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Handouts - 2018 - National - Compliance Institute

Pre Conference Morning Breakout Sessions


P1

Industry Immersion

Large Hospital Systems

  • Learn how to benchmark your program against other large hospitals and health systems
  • through use of polling software Understand challenges relevant to large hospitals and large health systems Engage in dialogue with your colleagues regarding operational solutions and best practices
  • for large hospitals and health systems

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

Cheryl Wagonhurst, Owner, Law Office of Cheryl Wagonhurst

Suzie Draper, VP Business Ethics & Compliance, Intermountain Healthcare

John Steiner, Health Care Compliance Professional

Margaret J. Hambleton, VP Corporate Compliance, Dignity Health

 

P2

General Compliance and Hot Topics

Compliance Program Start Up: What Are the Basics Needed for Your Infrastructure?

  • Describe the fundamental elements of a compliance program
  • Identify ways to leverage current resources
  • Provide tips on getting organization buy in

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

Debbie Troklus, Managing Director, Aegis Compliance & Ethics Center LLP

Sheryl Vacca, Chief Risk Officer, Providence St Joseph Health

 

P3

Long-Term Care

Keep Them Talking to You: A Culture of Trust & Integrity Improves Quality, Safety, and Organizational Outcomes!

  • Review how the principles of trust & integrity impact organizational approaches to improve reporting and decrease misconduct
  • Achieve business objectives by influencing the workforce to focus on principle centered performance
  • Employees form opinions about an organization’s ethics. The surprising tips tricks and perceptions

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

Karla Dreisbach, Vice President of Compliance, Friends Services for the Aging

Sarah Finnegan, Vice President of Compliance, Kindred Healthcare

Kelly Lipscomb, Attorney, Lane Powell

Jeramy D. Kuhn, Corporate Compliance Officer & Privacy Officer, Care Initiatives

 

 

P4

Privacy & Security

HIPAA Compliance That Addresses the Risks of Today and Will Grow with You in the Future

  • Understand the latest industry trends/developments and potential for a government audit
  • Using the 7 elements as a framework and the HIPAA Audit protocol as a guide to create a foundation for HIPAA compliance
  • Learn about OCR’s focus and continued scrutiny on risk analysis efforts while understanding techniques taken by leading organizations to minimize risk exposure in conjunction with these efforts

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Presentation 4 (2 slides/page)
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Kevin Dunnahoo, Senior Manager, Protiviti

Matt Jackson, Director, Protiviti

Benjamin Burton, Health Information Management Consultant, First Class Solutions, Inc.

 

P5

Physician Compliance

How Does Your Program Rate? Tried and True Principles of Compliance

  • Landscape—An overview of the physician acquisition landscape, identifying the setting, assets and participants with their associated roles, perspectives and objectives
  • Potential Pitfalls—A review of frequently encountered challenges and pitfalls that can delay or derail completion of the acquisition journey
  • Road Map—A compilation of tools, ideas, and lessons learned to facilitate a successful expedition through the process of acquiring a physician practice

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

Valerie T. Cloud, Assistant Regional Corporate Responsibility Officer, Catholic Health Initiatives

Marian E. Hughlett, Regional Privacy Officer, Catholic Health Initiatives

 

P6

Compliance Lawyer

False Claims Act Developments

  • Fundamentals of the False Claims Act’s liability, damages, procedure and whistleblower provisions from the viewpoint of the compliance official
  • Discussion of whistleblower, government and defense perspectives on the filing, investigation, litigation and settlement of qui tam cases
  • Review of recent important decisions by the federal and state courts with far-reaching implications for enforcement of the False Claims Act

Handout 1
Handout 2 (.docx)

Moderator: 
John T. Boese, Counsel, Fried Frank Harris Shriver & Jacobson LLP

Michael D. Granston, Director, Commercial Litigation Branch, Fraud Section, Civil Division, US Department of Justice

Gary W. Eiland, Partner, King & Spalding LLP

Michael Morse, Partner, Pietragallo Gordon Alfano Bosick & Raspanti, LLP

 

P7

Auditing & Monitoring

Immediately Address IT Access Compliance Challenges with These Techniques, Using Tools You Already Have

  • Hands-on workshop. Learn techniques to detect IT access compliance issues now using software you know and have, and with data your systems are already producing.
  • Data sets will be distributed to attendees (bring your laptop) After general instructions on using tools and techniques the speakers will circulate and assist attendees individually to detect IT access compliance issues in the dataset
  • There will be a brief review of IT compliance challenges of particular interest to healthcare organizations

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

Alan Norquist, CEO & Founder, Veriphyr, Inc.

John Vastano, CSO, Veriphyr, Inc.

 

P8

Internal Audit

EMR, CTMS and Clinical Trial Billing Audits: How These Tools Can Help You As An Internal

  • EMR and billing audits
  • CTMS and billing audits
  • Clinical Trial review and revenue cycle integrity

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

Handout 1

Kelly M. Willenberg, Owner, Kelly Willenberg, LLC

Cynthie M. Lawson, Consultant, Self-Employed

 

P9

How to Succeed as a Compliance Professional

Strategies to Build An Effective Compliance and Ethics Program

  • Discuss best practice strategies to establish a strong compliance and ethics program framework
  • Provide and review essential materials and resources for our toolboxes to strengthen our proficiencies
  • Engage participants in discussion regarding methodologies to reinforce our programs and key partnerships through defined accountabilities and metrics

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

Handout 1 (.docx)
Handout 2 (.xls)
Handout 3
Handout 4 (.docx)
Handout 5

Deann M. Baker, Sutter Care at Home Compliance Officer, Sutter Health

Dwight Claustre, Director, Aegis Compliance & Ethics Center, LLP

 

P10

Quality of Care

Drug Diversion Enforcement Trends, Investigation, and Prevention

  • Drug diversion is an ongoing risk for providers, and the DEA is increasing their enforcement of suspected diversion
  • This session will discuss recent DEA enforcement trends and developments, and offer practical recommendations for pharmacy and compliance professionals to prevent or investigate drug diversion when it occurs
  • On the basis of the case study, discuss practical aspects of investigation, data analysis, reporting/ resolution and corrective action plan

Presentation 1 (2 slides/page)
Presentation 1 (3 slides/page)

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

Regina F. Gurvich, Director, Contract Administration & Integrity Monitoring Program, New York City Health & Hospitals Corporation

Gary Cantrell, Deputy Inspector General for Investigations, OIG HHS

 

P11

General Compliance and Hot Topics

Minimizing Stark Law Execution Risks

  • This panel will address the most complex Stark Law issues facing health systems and physician groups with an optional ethical component. The purpose is to equip attendees to analyze and address complex Stark Law issues arising from physician arrangements
  • Specific issues to be covered include: Fair Market Pitfalls, Practical safeguards against non-compliant payments, Physician group practice structures, Stark Law implications of losses and subsidies and prevention of rogue arrangements
  • As Stark Law Compliance can create ethical quandaries for in-house counsel if management contravenes policy requirements or resists addressing identified issues, a long version of this program includes a review of relevant rules of professional conduct

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

Laura Martin, National Chair, Health Care Practice Group, Katten Muchin Rosenman LLP

Louis Glaser, Partner, Katten Muchin Rosenman LLP

 

P12

General Compliance and Hot Topics

A Case Study: How to Conduct an Effective and Compliant Internal Investigation

  • Beginning the Internal Investigation: When to Initiate, Defining the Scope of the Investigation, and Developing a Strategy and Plan for the Investigation
  • Ethical Issues: Who will Conduct the Investigation, Litigation Holds, Attorney/Client Privilege Issues, and Joint Defense Agreements
  • Conducting and Concluding the Internal Investigation: Interviews, Documentation, Writing the Final Report, Reporting to Leadership and the Board, and Making Voluntary Disclosure

