Nashville Regional Conference
Friday, November 18, 2016
HCCA Update 60-Day Overpayment Rule Considerations
Sara Kay Wheeler, Partner, King & Spalding
- Identifying an overpayment
- Defining ‘credible information’
- Quantifying an overpayment
- Practical tips for implementation
The Art of Combining Data Analytics and Compliance Monitoring: 340B Revealed
Suzann Hall, CPA, ACDA, Data Analytics Audit Manager, CHAN, LLC
Tim Krzeminski, Healthcare Compliance Director, PwC
- What is Data Analytics? Understanding how its use can help identify, mitigate, and continuously monitor quantifiable risks.
- Using Data Analytics to track and aggregate data from disparate systems for compliance purposes and goals.
- Highlight the transformative role Data Analytics can play in the 340B Drug Discount Program by identifying key areas of risk, reducing instances of non-compliance, and establishing opportunities to improve the administration and internal controls of the overall program.
OIG Enforcement Update
Tony Maffei, Special Agent, U.S. Department of Health and Human Services – Office of Inspector General
- Successful OIG investigations based on proactive data analysis
- Cases and schemes in the urine toxicology industry
- Recent trends in national healthcare fraud enforcement
Cyber Threats in Healthcare
Bart Lane, MBA, CISSP, CISM, Director, Information Security Assurance, Parallon Information Security
Scott E. Augenbaum, Special Agent, Federal Bureau of Investigation
- Are transnational criminal enterprises and foreign intelligences services targeting my organization and are we prepared to handle a data breach?
- Why being HIPAA compliant in not the same as being cybersecure.
- What do all data breaches have in common?
- How do I get my C-suite to understand the threat?
- What can we do today to reduce our attack surface?
Telemedicine: Healthcare Market Changes and Emerging Compliance Risks
Ethan Bachrach, MD, MBI, FACEP, Chief Medical Informatics Officer, TeamHealth
Nesrin Tift, Bass, Berry & Sims PLC
- Provide a description of current healthcare market changes in the United States, and how these will influence the rapid scaling and deployment of telemedicine into novel healthcare settings
- Describe the current reimbursement landscape and recognize areas for growth
- Identify regulatory and compliance challenges for telemedicine deployments, including information security and privacy obligations, scope of practice restrictions, and corporate practice of medicine prohibitions
The Evolving Relationship Between Counsel and the Compliance Officer
Matthew F. Tormey, Chief Compliance Officer, TeamHealth
Lisa Ohrin Wilson, Esq.
- How important is the relationship between a compliance officer and counsel?
- Identifying and managing conflicts of interest between counsel and compliance officer
- Are your investigative and other strategies always aligned?
- Corporate, board, and individual liability
Patient Safety and Medical Peer Review
Jeffrey Dickstein, Attorney, Phillips & Cohen
Lisa Rivera, Partner, Bass, Berry & Sims PLC
- Current enforcement trends in medical necessity and quality of care cases
- Ramifications of quality measurements and enforcement
- Patient safety compliance procedures – are they are sufficient given today’s enforcement trends?
- Peer review protections and limitations
Medicare Advantage Organizations’ Attestation Requirements and Implications
Chris Thomason, MBA, CHC, Director, Corporate Compliance and Privacy, CHSPSC, LLC
John C.J. Barnes, Partner, King & Spalding
Stephanie F. Johnson, Senior Associate, King & Spalding
- Regulatory obligations of MAO attestation requirements
- Hurdles and pitfalls to attesting before assessing compliance
Michael Rosen, Esq.,, Co-Founder, ProviderTrust
Walter Mann, Community Health Systems
Tyler Golden, Community Health Systems
Jerod J. Holloway, CIA, CFE, CHC, CICA, Director, PricewaterhouseCoopers LLP
- Expansion of Exclusion Authority
- OCR Audit Protocol
- OIG Compendium – formerly the Orange Book