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Handouts - 2017 - Regional - San Francisco

San Francisco Regional Conference
Friday, December 1, 2017
Walnut Creek, CA

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Regulatory Update

Gabriel Imperato, CHC, Managing Partner, Broad & Cassel

  • Recent developments in enforcement and compliance
  • Individual liability for organizational non-compliance
  • Department of Justice and Office of Inspector General Guidance on Effective Compliance

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

Toto we’re not in Kansas anymore: OCR audits, BAs and breaches, oh my!

Marti Arvin, CCEP-F,CHC-F,CHPC,CHRC, Vice President, Audit Strategy, CynergisTek, Inc.

  • Analysis of the findings of the OCR audits, the news is not good
  • Overview of the process for managing the risks associated with Business Associates
  • Discussion of the risk that standard BAA language creates for covered entities in breach notification

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

MACRA – Compliance Oversight

Hilary Isacson, Reimbursement Counsel, Sutter Health
Margia Corner, Principal Counsel, University of California, Office of the President

  • MACRA, and CMS’s implementation of the law through Medicare Quality Payment Program, mark a significant step furthering the decades-long shift towards value-based payment for the Medicare fee-for-service program. The Medicare Quality Payment Program’s regulatory requirements are complex and raise a number of critical compliance opportunities for health care organizations seeking to partner with, and reward, physicians and other non-physician practitioners who deliver high quality, efficient patient care.
  • Regulatory requirements for the two possible tracks of Medicare Quality Payment Program: The Merit-Based Incentive Payment System and Advanced Alternative Payment Models.
  • Key risk areas—such as coding accuracy and risk adjustment and Stark, Anti-Kickback, and Civil Monetary Penalty law compliance—for physician compensation and quality incentives.

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

Conducting Investigations

Daniel J. Falzon, Investigations & Compliance Manager, National Special Investigations Unit, Kaiser Permanente
Tamara Neiman, Director, National Special Investigations Unit, Kaiser Permanente

  • Planning and working the investigation
  • Interview protocol and techniques
  • Closing the investigation

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

What Role Does Compliance Play with Innovation and Healthcare?

Vanessa Ridley, Director, Healthcare Compliance & Privacy, University of California, Office of the President
​​​​​​​Robert Jagielski, Compliance Director, Clinical Integration, MedProVidex

  • Today’s most influential innovators are disrupting established norms in their respective industries. How should compliance professionals respond to innovations in clinical delivery and financing that are disrupting traditional models of health care?
  • Case studies of innovative practices and related compliance implications, including in the areas of reimbursement, telemedicine, and population health.
  • Evolving strategies and tools that will encourage the disruptors in your organization to balance innovation and compliance

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

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