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Handouts - 2017 - National - Clinical

SUNDAY, OCTOBER 15 ( Pre-Conference)


2018 Updates on ICD-10 Coding

Cynthia A. Trapp, Director, Coding, MA General Physician Organization

  • A comprehensive update to changes for ICD-10 Coding including additions, deletions, and revisions to ICD-10 Codes.
  • New ICD-10 guideline changes and appropriate use of coding from an ICD-10 book.
  • Provide tips for clinical practices to appropriately use ICD-10 to accurately reflect the severity of illness of the patient.

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



Unexpected allies: In the trenches with IT and Compliance to improve the Electronic Health Record (EHR)

Sandra Gilmore, Sr. Consultant Compliance - Information Services, Legacy Health

  • Understand the benefits of integrating Privacy and Compliance personnel into Information Technology (IT) departments.
  • After learning to speak a common language, explore paths to education internal (IT) and external (providers) on the value of integrated services
  • Build a better risk assessment and work plan by partnering on mitigation and monitoring activities.

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



The Art of Information Security Risk Assessments; you don’t have to be Classically Trained to be an Expert. The Basics of Risk Assessments and Strategies for Keeping your Assessment Current

James A. Donaldson, Chief Compliance, Privacy and Information Security Officer, Baptist Health

  • Why the lack of a comprehensive information security risk assessment is singled out in almost every OCR HIPAA settlement agreement.
  • Risk assessment basics and free references to help your organization through the process.
  • A walkthrough of a basic assessment. It’s actually a rewarding process!

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



Compliance Essentials – Internal Investigations and Self-Disclosures

Leia Olsen, Attorney, Hall Render Killian Heath & Lyman PC

Katherine Kuchan, Attorney, Hall Render Killian Heath & Lyman PC

  • Understand the key steps when conducting internal investigations as part of an effective compliance program
  • Through case studies, discuss the legal background and practical considerations related to various self-disclosure options
  • Identify operational challenges that occur during the investigation and self-disclosure process and understand the role of Compliance Counsel in the process

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



Healing the Healer: How to Find Happiness in a High-Stress Profession

Saud Juman, President & CEO, PolicyMedical Inc

  • Address the multiple causes of stress within the healthcare and compliance world.
  • Understand how to better take care of yourself (mentally, physically and emotionally) so that you can better care for your patients and employees.
  • Learn realistic techniques to combat burnout and stress through using helpful tactics such as meditation, journaling and affirmations.

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




How to Use “Measuring Compliance Program Effectiveness: A Resource Guide” – Some Perspectives

Laura Riddell, Chief Compliance Officer, Mountain Land Rehabilitation

Laura E. Ellis, Senior Counsel, Office of Counsel to the Inspector General U.S. Department of Health and Human Services

  • The Guide – What It Is and What It Is Not.
  • Right-sizing the Guide for Your Organization.
  • Putting Measures into Practice – A Discussion of Some Examples.

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




Physician Engagement in the Compliance Process

Sarah M. Couture, Associate, Aegis, Compliance & Ethics Center LLP

Dr. Neal Cohen, Distinguished Professor of Anesthesia and Perioperative Care and Medicine Vice Dean, UCSF School of Medicine Medical Director, International Service

  • Physicians as leaders; identifying opportunities for physicians to engage in compliance program oversight.
  • Physicians as partners; opportunities in the day to day operations of the compliance program.
  • Physicians as champions; leveraging relationships to demonstrate program compliance.

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



Medicare Review Entities 101

Diana Burns, Medical Review Team Lead, Noridian Healthcare Solutions

Tracy Schutt, Education Representative, Noridian Healthcare Solutions

Rachel Webber, CPC, CERT Team Leader, Noridian Healthcare Solutions

  • Learn what a Medicare Administrative Contractor (MAC) is and what they are responsible for.
  • Meet the 5 major players in Medicare auditing (MAC, CERT, ZPIC, RAC, OIG).
  • Learn how to differentiate between the review entities and what your responsibilities are.

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



The Compliance-Practice Partnership: Strategies for Success

Joseph A. Piccolo, VP Corporate Compliance, Inspira Health Network

  • Strategies to establish your compliance program as a resource for your physician practice with focus on communication strategies for physicians and staff.
  • Developing an effective Physician Practice Compliance Committee. Defining the role, responsibilities, accountability, and reporting structure of the committee.
  • Auditing, Monitoring and Risk Mitigation Strategies.

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


Why Physicians and Physician Organizations Should be Concerned About Stark Compliance

Steven W. Ortquist, Managing Director, Aegis Compliance & Ethics Center, LLP

  • Discussion of recent settlement & enforcement actions involving physicians.
  • What causes physicians and physician organizations the greatest risk.
  • Strategies for promoting compliance in your physician organization.

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



Navigating the Physician Practice Acquisition Experience

Valerie T. Cloud, Assistant Regional Corporate Responsibility Officer, Catholic Health Initiatives

  • On the Horizon — An overview of the physician practice acquisition landscape.
  • Potential Pitfalls — A review of frequently encountered challenges and pitfalls that can delay or derail completion of the acquisition journey.
  • A compilation of tools, ideas and lessons learned to facilitate a successful expedition through the process of acquiring a physician practice.

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



NP or PA as Billing Provider

Claire F. Agnew, VP of Financial Operations, Phoenix Children’s Medical Group

  • Shortage in physicians leading to higher use of NP’s and PA’s.
  • High level review of regulations at federal level (CMS incident to), state (regulatory bodies, Medicaid), and local level (payer, medical staff bylaws).
  • Documentation support of billing provider, hospitalist and intensivist considerations, and avoidance of duplicate claims.

