Dallas Regional Conference
February 17, 2017
Dallas, TX
An Update on Government Enforcement Actions from the OIG and US Attorney’s Office
Karen Schandler Glassman Senior Counsel Office of Counsel to the IG, DHHS
Lisa-Beth C. Meletta Assistant United States Attorney United States Attorney’s Office
- Areas of interest to the government in health care enforcement
- Tools used by the government to conduct investigations
- How the USAO and OIG work together during health care investigations
Presentation (2 slides/page)
Presentation (3 slides/page)
ICD-10 – Denial Management – Medicare Advantage
Janice Jacobs Managing Director Berkeley Research Group, LLC
- ICD-10 post implementation post mortem
- How did we do?
- What can we expect in 2017?
- Intersection of ICD-10 and Risk Adjusted Data Validation (RADV) audits
- Understanding the RADV audit process for Medicare Advantage Plans
- RADV audit appeals
- CMS early management of ICD-10, RAC and other government oversight
Presentation (2 slides/page)
Presentation (3 slides/page)
Effective Internal Investigations
Mary Findley Senior Vice President/Chief Compliance Officer Parkland Health and Hospital System
Paul Leslie Executive Vice President/General Counsel, Parkland Health and Hospital System
- Compliance Investigations Program:
- Oversight and Management Structure
- Systems, Processes, and Policies
- Anatomy of an Effective Investigation
- Legal Considerations:
- Attorney Client Privilege
- Protecting Investigative Work Product
Presentation (2 slides/page)
Presentation (3 slides/page)
The Importance of Understanding Cybersecurity in a Complex Threat Environment
Marti Arvin, CHPC, CHRC, CHC-F, CCEP-F Vice President of Audit Strategy Cynergistik
- Explain the current cybersecurity landscape in healthcare, including recent and emerging trends, and how these threats impact compliance programs
- Identify the risks posed to provider organizations by cyber attacks, and offer proven strategies for mitigating that risk
- Examine real-world examples of breaches caused by cybersecurity threats, such as phishing attacks, malware, ransomware and more
- Distinguish best practices for creating cybersecurity awareness at an organization-wide level
Presentation (2 slides/page)
Presentation (3 slides/page)
The Role of the Compliance Department in Today’s Challenging Quality Measurement Reporting Environment
Robin Brown Director, Advisory, Healthcare KPMG LLP
Catherine O’Leary Managing Director, Advisory Services KPMG LLP
- Overview of the CMS Quality Scoring methodology
- How does the Compliance Department align with the strategy for approaching quality and mitigating risk within the organization.
- What specific action items can an organization take to be successful in addressing quality and improving accuracy in measurement reporting?
Presentation (2 slides/page)
Presentation (3 slides/page)
Hot Topics in HIPAA Enforcement
Jamie Sorley Supervisor OCR
Erica Broussard Investigator OCR
- Highlight recent OCR enforcement actions
- Discuss recently issued OCR guidance
- Identify opportunities for improved compliance
Presentation (2 slides/page)
Presentation (3 slides/page)