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

Handout 1
Handout 2

Jennifer A. Kildea Dewane, Deputy General Counsel, CareSource

Mark R. Chilson, EVP General Counsel, CareSource

Jeffrey E. McFadden, Partner, Stradley Ronon Stevens & Young, LLP

 

P13

Industry Immersion

Laboratory Compliance: Maintaining Compliance in an Uncertain and Changing Environment

  • Compliance issues facing today's laboratories including topics such as reporting requirements under the Protecting Access to Medicare Act (PAMA), lab developed tests (LDTs), marketing arrangements, toxicology testing, test orders, custom panels, medical necessity issues and CLIA requirements.
  • Recent initiatives related to enforcement of legal and regulatory authorities, including increased use of private contractors, actions under Medicare enrollment authorities, proceedings against lab executives and referring physicians, reverse false claims (failure to return overpayments), and related protective strategies
  • Practices that can result in imposition of sanctions, steps to limit related legal and regulatory risk, and responding to unlawful competitor activities

Presentation 1 (2 slides/page)
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Presentation 3 (3 slides/page)

Handout 1 (.xlsx)
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Robert E. Mazer, Principal, Baker Ober Health Law Group

Tim Murray, National Director Laboratory Compliance, Corporate Responsibility, Catholic Health Initiatives

Barbara Senters, Chief Compliance & Ethics Officer, Amerito

 

P14

Industry Immersion

Discover How Managed Care Plans are Responding to Their Obligation in Detecting, Investigating, and Preventing Fraud and Abuse in the Health Care System

  • Learn strategies to address claim system clinical edits, clearinghouse review/actions, high-risk provider audits, and both pre-pay and post-pay software programs
  • Share significant investigative case results and financial outcomes and examine what worked and what did not including the preparation of corrective action plans
  • Explore the development of Health Fraud Prevention Partnerships to help achieve best practices and best outcomes

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

Caron R. Cullen, President, Positive Compliance Outcomes, Inc.

Katherine M. Leff, Director, Special Investigations, CareSource

Mary Beach, Operations Director, Trusted Third Party for HFPP, HMS

Bernadette Underwood, Senior Clinical Investigator/Recovery Manager, Affinity Health Plan

 


Pre Conference Afternoon Breakout Sessions | 1:30 pm - 4:30 pm

 

 

P15

Industry Immersion

Leveraging DMAIC and Active Management for Sustainable Quality Improvements

  • Trace a successful DMAIC quality improvement effort from start to finish using data and examples from the speaker’s completed project
  • Throughout the presentation, participants will have opportunities to apply key learnings to situations at their home institutions via exercises and group discussion
  • The presentation will conclude with a strong focus on the use of “Active Management” (versus auditing) to sustain improvements past the conclusion of a project

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

Kristine Koontz, Quality Management Director, Keystone Human Services Inc.

Amy Short, Project Director, Ohio Valley Sickle Cell Network

 

 

P16

General Compliance and Hot Topics

Compliance Investigations 101: CO Toolbox Essentials

  • Interviewing Basics: Strategies to get the information you need from the employees; why covering privacy, security, HR and legal aspects are important during and after the interview
  • Partnerships: Knowing when to engage Legal for establishing privilege and possibly IT to collect substantial evidence; HR is a powerful ally and often, management too!
  • Using SBAR (and other tools) to document the investigation using clear, concise, and legible structure

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

Handout 1 (.docx)
Handout 2 (.xls)
Handout 3 (.xlsx)
Handout 4
Handout 5
Handout 6 (.xlsx)
Handout 7 (.xlsx)
Handout 8 (.doc)
Handout 9 (.xls)
Handout 10

Walter E. Johnson, Director of Compliance & Ethics, Kforce Government Solutions

Dawn E. Lambert, Chief Privacy Officer, IASIS Healthcare

Cindy W. Hart, CPA, CHC, CPC, Compliance Professional

Adam K. Weinstein, Vice President for Regulatory Affairs, New York-Presbyterian/Queens

 

 

P17

Long-Term Care

CMS Final Rule: Reform of Requirements for Long Term Care Facilities

  • Analyze the new Requirements of Participation (ROPs) for Long Term Care (LTC) Facilities and the three implementation phases
  • Evaluate the ways in which the new ROPs are intended to improve the quality of life, care and services in LTC facilities, optimize resident safety, reflect current professional standards and the role of compliance in meeting and maintain these goals
  • Examine the intersection between compliance and LTC facilities’ QAPI programs as identified in the ROPs; Strategize about how to assure LTC facilities will be surveyed for the effectiveness of their compliance and ethics programs under the ROPs

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

Barbara Duffy, Shareholder, Lane Powell

Paula Sanders, Principal and Healthcare Chair, Post & Schell, P.C.

Nan Impink, Executive Vice President, Compliance and Regulatory Affairs, SavaSeniorCare Administrative Services, LLC

 

 

P18

Privacy & Security

Is Your Security Incident a Data Breach? Uncle Sam Wants to Know

  • Learn how to know if your privacy or security incident is a reportable breach and examine why it’s important to define an event vs. security incident vs. privacy incident vs. data breach
  • Understand why privacy/compliance and security should work together on incident response
  • Learn incident response best practices and how proper incident response protects your customers’ sensitive data against cyber threats

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

Mahmood Sher-Jan, CEO, RADAR Business Unit, ID Experts

Asra Ali, Compliance and Risk Manager, HealthScape Advisors

Laura Merten, Chief Privacy Officer, Advocate Health Care

Patricia Shea, Partner, K&L Gates LLP

 

 

P19

Physician Compliance

Compliant Physician Documentation and Coding in an Electronic Medical Record

  • CMS Documentation Guidelines were developed before the widespread use of electronic medical records, yet these guidelines are still the standard by which physician’s document and code. This session will highlight the challenges of documenting in EMR
  • Review the results of governmental and private payer audits as they relate to electronic documentation
  • Provide strategies for compliant documentation in an electronic medical record, including discussions with vendors, educating providers, responding to audits

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

Kimberly G. Huey, President, KGG Coding & Reimbursement Consulting

Sandra K. Giangreco, Coding Compliance Audit Senior Manager, CHAN Healthcare

 

 

P20

Compliance Lawyer

Anatomy of a False Claims Act Case: Investigation, Litigation, Negotiation, Resolution

  • The Investigation Phase: subpoenas, witness interviews and more
  • The Litigation Phase: Discovery and Motions Practice
  • The Resolution Phase: Settlements, CIAs and Relator issues

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

Craig Holden, Chairman & COO, Baker Ober Health Law Group

Laura Laemmle-Weidenfeld, Partner, Jones Day

Amy Easton, Of Counsel, Phillips and Cohen LLP

Lisa Re, Assistant Inspector General for Legal Affairs, Office of Inspector General, Department of Health & Human Services

Laurie A. Oberembt, Senior Trial Counsel, U.S. Department of Justice

 

 

P21

Auditing & Monitoring

Achieving 340B Program Integrity

  • Identify areas to consider as part of your 340B compliance monitoring program, including suggested audit procedures that will provide a full picture of your current program and areas for potential optimization
  • Discuss the HRSA and Manufacturer audit process while also identifying best practice strategies to adequately prepare
  • Present the most frequently identified audit issues, root causes and potential action plans to mitigate the risks moving forward

