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Handouts - 2017 - Regional - Orlando

Orlando Regional Conference
February 3, 2017
Lake Buena Vista, FL

Conference Brochure

Managed Care Enforcement and Compliance

Thomas F. O’Neil, III, The Saranac Group LLC
Christopher Horan, CCEP, VP Corporate Compliance Investigations, WellCare

  • Common Risk Areas for Managed Care Organizations
  • Compliance for Managed Care Organizations and CMS and OIG Oversight and Expectations
  • Public and Private Efforts to Combat Fraud in Managed Care Health Care Delivery

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

Compliance and Overpayments

David Glaser, Shareholder, Fredrikson & Byron
Tony Maida, Partner, McDermott Will & Emery LLP

  • Obligation to return “known overpayments”
  • “Identification” of an overpayment and 60-day rule
  • Options and strategies for self disclosure

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

Privacy, Security, and Protection of Health Care Information: What’s happening at HHS

Emily Crabbe, JD, Investigator, U.S. Department of Health and Human Services, Office for Civil Rights, SE Region

  • Discuss unique breach cases and resolution agreements from the Southeast Region.
  • Examine gaps and best practices to prevent such breaches in the future.
  • Understand the impact of cyber security, ransom ware, mobil apps, using your own devices, and other areas of interest to prepare for these risks.

Handout

Operational Compliance for Pharmacies

Nancy Perilstein, Senior Manager, Deloitte & Touche LLP
​​​​​​​Erin Aebel, Partner, Shumaker, Loop & Kendrick, LLP

  • Billing compliance and 340B drug programs
  • Diligence related to bona fide prescriptions
  • Compliance related to improper inducements to patients and referring physicians
  • Special issues for compounding pharmacies.

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

Enforcement and Compliance in Home Health - Hospice - Nursing Home

Gabriel Imperato, CHC, Managing Partner, Broad and Cassel
​​​​​​​Adam Schwartz, Shareholder, Carlton Fields
Claudia E. Reingruber, CPA, Reingruber & Company, P.A.

  • False Claims Act liability for home Health agencies, hospice organizations and nursing homes
  • Important risks areas for long term care
  • Compliance strategies for minimizing compliance risks for home health, hospice and nursing homes

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

Handout 1
Handout 2 (docx)

Crisis Management in Compliance: Orlando Health Response to the Pulse Nightclub Tragedy

David Huddleson, Chief Compliance & Ethics Officer, Orlando Health
​​​​​​​Steve Stallard MS CIS, MBA, CISSP, CHC, Corporate Director, Privacy and Information Security, Corporate Privacy and Information Security Officer, Compliance & Ethics, Orlando Health

  • A detailed account of the events of June 12, 2016
  • Compliance and privacy implications and challenges
  • Lessons learned and plans for the future

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

Government Enforcement Panel: Update on Federal/State Initiatives

James Varnado, Director, Medicaid Fraud Control Unit, Florida Office of the Attorney General
​​​​​​​Randy Harwell, Chief, Civil Division, United States Attorney’s Office, Middle District of FL
Felicia E. Heimer, Senior Counsel, Office of Counsel to the Inspector General, Office of Inspector General, U.S. Department of Health and Human Services

  • Criminal and civil enforcement in the new Administration
  • DOJ and OIG enforcement and compliance developments
  • Florida Medicaid Managed Care Anti-Fraud Initiatives

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