Nashville Regional Conference
Friday, November 18, 2016
Nashville, TN
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
Presentation (2 slides/page)
Presentation (3 slides/page)
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.
Presentation (2 slides/page)
Presentation (3 slides/page)
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
Presentation (2 slides/page)
Presentation (3 slides/page)
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?
Presentation (2 slides/page)
Presentation (3 slides/page)
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
Presentation (2 slides/page)
Presentation (3 slides/page)
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
Presentation (2 slides/page)
Presentation (3 slides/page)
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
Presentation (2 slides/page)
Presentation (3 slides/page)
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
Presentation (2 slides/page)
Presentation (3 slides/page)
Handout (docx)
Hot Topics
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
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)