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Handouts - 2016 - Regional - New York

New York Regional Conference
Friday, May 13, 2016
New York, NY

Conference Brochure

Hot Topics

Lourdes M. Martinez, Partner, Garfunkel Wild, P.C.

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

Government Enforcement Perspective

Dennis Rosen, Medicaid Inspector General, New York State Office of the Medicaid Inspector General

No presentation or handouts available

Managed Care Panel

Lisa Landau, Bureau Chief, Health Care Bureau, NYS Office of the Attorney General
John Powell, Acting Deputy Superintendent for Health, NYS Department of Financial Services
Jonathan Bick, Director, NYS Department of Health, Division of Health Plan Contracting and Oversight

  • Importance of plans and providers working together to assure compliance with state and federal requirements
  • The requirements government agencies use to monitor for compliance and current focus areas
  • Importance of assuring quality care and appropriate utilization of services

No presentation or handouts available

Compliance Issues Associated with DSRIP and Value-Based Payments

Laura Alfredo, Deputy General Counsel & Senior Vice President, Legal, Regulatory, and Professional Affairs, Greater New York Hospital Association
Matthew D. Babcock, Assistant Medicaid Inspector General, Bureau of Compliance, New York State Office of the Medicaid Inspector General
Deborah A. Brown, Esq., Vice President, External Affairs, Montefiore Health System

  • What are the unique aspects of DSRIP Compliance programs?
  • Ideas for PPS leads and partners juggling multiple compliance program and DSRIP Compliance program needs.
  • What are DSRIP Compliance, Privacy and Security risks that PPS leads and partners should look for?
  • The role of the OMIG in DSRIP Compliance

Handout 1
Handout 2

HIPAA Enforcement

Lisa Lee Anderson, Special Assistant to the Regional Manager, U.S. Department of Health and Human Services, Office for Civil Rights

  • What are OCR’s HIPAA enforcement priorities?
  • What industry compliance issues does OCR continue to see when enforcing HIPAA?
  • New HIPAA Access Guidance

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

Stark Simplified: How to navigate thru basic Stark physician contracting issues based on the seminal legal concept of non stultas

Robert G Trusiak, Esq., Partner, Compliance Experts, LLC

  • Fair market value (FMV) is more than (in the immortal words of Richard Dawson) “Survey Says”
  • Not everyone is a “Rock Star” or “The Father of…” supporting an inflated FMV
  • Atypical contracts, based on reactive economic events, create persuasive prosecutorial prisms

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

Advanced Data Mining - Social networks and claim analysis

Michael P. Salve, PhD, Senior Managing Director, FTI Consulting
​​​​​​​Robert D. Fuite, Managing Director, ECON-EAS, Economics

  • Making complex claims analysis simple to understand
  • Recent developments in the analysis of claims data and case studies
  • Common procedures used by the OIG in audits

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