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Handouts - 2017 - Regional - Seattle

Seattle, WA Regional Conference
June 9, 2017
Seattle, WA

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Fighting Fraud: the Medicaid Fraud Control Unit at the Attorney General’s Office

Bob Ferguson, State Attorney General, Washington State
Larissa Payne, Deputy Director, Medicaid Fraud Control Unit, Washington State Attorney General’s Office

  • Types of cases in medicaid fraud
  • Being a partner in enforcement
  • Identifying medicaid fraud
  • Measuring medicaid fraud
  • Knowing your obligations

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

HIPAA Updates from OCR

Evelyn Zeller, JD, Supervisor, Office for Civil Rights, Pacific Region Seattle Office, US Department of Health & Human Services

  • Individual access to PHI
  • Working in the Cloud
  • Update on OCR’s audits
  • Frequent compliance issues
  • Recent enforcement examples

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

Medicaid Program Integrity Today

Lisa DeLaVergne, RHIT, CCS, Section Manager, Program Integrity, Washington Health Care Authority

  • Most common types of Medicaid fraud, waste and abuse
  • Documentation pitfalls
  • Implementing internal compliance programs
  • Prepare for a Medicaid audit or review
  • Alternative Payment Models

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

Federal Update – Healthcare Fraud/Waste/Abuse

Lori Ahlstrand, Regional Inspector General, U.S. Department of Health & Human Services
Steven Ryan, Special Agent in Charge, OIG, Regional Field Office, U.S. Department of Health & Human Services, Understanding the role of the HHS, OIG

  • Recent cases and audits relating to current trends in healthcare fraud, Waste, and Abuse
  • Legal consequences of medicare fraud
  • Impact of medicare fraud on patient care
  • How to work with HHS, OIG to combat medicare fraud

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

How to Prepare for a RAC Audit

Margaret Evans-Perkins, Program Director, RAC Region 4
Crystal Guadan, Program Manager, RAC Region 4

  • RAC Region 4 Provider Portal overview and process for provider address customization
  • New issue development overview
  • Additional Documentation Request, Informational and Review Results letters, samples and timing
  • Discussion period request process
  • Process to request for a physician-to-physician teleconference

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

The Changing Landscape for Behavioral Health

David Dickinson, MA, Regional Administrator, Substance Abuse & Mental Health Services Administration, U.S. Department of Health & Human Services

  • Why integrate behavioral health in other healthcare settings?
  • SAMHSA support for primary and behavioral health care integration
  • State approaches to health care integration
  • Tribal healthcare integration model
  • Changes to 42 CFR Part 2 confidentiality rules for SUD treatment support integrated care

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

Healthcare Compliance Hot Topics and Trends

Sheryl Forrester, CHC, Compliance Officer, Children’s Medical University Group
​​​​​​​Johanna Brown, Compliance Director, Kootenai Health
Carolyn Barton, CHPC, CHC, Vice President Compliance & Regional Compliance Officer, Compliance, Ethics and Integrity Office, Kaiser Foundation Health Plan of Washington
Theresa Anderson, Compliance Officer Laboratory Medicine, UW Medicine

  • Developing a centralized compliance department – a hospital’s first compliance officer will share her experiences in building a robust compliance program
  • Cultivating a positive (and effective) relationship between the compliance department and the organization
  • Compliance program effectiveness reviews from the health plan perspective, including acquisition considerations
  • Tips and tricks for dealing with social media

No presentation available

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