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

Chris Wasik, Consulting Manager, CHAN Healthcare

Jerry E. Lear, Senior Vice President, CHAN Healthcare

 

 

P22

Internal Audit

Auditing Emerging Compliance Risk Areas

  • Discussion of Emerging Compliance Risk Areas
  • In depth review of key areas on risks/monitoring/controls
  • Sharing of best practices to address the risk

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

Debi Weatherford, Executive Director Internal Audit, Piedmont Healthcare

Debra A. Muscio, SVP, Chief Audit, Ethics & Compliance Officer, Community Medical Centers

 

 

P23

How to Succeed as a Compliance Professional

Enabling Compliance Across the Organization: Toolkits for Operational Compliance

  • Foster compliance activities by enabling operators at local level to understand, recognize, and respond for risks of noncompliance by equipping them with the knowledge and tools necesary to mitigate and prevent risk of noncompliance
  • Create three-part toolkits with legal or regulatory requirement or concern, template for identifying and reporting compliance activity, and template for addressing compliance matter is a uniform fashion across the organization
  • Provide mechanisms for tracking, trending, and reporting results of toolkit implementation to involved operators to aid corrective action and to leaders and committees to empower effective oversight of compliance activities and results

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

Anne S. Daly, Corporate Compliance Officer, Ann & Robert H. Lurie Children's Hospital of Chicago

Barbara Martinson, Compliance Program Director, Banner Health

 

 

P24

Quality of Care

Swords into Plowshares: Leveraging Clinical Data Quality Excellence and Data Mining Tools for Promoting Quality of Care

  • Data-mining has long been used by government enforcement agencies as a means of extracting overpayments and penalties from healthcare provider organizations. With the growth of data analytics tools, those same techniques can now be turned to the constructive task of monitoring and improving quality of care through the automated generation and distribution of actionable exception reports.
  • However, in order to unlock this opportunity, clinical data quality needs to be improved. We will examine the criticality of clinical data quality and ask the key question of WHY we are not treating clinical data with the same rigor, diligence, control and auditability as financial data?
  • We will explore how COSO, Enterprise Risk Management and High Reliability Organizing principles can help drive clinical data quality, reporting integrity, and diagnosis accuracy and reduce potential patient harms. We’ll also discuss how the organization can work synergistically to better utilize data and achieve desired quality outcomes.

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

Aloha McBride, Principal, Ernst & Young

Peter Pronovost, Sr. Vice President for Patient Safety and Quality, Johns Hopkins Hospital

Marc Schulman, Executive Director, Ernst & Young

David N. Hoffman, Chief Compliance Officer, Physician Affiliate Group of New York, P.C.

 

 

P25

General Compliance and Hot Topics

Whistle While You Work: How to Prevent Activity Leading to Whistleblower Actions and Protect Health Organizations and Medical Practices

  • Whistle Blower of the largest False Claims case in Arizona shares tips on how your organization can develop an active and effective compliance plan to protect your organization
  • Hindsight is 20/20. Be proactive and design compliance steps that you can easily implement to assist your Board with the tools they need to protect your organization from risks that may end up resulting in fines as well as damage your reputation
  • Prior Los Angeles Police Commissioner—now White Collar Crime Attorney; Long Term Care Chief Officer; Long Term Care Attorney; and HIM/HIT Professor / Compliance Expert team up to assist Boards across the USA to protect their organization

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

Jacqueline N. Bloink, Professor, Saddleback College

Christine Zack, Senior VP, Chief Risk Officer, Fundamental Administrative Services LLC

Linda W. Taetz, Senior Vice President & Compliance Officer, Mariner Health Care

Linda Woolf, Managing Partner, Goodell, DeVries, Leech & Dann

 

 

P26

Industry Immersion

Fighting for Survival: DMEPOS

  • Understand the Impact of competitive bid-derived pricing on products in non-bid areas plus future of competitive bid rounds
  • Investigate Alternative payment arrangements, including the pros and cons of submitting non-assigned claims
  • Learn how to manage the continued impact of Medicare/RAC audits and new program integrity contractors
  • Hodge Podge of compliance issues discussions—Exclusion

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

Ruth Krueger, Enterprise Compliance Program Manager, Sanford Health

Wayne H. van Halem, President, The van Halem Group-A Division of VGM Group, Inc.

Paula Koenig, Corporate Compliance Officer, Numotion

 

 

P27

Industry Immersion

Academic Medical Center Compliance: Tips, Traps, and Emerging Best Practices

  • Revenue cycle compliance within the academic medical center environment including specific challenges with research billing and overlapping surgeries
  • Issues around conflict of interest and conflict of commitment—working with clinical research faculty and faculty working with outside funded research
  • Privacy, security, and academic freedom—how they intersect and how they are different

Presentation 1 (2 slides/page)
Presentation 1 (3 slides/page)

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

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

David Lane, Deputy Compliance Officer, University of California

Dan J. Weissburg, Chief Compliance & Privacy Officer, University of California San Diego Health

Colleen Shannon, Chief Compliance Officer, Duke University Health System

Ajay Vyas, Deputy Director of Healthcare Compliance, University of Southern California

 

 

P28

Industry Immersion

Research Law and Compliance: 2016–2017 Year In Review

  • Understand the DHHS OIG’s Research Investigation and Enforcement Focus Areas for the 2017 Fiscal Year
  • Learn about recent investigations and settlements from federal government agencies charged with oversight and enforcement in clinical research (E.g. OHRP, ORI, FDA, DOJ, etc.)
  • Hear about federal agency recent guidance in areas such as human research protections, grants management, conflicts of interest and understand the status of the NPRM related to updates to the Common Rule (45 CFR Part 46, et. seq.)

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

 

Session

Title/Description

Speakers

General Session | 8:45 am - 9:15 am


GS1

OIG Update

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

Daniel R. Levinson, Inspector General, Office of Inspector General, U.S. Department of Health and Human Services


General Session 


GS2

How to Be a Wildly Effective Compliance Officer

  • Learn specific influence, persuasion and motivation techniques to help you be a powerful business asset
  • Find out how to deal with burnout and learn when to say, “That’s not my job!”
  • Super-charge how you and others perceive you and your role

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

Kristy Grant-Hart, Owner, Spark Compliance Consulting


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Break Out Sessions 


101

General Compliance and Hot Topics

340B Compliance: Life after a HRSA Audit and Implementing a Corrective Action Plan

  • Case Study: Piedmont Athens Regional‘s HRSA audit and resulting corrective action plan (Case Study will include manufacturer repayment, process changes and independent audit activities)
  • Recent independent 340B assessment results
  • Best practices for implementing internal auditing and monitoring tools, including leading practice action plans

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

Sarah E. Bowman, Consulting Manager, PYA

Melissa C. Prince, Director, Compliance & Privacy, Piedmont Athens Regional

 

102

General Compliance and Hot Topics

Latest Policy & Regulatory Changes to the Medicare Appeals Process

  • Chief ALJ Nancy J. Griswold will highlight key initiatives taking place at the ALJ appeal level, including expansions to the Settlement Conference Facilitation (SCF) program enabling providers to participate in open settlement discussions with CMS
  • Discussion of significant reforms to the Medicare appeals process, including recent HHS proposed rulemaking aimed at reducing the backlog of pending appeals and encouraging resolution of cases earlier in the appeals process
  • Successful appeal strategies and best practices to utilize when defending against Medicare audits, including strategic approaches for participating in settlement discussions with CMS through the SCF program

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

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

Andrew Wachler, Managing Partner, Wachler & Associates, P.C.

