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Conference Agenda | Overall Evaluation

Clinical Research Billing Compliance Risks and Challenges

Speakers: Isaiah Costner, Kelly Willenberg

  • Review process (case study) 
  • Create an "audit ready" environment 
  • Analyze basic billing rules


Spotlight on Healthcare Pricing: Update on No Surprises Act and Hospital Price Transparency Rules

Speaker: Jeff Davis

  • Review health care facility and provider compliance obligations related to the No Surprises Act’s (NSA’s) ban on balance billing
  • Gain an understanding of the latest enforcement of the NSA requirements to provide a good faith estimate of standard charges
  • Learn about changes to the CMS hospital price transparency requirements to post a machine-readable file of standard charges and consumer-friendly display of shoppable services and the latest CMS enforcement actions


Generative AI and Compliance Implications

Speakers: Jaime Pego Curcio, Mark Johnson, Wontae Kim

  • Understand emergence of Generative AI
  • Learn about how Generative AI will impact the healthcare landscape
  • Review key compliance risks to navigate and manage these risks


Medicaid Fraud Government Update

Speaker: Tony Hullender

  • Introduction to the Civil Medicaid Fraud Section of the Office of the Tennessee Attorney General
  • Review of fraudulent billing of medical tests
  • Case study 


Remote Patient Monitoring/Digital Health

Speaker: Bill Mathias

  • Overview of what digital health is and what some of the compliance risks are
  • Explore how RPM/RTM arrangements are structured and operate
  • Dive into the compliance risks around RPM/RTM


Compliance Focus Areas for Behavioral Health Providers

Speaker: Bill Priest

  • Review distinctions of compliance programs for behavioral health companies: audits, education, investigations, etc.
  • Obtain an understanding of HIPAA and 42 CFR Part 2 requirements for behavioral health and substance use disorder facilities
  • Learn about current legislation affecting behavioral health and addiction treatment facilities: Behavioral Health Information Technology Coordination Act (EHR funding), Modernizing Opioid Treatment Access Act, Parity Laws