Kansas City Regional Conference
Monday, September 25, 2017
Kansas City, KS
CEU Application | Conference Brochure
Chair Update – Year in Review
Brian Bewley, Shareholder, Polsinelli PC
- Overview of recent enforcement activity
- Notable settlements
- Key litigated cases and decisions
- Perspectives going forward under new administration
Presentation (2 slides/page)
Presentation (3 slides/page)
Key Practices in Prevention of Medical Necessity Denials and Recoupments
Denise Hall-Gaulin, Principal, PYA
Richelle Marting, JD, MHSA, RHIA, CPC, CEMC, CPMA, CPC-I, Attorney, Forbes Law Group, LLC
- A discussion of medical necessity – what it means and what it affects
- Details regarding the types of medical necessity determinations and the criteria for determining medical necessity
- An explanation of categorically excluded services
- Admission criteria [to include Skilled Nursing Facilities (SNF) and Inpatient Rehabilitation Facilities (IRF)]
- The use of Advanced Beneficiary Notification (ABN) and Hospital Issued Notice of Non-Coverage (HINN), and the outcomes and penalties for not using ABNs or HINNs
Presentation (2 slides/page)
Presentation (3 slides/page)
Compliance in the Managed Care World: Key Lessons for Providers
Anthony H. Choe, Counsel, Polsinelli PC
Rodney K. Miller, JD, Associate Counsel, Mosaic Life Care
- Compliance obligations for providers
- Oversight activities of payers
- Common pitfalls and best practices
Presentation (2 slides/page)
Presentation (3 slides/page)
Stark Wars: The Government Strikes Back
Megan Phillips, Attorney, Husch Blackwell LLP
Cori Casey Turner, Partner, Husch Blackwell LLP
- A general overview of the Stark Law, including key requirements of many regulatory exceptions
- Update on recent developments, including new exceptions, guidance, and self-disclosure protocol procedures
- Discussion of enforcement trends, including recent case law and settlements
- Lessons learned from a recent Stark voluntary self-disclosure
Presentation (2 slides/page)
Presentation (3 slides/page)
Coding and CDI Compliance Programs (What Compliance Officers need to know or should know under Auditing and Monitoring Guidelines)
Diana Adams, RHIA, Consultant, RRA, Inc.
- Discovering who are the healthcare industry watchdogs for coding and CDI programs
- Understand the history of Clinical Documentation Improvement (CDI) programs
- Getting involved with the CDI and coding teams from the compliance standpoint
- Ensuring the coding and CDI reflect an accurate picture of clinical care being given under compliance-audit and monitoring
Presentation (2 slides/page)
Presentation (3 slides/page)
What Every Compliance Officer Needs in Their Toolkit
Bret Bissey, MBA, FACHE, CHC, CMPE, Healthcare Compliance Executive Consultant, MediTract
- Learn of the resources needed to develop an effective compliance program
- The obstacles that will be present, challenges that will need to be overcome
- Potential strategies to achieve success
Presentation (2 slides/page)
Presentation (3 slides/page)