Nancy Griswold, Chief Administrative Law Judge, Department of Health and Human Services, Office of Medicare Hearings and Appeals

 

103

Long-Term Care

Highlights of the CMS Final Rule: Reform of Requirements for Long Term Care Facilities—The Impact on Compliance

  • General overview of Requirements of Participation
  • Specifics on requirements of the new requirements as it relates to Compliance & Ethics
  • Responsibilities as a compliance professional beyond having a compliance program

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

Handout

Kris D’Ann Maples, Counsel/Compliance Director, Hillcrest Health Services

Lyn Bentley, Vice President, Quality & Regulatory Affairs, AHCA

 

104

Privacy & Security

OCR Enforcement Update

  • Recent important guidance from OCR
  • Current trends in HIPAA enforcement, including lessons learned from settlement agreement cases
  • Latest statistics on breaches reported to OCR

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

Iliana Peters, Senior Advisor for HIPAA Compliance and Enforcement, HHS Office for Civil Rights

 

 

105

Physician Compliance

The Best Approach to Design Effective Corrective Action Plans (CAP)

  • Discuss and review the CMS Guidance for Performing Root Cause Analysis (RCA)
  • Provide resources tools and techniques
  • Review the RCA, CAP and monitoring documentation best practices

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

Handout 1
Handout 2
Handout 3
Handout 4
Handout 5 
Handout 6 (.xlsx)

Marcela Alaniz, Compliance Program Manager, Sutter Health

Deann M. Baker, Sutter Care at Home Compliance Officer, Sutter Health

Christos G. Arvanitis, Compliance Officer, Sutter Health

 

106

Compliance Lawyer

Telehealth: Legal and Compliance Issues

  • Advances in telemedicine promote good patient care, but the rules when building a multi-state arrangement can be daunting. This course discusses the hot topics compliance professionals should look out for
  • Participants will discuss: coding and billing, interjurisdictional Medicare enrollment, second opinions and licensure, corporate practice of medicine, HIPAA and privacy
  • Q&A will be strongly encouraged. Attendees will receive checklists and handouts. The session will also address telemedicine in mental health and crisis management

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

Nathaniel Lacktman, Partner, Foley & Lardner LLP

Anna Whites, Attorney, Anna Whites Law Office

 

107

Auditing & Monitoring

Elements of a Successful Corporate Integrity Agreement

  • LHC Group’s CIA: Lessons Learned
  • Keys to success for Independent Review Organizations
  • Compliance Program development post-CIA

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

Peter Dressel, Senior Managing Director, FTI Consulting

JoAnne Little, Chief Compliance Officer, LHC Group

Susan Gillin, Deputy Branch Chief, Administrative and Civil Remedies Branch, Office of Counsel to the Inspector General

 

108

Internal Audit

Leveraging Internal Audit to Improve Quality of Care Metrics

  • Identify key Evidence-Based Practices (EBPs) which drive Quality of Care metrics, such as Falls, Restraints, Surgical Never Events, CAUTI and CLABSI
  • Provide guidance as to how Internal Audit can be leveraged to assist in identifying effectiveness of EBP implementations
  • Discuss common findings from internal audits of EBPs

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

Shawn A. Stevison, Manager, Healthcare Consulting, Dean Dorton

 

109

How to Succeed as a Compliance Professional

Top 10 Things a Compliance Professional Needs to Know About Coding

  • Learn how to approach Hot Coding Topics for Audit
  • Learn how to “talk the talk” and “walk the walk” about coding issues
  • Learn about the top 10 Coding issues in the industry and how to develop controls within the Compliance Program

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

Melissa J. McCarthy, AVP, Chief Corporate Compliance Officer, Northwell Health

 

110

General Compliance and Hot Topics

Behavioral Health Compliance: It Doesn’t Need to be a Mystery

  • Identify top risk areas in behavioral health compliance: documentation, medical necessity, supervision, credentials, screening/background checks; privacy of behavioral health and substance abuse treatment records; opioid treatment programs
  • Discuss how changes in the regulatory and operational landscape are impacting behavioral health compliance (e.g. increased utilization of telemedicine and non-physician practitioners)
  • Review strategies and mechanisms for auditing behavioral health records to achieve compliance

No presentation or handout available

Michelle Calloway, Attorney, McGuireWoods

Rebekah Stewart, Chief Ethics and Compliance Officer, Diamond Healthcare

 

111

General Compliance and Hot Topics

The Former Ameritox Whistleblower and the Ameritox Compliance Officer, Together

  • Hear how to use the compliance program to deter employees from becoming relators
  • Learn how to go beyond CIA requirements to improve the compliance program and company culture as well as how to sustain it after the CIA ends
  • Understand the importance of Compliance & Human Resources department partnership in enhancing compliance program effectiveness

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

Barb Senters, Chief Compliance & Ethics Officer, Ameritox

Debra Maul, Former Whistleblower, Ameritox

  

 

AD1

Advanced Discussion Groups

Social Media Risks

  • Hiring concerns
  • HIPAA compliance
  • Responding to healthcare questions  

No presentation or handout available

Lynda Hilliard, Healthcare Compliance Professional, Hilliard Compliance Consulting

 

AD2

Advanced Discussion Groups

Dealing with Privacy Breaches

  • Learn how to assess a violation of the HIPAA Privacy Regulations
  • Understand how to perform a risk assessment for “low probability of compromise”
  • Discuss and assess the factors for determining if a breach is reportable

No presentation or handout available

Darrell Contreras, Chief Compliance Officer, Millennium Health

 


Break Out Sessions


201

General Compliance and Hot Topics

Compliance Today, Effectiveness Tomorrow: The Necessary Steps to Success

  • Explore the evolution of the healthcare compliance market over the last 20 years through a first-hand perspective of landmark investigations/settlements, while making preparations for increased risk which will be prevalent in the future
  • Learn about significant developments in the compliance marketplace in recent years, including the Yates Memo, updated OIG and DOJ guidance, and Supreme Court FCA rulings; and how to implement leading practices to mitigate against an enforcement action
  • Compliance problems are ubiquitous and should be proactively addressed with an effective compliance program. This discussion will focus on the tools to “sell” your program, demonstrate its effectiveness, and protect your entity against increasing risk

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

Bret S. Bissey, Senior VP Compliance Services, MediTract, Inc.

Kenneth Zeko, Senior Vice President, CHAN Healthcare

Sean R. McKenna, Shareholder, Greenberg Traurig, LLP

 

 

202

General Compliance and Hot Topics

The OIG’s New CIA Form: How Your Compliance Program Can Benefit

  • New CIA Provisions: What They (Could) Mean for Your Compliance Program
  • Do the New Provisions Enhance Compliance Programs?
  • How to Sell the New Provisions Without the Benefit of the CIA “Stick”

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

Steven W. Ortquist, Managing Director, Aegis Compliance & Ethics Center LLP

Nicole Caucci, Senior Counsel, OIG HHS

 

203

Long-Term Care

Dealing with a Worthless Services Allegation

  • Factors to Consider in Moving Forward with Settlement vs. Litigation
  • Negotiating a Settlement & Quality Care CIA
  • Living Life with a Quality Care Monitor

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

Michael D. Smith, Chief Compliance Officer, Foundation Health Services, Inc.

