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
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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
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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
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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
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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
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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
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