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



Clinical Practices — Applying a Common Sense Approach to HIPAA Compliance

Jay Hodes, President, Colington Consulting

  • With HIPAA data breaches occurring at an alarming rate and with an increase in enforcement, fines and penalties, organizations need to fully understand the requirements of a compliance program.
  • Being in compliance with HIPAA involves not only ensuring you provide the appropriate patient rights and controls on your uses and disclosures of protected health information, but you also have the proper policies and procedures in place.
  • After completing this session, a Covered Entity will know how to assess their current compliance program and determine if their organization is meeting all of the HIPAA requirements.

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



Assuring Section 1557 Compliance in a Federally Qualified Health Center: Do the Right Thing!

Robyn M. Hoffmann, Compliance Officer & QI Liaison, Fair Haven Community Health Center

  • Engaging inter-departmental and executive collaboration to assure Section 1557 compliance.
  • Conducting analysis of current on-site and remote interpretation resources for patients with limited English proficiency (LEP).
  • Developing associated policies and a written plan for Section 1557 compliance and communicating these to patients, clinicians, all staff, the Board, and the community.

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

Handout 1
Handout 2



Creating the Annual Compliance Work Plan for Large Physician Practices

Lori A. Laubach, Partner Reg. Compliance Practice, Moss Adams, LLP

Tom Loughrey, Director of Compliance, St. Joseph Health

  • Effectiveness is driven by how compliance focuses their efforts with one part being the work plan. Participants will learn how physicians and practice management are brought into the process.
  • Learn how the work plan forms the basis of communication, resource allocation, management of risk, and timing of critical events for physician compliance.
  • Learn how physician and administrative leaders are engaged to provide purposeful compliance and demonstrate support to physician members.

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




MACRA and the New CMS Quality Payment Program

Howard Pitluk, MD, MPH, FACS, Vice President Medical Affairs and Chief Medical Officer, Health Services Advisory Group, Inc. (HSAG)

  • Assess provider eligibility for Merit Based Incentive Payment Program participation.
  • Understand the impact of participation on Medicare fee for service reimbursement.
  • Learn where and how to access program resources and technical assistance.

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



Outside Looking In: In-House and Outside Counsels’ Perspectives on Compliance & Enforcement Investigations

Sean McKenna; Shareholder; Greenberg Traurig, LLP

Michael McCarthy; Associate General Counsel; Cooper University Health Care

  • Learn about in-house, defense, and compliance perspectives from working with and advising clinicians
  • Receive an overview of the regulatory landscape in health care, which includes relevant statutes and government procedures for investigations.
  • Understand leading practices regarding internal investigations from the perspectives of in-house and outside counsel

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



Physician(s) and Clinical Research in Private Practice...Should I Care?

Sheri Sanders, Executive Director, Research, Dignity Health

  • Learn the basic compliance risks associated with clinical research in private practice and how to minimize such risk.
  • What you need to know about research and your medical malpractice policy.
  • Educating your providers down gently.

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



42 CFR Part 2 v HIPAA--Compare and Contrast

Dorothy P. Pickles, Compliance Director, Akeela, Inc

  • HIPAA has many requirements. 42 CFR Part two applies to federally assisted substance use disorder providers. The provisions of both laws are not identical.
  • 42 CFR Part 2 has some similar provisions and some provisions which are much stricter than those in HIPAA. It is important to know the differences.
  • 42 CFR Part 2 was recently revised. The new provisions are important to recognize and incorporate into your clinical practice.

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



It’s All About That E/M — No Treble

Maggie M. Mac, President, Maggie Mac-MPC Inc.

  • Understand the E/M reports published by the OIG and their findings, documentation deficiencies and impact to practices.
  • Discussion of typical areas of E/M documentation deficiency and examples with recommendation for clarity.
  • Discussion of defensive documentation.

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


MACRA: A shift to Quality and Value-Based Care

Nicolet Araujo, Protiviti

David Zavala, Senior Manager, Protiviti

  • On October 14th, 2016 the Centers for Medicare and Medicaid Services (CMS) issued the 2,398 page final rule for the Medicare Access and CHIP Reauthorization Act (MACRA). In general, MACRA brings an end to the existing Sustainable Growth Rate (SGR) formula
  • These changes are creating significant concern and operational challenges for purposes of predicting and managing quality incentives and related compliance, forcing providers to look more closely at their quality and outcomes metrics.
  • In this session, we’ll discuss what your organization should be doing to prepare for the Quality Payment Program, hear case studies of how other organizations are addressing these changes, and learn about what changes may still be in store.

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



Ransomware: Don’t Be a Hostage!

Frank Ruelas, Facility Compliance Professional, St. Joseph’s Hospital and Medical Center/Dignity Health

  • Understand the specifics of Ransomware and how it may affect the practice’s ePHI.
  • Learn from to apply the HHS guidance on Ransomware to determine if you have experienced a breach using the LoProCo Model.
  • Compare and contrast the different strategies that organizations have used successfully to minimize the risks associated with a successful Ransomware attack

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



Negotiating conflicts of interest with family members and staff in treatment: A clinical conversation of slippery situations

Cynthia Grant, VP of Quality Improvement, AllHealth Network

  • Explore suggested guidelines to prevent and mitigate the potential for conflicts arising from the treatment of known persons.
  • Discuss compliance hot topics when writing policies and procedures associated with family members or staff receiving care at your organization.
  • Case studies: Compliance investigations in a behavioral health organization.

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

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