Julie B. Mitchell, Attorney, Mitchell Day Law Firm, PLLC

 

204

Privacy & Security

Successfully Resolving a Multi-Year OCR Investigation

  • After multiple years of an OCR investigation related to a health plan breach, the investigation was successfully closed in 2016
  • The successful conclusion to this investigation is attributed to the health plan’s transparency and responsiveness
  • This presentation will summarize the experience and share the organizational, legal and compliance lessons learned from the multi-disciplinary team that responded to the investigation

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

Cliff Baker, Managing Partner, Meditology Services

Adam Greene, Partner, Davis Wright Tremaine, LLP

Karen M. Eastmond, Chief Compliance Officer, CenterLight Health System

 

205

Physician Compliance

Cleaning Up the Low Hanging Fruit to Protect Your Physician Practices

  • 206: Random" is Not Necessarily "Valid": Managing and Defending Against Statistics in Audits and FCA Claims "

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

Vicki L. Dwyer, Chief Compliance Officer, Valley View Hospital

Nancy C. Kennedy, Chief Compliance & Privacy Officer; Chief Operations Officer, Galichia Medical Group

 

206

Compliance Lawyer

“Random” is Not Necessarily “Valid”: Managing and Defending Against Statistics in Audits and FCA Claims

  • With the recent increases in government investigations and FCA cases, understanding the weaknesses and defenses available to counter overpayment and false claims is essential to protecting providers against these allegations
  • Learn to identify flawed statistical extrapolations and flawed assumptions
  • Learn practical suggestions for defending audit overpayments and false claim allegations based on statistical extrapolation

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

Tracy M. Field, Partner, Parker Hudson Rainer & Dobbs

Sandra Miller, Attorney, Womble Carlyle Sandridge & Rice LLP

 

207

Auditing & Monitoring

Implementing Drug Diversion Risk Rounds

  • Why do this work? Internal drug diversion in healthcare is on the rise and regulatory agencies are taking action. This has been exhibited by the Massachusetts General Hospital DEA settlement in 2015. We will highlight key learnings from their action plan
  • Attendees will walk through a Diversion Risk Round using the monitoring tool which provides baseline information to clinical leaders on the security of medication storage, dispensing, wasting, and inventory management
  • Attendees will hear specific examples of issues found during the Risk rounds and the improvements made as a result. We will share our learnings and provide a detailed plan that could be applied at your organization

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

Tracy E. Tracy, Senior Director Integrity and Compliance, HealthPartners

Sara Schroeckenthaler, Program Manager, HealthPartners

 

208

Internal Audit

Sampling 101: A Primer for Conducting Self Disclosure and Internal Audits

  • Get a solid understanding of the different types of sampling techniques available and which work best under different circumstances
  • Create your own samples for conducting self-disclosure and internal audits
  • Learn how to defend yourself against CMS and private payer audits that use poor sampling techniques

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

Frank D. Cohen, Director of Analytics, Doctors Management LLC

 

209

How to Succeed as a Compliance Professional

Yeah, but What’s in It for Me? Making Training and Communications Impactful, Relevant, and Fun!

  • Impactful: Tailor your training and communications to be impactful, focusing on the ways different generations enjoy learning
  • Relevant: Learn how to use the Four Primary Motivators to emotionally resonate with each member of your audience
  • Fun!: Utilize best practices in adult learning to make your training and communications as enjoyable and memorable as possible

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

Kristy Grant-Hart, Owner, Spark Compliance Consulting

Calin M. Elardi, Compliance Project Manager, Sound Physicians


210

General Compliance and Hot Topics

Conflicts of Interest and Big Data: What Can We Learn from Large Databases of Provider Disclosures?

  • This talk will focus on how big data analytics can be used to identify COI outliers at both a macro level (a hospital within a system) and the micro level (a provider within a hospital), to target compliance efforts where they are most appropriate
  • What are the top 10 COI disclosures? Does this vary based on the bed size or academic and research intensity of an organization? Does the for-profit vs. not-for-profit status of an institution influence the types and numbers of disclosures made?
  • Using publicly available and proprietary databases containing millions of disclosures, the speakers will provide insight into how compliance professionals can use data to gain useful insights and to identify and reduce COI risk at their institutions

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

William Sacks, VP Product Management, HCCS - A HealthStream Company

Alan Beer, Senior System Engineer, Carolinas HealthCare System

 

211

General Compliance and Hot Topics

Audit Log Demands During Litigation: Response Conundrums from a Compliance Perspective

  • Increased awareness of electronic health record capabilities has resulted in an exponential increase in the legal demands for the production of audit logs for use in litigation
  • What are a covered entities obligations under HIPAA to retain these audit logs?
  • Are audit logs an accurate source of information on which to base clinical activity for litigation purposes?

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

Carey Cothran, Executive Director, Corporate Compliance and Audit, WellStar Health Systems

Emily Reilly, Compliance Administrator, WellStar Health System, Inc.

 

AD3

Advanced Discussion Groups

The Partnership of Risk and Compliance

  • Discuss the primary differences between the roles of risk and compliance
  • Identify the key areas where risk and compliance can gain synergies in their functional activities, e.g.: risk assessments, planning, training, communications, auditing and monitoring, etc.
  • Discuss metrics for identifying return on investment for this partnership

No presentation or handout available

Sheryl Vacca, Chief Risk Officer, Providence St Joseph Health

 

AD4

Advanced Discussion Groups

Program Operational Components: Monitoring and Safeguards

  • Discussion of the routine monitoring processes
  • Share ideas on how to identify and develop program safeguards
  • Come prepared to share your most effective compliance tools

No presentation or handout available

Jawanna King, Regional Compliance Director, Tenet Healthcare Corporation

Jeff Paul, Regional Compliance Director, Tenet Healthcare

 

AD5

Advanced Discussion Groups

Pointers and Pitfalls in Managing Work-Life Balance, Stress, and Burnout in the Compliance Profession

  • To bring compliance professionals together for a professional exchange of common stress points
  • Discuss the personal impact of the electronic communication
  • Learn from each other’s knowledge and experience

No presentation or handout available

Shawn DeGroot, Global Business Process Management Compliance Officer, Navigant Cymetrix

Robert Ossoff, Maness Professor of Laryngology and Voice, Vanderbilt University Medical Center

 

Break Out Sessions | 3:00 pm - 4:00 pm

 

301

General Compliance and Hot Topics

Compliance Challenges in the Yates Memo Era

  • What Does the Risk of Heightened Criminal and Civil Enforcement and Focus on Individual Accountability Mean for Your Compliance Program
  • A veteran prosecutor and experienced defense counsel will provide compliance personnel with practical information for their compliance programs in light of DOJ’s focus on individual/corporate accountability

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

Gina Simms, Principal, Baker Ober Health Law Group

George Breen, Shareholder, Epstein Becker & Green PC

Tarra R. DeShields, Assistant US Attorney, US Attorney’s Office for the District of Maryland

 

302

General Compliance and Hot Topics

The Blame Game: Accountability in Healthcare Compliance

  • Learn best practices about how to best manage your business associate and examine what a business associate agreement should entail
  • Learn adequate data safeguards and security policies and procedures in order to respond effectively to a data breach
  • Learn what your organization can do to be prepared for a security incident

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

Rick Kam, President & Co-Founder, ID Experts

 

303

Long-Term Care

Making the Most of a CIA

  • How to get past the "this isn't fair" phase
  • How to make the most of the expertise of the Monitors and the OIG
  • Top five tips to implementing a CIA

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

Donna J. Thiel, Director, ProviderTrust

Laura Ellis, Senior Counsel, OIG HHS

 

