement
  • Tips for setting project goals and budgets and avoiding “audit creep” so that you get projects completed on-time and on-budget

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

Jeffrey Fitzgerald, Shareholder, Polsinelli PC Catharine E. Fortney, Director of Compliance and Internal Audit, Denver Health and Hospital Authority




W10

Quality of Care

Plug & Play: Quality & Care Coordination in a Volume to Value Transition

  • Transparency in Reporting Quality (Language of Providers and VIP, how they differ)
  • Care Coordination in the Continuum of Care
  • Team Success-Integration of Care Coordination and Quality (Contractual Pitfalls, Patient Needs and Physician Relations)

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

Handout

Heather McConnell, Managed Care Quality Manager, CaroMont Medical Group

Lauren B. Wright, Primary Care Service Line Administrative Director, Caromont Health

Leann Richard, Care Coordination Manager, CaroMont Medical Group




W11

General Compliance and Hot Topics

Criminal and Civil Heath Care Fraud

  • The government’s increased focus on fraud cases involving medically unnecessary procedures, and the implications for hospitals, SNFs, home health agencies and other institutional health care providers
  • Liability of institutional providers for the wrongdoing of their employed and contracted physicians and other medical professionals
  • Collateral consequences for institutional providers and doctors (corporate integrity agreements, exclusion from federal health care programs and private insurance panels, state regulatory oversight and discipline) and practical tips for avoiding liability under the False Claims Act and criminal health care fraud statutes

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

Amy Easton, Of Counsel, Phillips & Cohen LLP

Ryan Stumphauzer, Partner, O’Quinn Stumphauzer & Sloman


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)




Post Conference Breakout Sessions | 10:00 AM - 11:45 AM

W12

General Compliance and Hot Topics

Apples, Oranges and Grapes: Implementing an Effective, System-wide Compliance Program across Multiple Locations and Lines of Business

  • Strategies on how to integrate a culture of compliance into different lines of business within the same organization
  • Tips on how to avoid common pitfalls of introducing a new acquisition into an existing organization
  • Examples of helpful tools and resources used to assess compliance program effectiveness in both large and small organizations with multiple locations and lines of business

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

Jeff B. Paul, Regional Compliance Director, Tenet Healthcare

Tiffany Thompson, Chief Compliance Officer, United Surgical Partners International

Melanie Roberts, Regional Compliance Director, Tenet Healthcare



W13

General Compliance and Hot Topics

Physician Compensation Under the Microscope: Lessons Learned from Recent Settlements

  • Review of lessons learned from recent settlements, including Tuomey, Adventist Health, and North Broward Hospital District
  • Understand the regulatory requirements related to physician compensation, including Stark group practice and incentive compensation models
  • Discuss best practices for establishing and auditing physician compensation

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

Anna Grizzle ,Partner, Bass, Berry & Sims PLC

Tizgel K.S. High, Vice President, Associate General Counsel, Legal, LifePoint Health

Charity Elmer, Sr. Vice President and General Counsel, Legal Department, CoxHealth

 



W14 

General Compliance and Hot Topics

Responding to Medicare Contractor Audits and Investigations

  • The right way and the wrong way to approach contractor audits and investigations—yes, they do investigate
  • Strategies for appealing contractor actions—overpayments, revocations, suspensions, etc
  • The future: what can we expect (or hope for)?

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

Kimberly Brandt, Chief Oversight Counsel, U.S. Senate Finance Committee, Majority Staff

Lester Perling, Partner, Broad and Cassel



W15

Privacy & Security

Privacy Officer Roundtable: Part II

  • Interactive discussion of challenges in applying the Breach Notification Rule risk assessment
  • Discussion of how covered entities are managing their business associate contracting and due diligence
  • Attendees will share what remains their biggest challenges three years after the effective date of the HIPAA Omnibus Rule and what practices have helped address these challenges

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

Adam Greene, Partner, Davis Wright Tremaine, LLP

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



W16

Physician Compliance

It’s All About Documentation When Coding for Clinical Trials

  • Medical necessity when you submit claims
  • Coding for “qualifying” clinical trials
  • Common mistakes

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

Kelly M. Willenberg, Owner, Kelly Willenberg, LLC

     


W17

Compliance Lawyer

Handling a Criminal Healthcare Fraud Case

  • US Attorney’s Offices are bringing large numbers of cases. The Panel will address how Compliance Officers and In-House Counsel should handle Criminal Investigations from Beginning to End
  • Understanding how to handle Parallel proceedings and discuss specifics on how to handle subpoena compliance
  • Hear details about the Yates Memo and Individual liability

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

Kirk Ogrosky, Partner, Arnold & Porter LLP

Paul Pelletier, Member, Mintz Levin

Allan Medina, Assistant Chief-Fraud Section, Criminal Division, U.S. Department of Justice



W18

Auditing & Monitoring

 Understanding and Preparing for the Marketplace Initial Validation Audit (IVA) and Medicare Advantage Risk Adjustment Data Validation (RADV) Audits

  • Gain an understanding of the processes involved with a CMS RADV Audit, the financial and compliance implications to the plan and changes for 2016 and 2017
  • Gain an understanding of the processes involved with the Commercial Marketplace IVA Audit, the financial and compliance implications to the plan and how 2016 and beyond will be like nothing seen before
  • Learn important practices needed to protect your plan ahead of time for the audits and drive successful outcomes when your plan is selected

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

Scott Weiner, SVP of Analytics and Strategy, EMSI Health



W19

Internal Audit

Unleashing the Power of Data Analytics

  • Adding value to the internal audit process using data analytics
  • Using data analytics in all aspects of the internal audit process from risk assessment to audit follow up
  • Examples of high value data analytics

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

Handout 1

Terri Allen, Data Analytics Audit Director, CHAN Healthcare



W20

How to Succeed as a Compliance Professional

The Metric System: Measuring and Reporting Compliance Effectiveness from “Process” to “Progress”

  • The importance of developing and effectively executing a compliance metrics program to better manage compliance programs, drive ownership of compliance throughout the organization and increase the success of the compliance professional and program
  • How to identify and design compliance metrics that are valuable, achievable, reasonable and measurable, covering each of the key core elements of your compliance program
  • How to build a sustainable, flexible, and scalable compliance metrics program that is aligned with your compliance department goals and can evolve over time from measuring “process” to measuring “progress”

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

Ryan Haggerty, Senior Manager, Deloitte

Robert R. Michalski, Chief Compliance Officer, Baylor Scott & White Health



W21

Quality of Care

At the Brink of Death: Surviving Termination

  • Negotiating a System Improvement Agreement (SIA)
  • Assessing your compliance with all relevant CoPs
  • Gathering the troops and implementing plan of correction, and preparing the organization for survey

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

Diana Salinas, Sr VP & CCO, Mount Sinai Medical Center

Monica Arrowsmith, Vice President, Quality Management and Patient Safety, Rideout Health System



W22

General Compliance and Hot Topics

Fun and Engaging Compliance Training! Really!

  • What makes compliance training “sticky”
  • Keeping it real; story telling in compliance training
  • Learn how adding simple gamification elements can improve engagement

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

Debbie Newsholme, Senior Director, Content Operations, HCCS, A HealthStream Company

Christine M. Thomas, Content Development, HCCS, A HealthStream Company


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)