304

Privacy & Security

Managing the Business Associate Relationship: From Onboarding to Breaches

  • Health care providers and payers have a duty to ensure that the vendors in which they entrust PHI will protect it and use it appropriately—we will discuss business associate onboarding strategies, pitfalls and best practices
  • Ensuring ongoing compliance with HIPAA and other privacy laws by your business associates is challenging—we will discuss monitoring your business associates, auditing rights and handling disputes
  • Business associates are a leading cause of breaches for health care providers and payers—we will discuss how to best prepare your organization upfront should a breach occur and special considerations for handling a business associate breach

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

William J. Roberts, Associate, Shipman & Goodwin, LLP

Jay Hodes, President, Colington Consulting

 

305

Physician Compliance

Split Shared/Consulting Services…to Split Share or Consult Is the Question

  • Discuss clinical case scenarios to understand the importance of billing accurately for split shared and consulting E/M services
  • Review an audit plan used to validate levels of E/M codes
  • How to code split/shared or consulting services rendered by providers in the same specialty in an office setting

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

Handout 1 (.doc)
Handout 2 (.doc)

Nicole S. Huff, Chief Compliance & Privacy Officer, St. Luke’s University Health Network

Andrea J. Riccelli, Supervisor, Provider Services Compliance, St. Luke’s University Hospital

 

306

Compliance Lawyer

Advice of Counsel and Good Faith Reliance: Best Practices in a Risky Environment

  • The necessary elements for reliance upon that legal advice and the form the advice may take, and the consequences of that form (oral or written, the stated facts and assumptions upon which the advice is based)
  • Collateral damage-the individual and organizational consequences of asserting an advice of counsel defense, including waiver of applicable privileges, securities and public reporting, discovery of attorney and client files
  • The ethical duties and responsibilities of the attorney when the client asserts an advice of counsel claim, the “oops” problem in depositions, and the doctrine of “selective disclosure”

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

Kevin G. McAnaney, Attorney, Law Office of Kevin G McAnaney

James Sheehan, Chief, Charities Bureau, NY Attorney General

 

307

Auditing & Monitoring

Physician Arrangements: Conducting the Audit & Ensuring a Resolution

  • Conduct a mock audit of a physician arrangement by reviewing key areas of focus as defined by the Stark law
  • Discuss the role distinctions between the compliance officer and legal counsel when issues are identified
  • Learn how to effectively report results to get management & legal buy-in

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

Juliette Stancil, Regional Compliance Officer, Presence Health

Anne E. Brummell, Regional Compliance Officer, Presence Health

 

308

Internal Audit

Auditing Compliance for Clinical Documentation and Coding: Collaboration Is Key!

  • Learn how an effective partnership between Compliance, Coding and Clinical leadership can lead to an effective internal auditing and education program
  • Hear how an Auditing Compliance Committee and a Clinical Documentation Improvement Committee work together to identify trends and develop effective provider education that increases provider engagement and improves accuracy rates
  • Leave this session with a template for creating an effective internal auditing program that engages providers, EHR trainers, coders and compliance and results in clinical documentation improvements

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

Handout

Debbie G. Morgan, Compliance Officer, Clinica Family Health

Justin Wheeler, VP of Clinical Services, Clinica Family Health

 

309

How to Succeed as a Compliance Professional

Risk: A Fundamental 4-Letter Word for Compliance Professionals

  • Understand how to break down risk into its fundamental components so that associated or related mitigating activities are better aligned to reduce the identified risk to an acceptable level
  • Identify the strengths and weaknesses of using qualitative and quantitative approaches to assessing risk and how they differ and how they are surprisingly similar
  • Evaluate how other compliance program elements, particularly auditing and monitoring, can provide valuable and meaningful information on how well the identified risks are being managed

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

Frank Ruelas, Facility Compliance Professional, St. Joseph’s Hospital and Medical Center/Dignity Health

 

310

General Compliance and Hot Topics

You Don’t Need to Be a Wizard to Solve Today’s Compliance Challenges: Seven Steps to Ensure Your Compliance Program Follows the Yellow Brick Road

  • Current trends in government enforcement in Home Health and Hospice
  • Seven elements of an effective compliance program and practical solutions to assist organizations in the implementation of their compliance program
  • Overview of current Home Health and Hospice CIAs to include DHSS and OIG expectations for compliance programs

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

Karen Bommelje, Senior Manager, Compliance, Simione Healthcare Consultants, LLC

John R. Hamilton, Vice President of Compliance, Kindred Healthcare

 

 

311

General Compliance and Hot Topics

Overlapping Surgery Developments

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

 

Sara Kay Wheeler, Partner, King & Spalding

Alana Sullivan, Chief Compliance Officer, Erlanger Health System

 

AD6

Advanced Discussion Groups

 Operational Components of a Compliance Program

  • What are the fundamental safeguards and how do we monitor?
  • Share your approach to annual compliance training
  • How do you measure compliance program effectiveness?

No presentation or handout available

Alvin Josephs, Senior Director, Risk Assessment and Culture, Tenet Healthcare Corporation

Ryan Whitehill, Manager Ethics & Compliance Training, Tenet Healthcare Corporation

 

AD7

Advanced Discussion Groups

Compliance Programs for Provider-owned Health Plans and Alternative Payment Programs

  • Providers operating Medicare Advantage plans or participating in Medicare's Accountable Care Organization or other alternative payment programs (e.g. bundled payments)
  • Compliance Program implications and expectations
  • Regulatory oversight and areas of audit and enforcement focus

No presentation or handout available

Jenny M. O’Brien, Chief Compliance Officer, UnitedHealthcare

Michael Holper, SVP Integrity & Audit Services, Trinity Health

 

AD8

Advanced Discussion Groups

Beyond the Law: Business Ethics & the Compliance Officer

  • Examine 4 business ethics scenarios that compliance officers find themselves in
  • Discuss approaches to examining ethical quandaries
  • Dialogue on the boundaries and limits to decisions that are legal questions but ethical questions

No presentation or handout available

Ryan Meade, Director Regulatory Compliance Studies, Loyola University Chicago School of Law

 


Break Out Sessions | 4:30 pm - 5:30 pm


401

General Compliance and Hot Topics

Down the Rabbit Hole: Compliance Investigations, Corrective Action Planning, and Self-Disclosure

  • Explore best practices and the roles of Legal, Compliance and outside counsel in conducting internal compliance reviews, corrective action planning, and disclosure decision-making
  • Review the analysis for determining whether an overpayment has been received and compliance with the 60 Day Overpayment Rule
  • Discuss the benefits and risks of self-disclosure and strategic considerations in deciding where to disclose

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

Tony Maida, Partner, McDermott Will & Emery

Anne S. Daly, Corporate Compliance Officer, Ann & Robert H. Lurie Children's Hospital of Chicago

 

402

General Compliance and Hot Topics

Congratulations on that New Hospital/Provider Practice Acquisition! Compliance Lessons Learned the Hard Way

  • Why Compliance and Internal Audit need to be part of the acquisition due diligence team (and what can go wrong if they are not)
  • How to prioritize compliance activities in the immediate post-acquisition period
  • How integration of an effective compliance program can mitigate acquired compliance risks

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

Donald A. Sinko, Chief Integrity Officer, Cleveland Clinic

Vicki R. Bokar, Senior Director Corporate Compliance, Cleveland Clinic

 

403

Long-Term Care

Mitigating Hot Button Risk Areas in Home Health & Hospice

  • Explore current and potential future risk areas in home health and hospice
  • Learn what to look for in your documentation and how to improve it
  • Review practical tips/tools such as PEPPER to lower risk and prepare for auditors

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

Kathryn A. Krenz, Clinical Analyst, Brookdale Senior Living

Kimberly M. Hrehor, Director, TMF Health Quality Institute

 

404

Privacy & Security

Mobile Health (mHealth) Applications in a Healthcare Environment

  • Legal and Privacy implications regarding the expansion of mobile health applications in combination with patient-centric care
  • HIPAA and the liability for clinical providers in a world of Smartphones, Tablets, and Smartwatches
  • Discussion of the oversight process for health apps, including FDA, FCC, and federal regulations

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

Brandon Goulter, Facility Compliance Professional, Dignity Health

Steven R. Baruch, Service Area Compliance Director, Dignity Health

 

405

Physician Compliance

Making Compliance Work in Physician Practices

  • How to Effectively Communicate Across Practices
  • Training Methods for Practices—It’s All About Buy In
  • Major Initiatives Impacting Physician Practices

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

Betty Baber-Kinsey, Phys. Practices Compliance Officer, Tenet Healthcare

 

 406

Compliance Lawyer

Federal Administrative Sanctions: Exclusion and Civil Money Penalties

  • OIG’s focus on its Affirmative Administrative Remedy Authority
  • Navigating CMS’ Revocation Authority—it's not the same as exclusion
  • The impact of the government administrative remedies on providers

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

Julie Kass, Lawyer, Baker Ober Health Law Group

Lauren Marziani, Senior Counsel, OIG HHS

 

407

Auditing & Monitoring

Research Risks Assessments: What Must be Considered and Why

  • Discuss the importance of research risks for compliance officers
  • Delve into how research risks affect approval, IRB review, consent, and indemnifications
  • Describe how risk can be minimized using preliminary risk assessments

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

Sarah Fowler-Dixon, Education Specialist, Human Research Protection Office, Washington University School of Medicine

 

408

Internal Audit

Dynamic Board Reports: What Do They Really Want to Know?

  • Board Expectations
  • Key Metrics to share
  • Program risk and growth needs

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

Handout 1 (.docx)
Handout 2 (.docx)
Handout 3 (.docx)
Handout 4 (.docx)

Ruth Krueger, Enterprise Compliance Program Manager, Sanford Health

Cindy J. Matson, VP Health Services Compliance, Sanford Health

 

409

How to Succeed as a Compliance Professional

How to Get More LinkedIn Views than Roy: Practical Tips for Improving Your LinkedIn Profile & Getting Employers to Seek You Out

  • Learn valuable tips on how to make yourself stand out in a sea of over 400 million users
  • Find out about common mistakes users make with their profiles
  • Learn how to attract employers, network and stop wasting time with the online job application black hole

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

Handout

 

Brenda K. Manning, JD, CHC, CHPC, Privacy & Regulatory Affairs Director University of Minnesota Physicians

 

 

410

General Compliance and Hot Topics

Medicare FDRs and Compliance Programs: What the Feds Expect and Tips for Ensuring Your Organization Satisfies the Requirements

  • Understand the current status of Medicare managed care compliance program requirements for “first tier” and “downstream” and “related” entities
  • Learn how to effectively achieve compliance
  • Gain insights for negotiating compliance program provisions in managed care agreements
Presentation (2 slides/page)
Presentation (3 slides/page)

Handout 1
Handout 2
Handout 3
Handout 4
Handout 5
Handout 6

Heather L. Fields, Shareholder, Chair - Hospital/Health Systems Practice, Reinhart Boerner Van Deuren s.c.

Catherine M. Boerner, President, Boerner Consulting LLC

Jenny M. O’Brien, Chief Compliance Officer, UnitedHealthcare

 

411

General Compliance and Hot Topics

The Business of Health Care Fraud Enforcement: A Pragmatic Discussion and Assessment

  • Review of noteworthy settlements and enforcement activity from the last two years
  • Discussion of significant FCA and health care fraud court decisions
  • Trends, implications, and predictions for the future

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

Brian Bewley, Shareholder, Polsinelli PC

Jeffrey Fitzgerald, Shareholder, Polsinelli PC

 

AD9

Advanced Discussion Groups

Strategies for Managing Potential Overpayments and Compliance with the 60-Day Rule

  • Discuss 60-day rule developments, including CMS’s rulemaking and enforcement developments
  • Explore compliance challenges for providers attempting to navigate the 60-day rule in the face of real-world obstacles
  • Share practical strategies for meeting these challenges, including approaches to monitoring and reporting potential overpayments

No presentation or handout available

Sara Kay Wheeler, Partner, King & Spalding

 

AD10

Advanced Discussion Groups

Privacy and Research

  • Discuss methods to collaborate together for improved outcomes
  • Is there a productive tension between the two functions
  • Strategize on ways to improve communication and collaboration

No presentation or handout available

Joan Podleski, Chief Privacy Officer, Children’s Health

Brian Annulis, Partner, Meade Roach & Annulis, LLP

 

AD1b/repeat

Advanced Discussion Groups

Social Media Risks

  • Hiring Concerns
  • HIPAA Compliance
  • Responding to Healthcare Questions

No presentation or handout available

Lynda Hilliard, Healthcare Compliance Professional, Hilliard Compliance Consulting

 

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Session

Title/Description

Speakers

     

General Sessions | 8:45 am - 9:30 am


GS3

Human Trafficking and Modern Slavery: The Next Compliance Challenge

No presentation or handout available

Margaret J. Hambleton, VP Corporate Compliance, Dignity Health

William Shepherd, Partner, Holland & Knight


General Sessions | 9:30 am - 10:30 am


GS4

Wonders of Spaceflight and Its Risks: Lessons from the Space Shuttle Program

  • The challenges and rewards of high risk environments at NASA and in commercial space flight
  • How to encourage a culture where people speak up and listen
  • Where cultures go wrong and the consequences when they do

No presentation or handout available

Dr. Garrett Reisman, Director of Space Operations, SpaceX

 

Break Out Sessions


501

General Compliance and Hot Topics

Data Dashboards: What Should You be Tracking

  • In this session we will discuss what an effective data dashboard could look like in order to stay as informed as possible on key metrics. In today’s data driven world, there is so much that can be tracked, learned and made transparent in order to maintain
  • Why data and metrics matter in an effective compliance program and who are the key stakeholders and how to coordinate data
  • What data should you be tracking to meet OIG and CMS metrics for quality and compliance. What additional data will you be required to track if under a CIA. We will review recent CIA’s for what the OIG requires

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

Michael Rosen, Co-Founder, ProviderTrust Inc.

Donna J. Thiel, Director, ProviderTrust

Susan Coppola, Sr. VP, Resident Care, Sunrise Senior Living

 

502

General Compliance and Hot Topics

Navigating Medical Necessity Denials Management for All Payers

  • What should be included in a denials management and prevention strategy
  • The standard appeal processes for medical necessity denials
  • What are the challenges and some best practices surrounding appealing and preventing medical necessity denials

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

 

Marc Tucker, Vice President, Compliance and Physician Education, Optum Executive Health Resources

 

503

Long-Term Care

Bundled Payments and Other Risk Arrangements for Post-Acute Care Providers

  • Discussion of bundled payments and other risk arrangements for post-acute care (“PAC”) providers including the CMS Comprehensive Care for Joint Replacement Model
  • Discussion of compliance challenges presented by these risk arrangements for PAC providers
  • Discussion of fraud and abuse and contracting issues presented by these risk arrangements

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

Alan Schabes, Partner, Benesch, Friedlander, Coplan & Aronoff LLP

Shannon Drake, Senior Vice President; Chief Counsel, Kindred at Home

 

504

Privacy & Security

Medical Device Security: The Transition from Patient Privacy to Patient Safety

  • Describe how to deploy an effective compliance program to ensure medical device security risks can be mitigated to an acceptable level
  • Identify how healthcare Information Security needs to be adapted in order to address and mitigate the risk of a cyber-attack against medical devices
  • Identify the current security risks associated to medical devices as a result of our research and ongoing work with federal agencies and medical device manufacturers

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

Scott Erven, Managing Director, Health Industries Advisory Cyber Security & Privacy, PwC

 

505

Physician Compliance

Physician Engagement in the Compliance Process

  • Physicians as leaders; identifying opportunities for physicians to engage in compliance program oversight
  • Physicians as partners; opportunities in the day to day operations of the compliance program
  • Physicians as champions; leveraging relationships to demonstrate program compliance

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

R. Brett Short, Chief Compliance Officer, UK HealthCare/University of KY

Sarah M. Couture, Associate, Aegis Compliance & Ethics Center LLP

 

506

Compliance Lawyer

Managed Care Fraud: Enforcement and Compliance

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

Pamela Brecht, Attorney/Partner, Pietragallo Gordon Alfano Bosick & Raspanti, LLP

Sarah Kessler, Associate Counsel, OIG HHS, Washington, DC

Ed Crooke, Senior Counsel for Healthcare Fraud, U.S. Department of Justice, Civil Division

 

507

Auditing & Monitoring

Sampling and Statistical Methods for Compliance Professionals

  • Random and non-random sampling methods as applied to compliance audits along with mention of attribute and variable sampling
  • Descriptive and inferential statistical methods employing data derived from random audit samples
  • Overview of Predictive Modeling and Data Mining

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

Andrea C. Merritt, Partner, Athena Compliance Partners

Frank C. Castronova, Health Care Management Biostatistician, BCBS of Michigan

 

508

Internal Audit

The How and When of Leveraging Internal Audit

  • Discuss how internal audit serves the organization
  • Learn how departments can leverage this function to serve as advisors both from a controls and consultative factor
  • Understand trends in internal audit, and how the function is changing for the future

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

Keith Graff, Director, PricewaterhouseCoopers

Alice Louie, Manager, PricewaterhouseCoopers

 

509

How to Succeed as a Compliance Professional

How to Keep Your Head Above Water in a Sea of Change

  • Strategies to identify what types of change your organization is dealing with and how to respond accordingly so you aren’t left wondering “how did I get here?”
  • The friends and enemies of a successful Compliance Professional... which do you possess?
  • Ever left wondering, now that I am here, what do I do next? We have some best practices that will help you define a path forward

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

Rick Irby, Senior Director, U.S. Ethics and Compliance Health and Wellness Practice Compliance, Walmart Stores, Inc.

JoAnn M. Stevens, Senior Director, U.S. Ethics and Compliance, Health and Wellness Operations Compliance, Walmart Stores, Inc.

 

510

General Compliance and Hot Topics

Join the JV (Joint Venture) Team! Best Practices for Providers, Payers and Vendors to Align Business Development, Legal Affairs and Corporate Compliance and Control Compliance Risk Before and After a Joint Venture Go-Live

  • Overview of Different JV Models: JV models to best align the partners and purposes: new enterprises, purchased assets, equity ownership models, and management services agreements, with a brief overview of Stark issues
  • Decision-Making and Joint Governance: Managing divergent interests to get buy-in from partners. Define a Code of Conduct, converge policies, and delineate responsibility for implementing and maintaining an effective compliance program
  • Auditing, Monitoring and Reporting: Due diligence during development, DRA and OMIG requirements, navigating a Risk Assessment and audit Work Plan, addressing findings, and reporting for independence and accountability

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

J. Eric Sandhusen, Compliance Director & Privacy Officer, Northwell Health

 

511

General Compliance and Hot Topics

Investigative Interviewing: What Researchers Have Found Works and Doesn’t Work

  • In this educational and entertaining session from a former U.S. Department of Justice attorney, you will learn which techniques are effective and which are not
  • Learn how to use scientifically validated interviewing techniques proven to obtain more information from witnesses
  • Learn advanced interviewing techniques that make it easier to differentiate between truth-tellers and those who are deceptive

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

Michael Johnson

 

AD2b/repeat

Advanced Discussion Groups

Dealing with Privacy Breaches

  • Learn how to assess a violation of the HIPAA Privacy Regulations
  • Understand how to perform a risk assessment for “low probability of compromise”
  • Discuss and assess the factors for determining if a breach is reportable

No presentation or handout available

Darrell Contreras, Chief Compliance Officer, Millennium Health

 

AD3b/repeat

Advanced Discussion Groups

The Partnership of Risk and Compliance

  • Discuss the primary differences between the roles of risk and compliance
  • Identify the key areas where risk and compliance can gain synergies in their functional activities, e.g.: risk assessments, planning, training, communications, auditing and monitoring, etc.
  • Discuss metrics for identifying return on investment for this partnership

No presentation or handout available

Sheryl Vacca, Chief Risk Officer, Providence St Joseph Health

 

AD4b/repeat

Advanced Discussion Groups

Program Operational Components: Monitoring and Safeguards

  • Discussion of the routine monitoring processes
  • Share ideas on how to identify and develop program safeguards
  • Come prepared to share your most effective compliance tools

No presentation or handout available

Jawanna King, Regional Compliance Director, Tenet Healthcare Corporation

Jeff Paul, Regional Compliance Director, Tenet Healthcare

 

 


Break Out Sessions 


601

General Compliance and Hot Topics

Compliance, The C-Suite, and The Board Of Directors: What To Report And How?

  • Maintaining an effective compliance program in a heighted enforcement climate while still helping to move the business forward
  • Effective communication strategies for interacting with Senior Management and the Board
  • How to address problem areas, given the increased risk of enforcement—both civil and criminal—and the focus on individual accountability with the leadership team

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

George Breen, Shareholder, Epstein Becker & Green PC

Lisa Melamed, Vice President of Corporate Compliance and Corporate Compliance Officer, Laser Spine Institute

Karen Glassman, Senior Counsel, Office of Counsel to the IG, DHHS

 

602

General Compliance and Hot Topics

How to Use and Not Abuse MGMA and Other Survey Data in FMV Compliance Programs: Why Flawed Data Usage Leads to Increased Compliance Risk

  • Understand the facts about what the survey data represent and how the data can be used appropriately for FMV
  • What data analytics show about the relationship of compensation to productivity, quality, and compensation stacking
  • Learn to use statistically valid and supportable methods in applying data for FMV physician compensation

 

Presentation

(2 slides/page)

 

Presentation

(3 slides/page)

Handout

 

Timothy Smith, Senior Managing Director, Ankura Consulting Group

Meghan Wong, Assistant Director, Data Solutions, MGMA

 

603

Long-Term Care

Are You Billing the New PT and OT Evaluation Codes Properly?

  • Understand definitions of new PT and OT evaluation codes
  • Learn the components that will determine the level of the evaluation code billed
  • Take away an audit tool to ensure your therapy departments compliance

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

Handout 1
Handout 2

Shawn M. Halcsik, Corporate Compliance Officer, Encore Rehabilitation

Nancy J. Beckley, President, Nancy Beckley & Associates LLC

 

604

Privacy & Security

Study of 1000 Vendor Security Practices

  • This presentation will cover the results from the most expansive study conducted to date of the security practices for 1000 vendors that provide products and services to healthcare providers and payers
  • The results of the study includes fascinating statistics about the prevalent gaps in security required to protect PHI
  • The presentation also includes practical case study for proactively mitigating your vendor breach risk

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

Alex Masten, Client Engagement Lead, Corl Technologies

Peter Merrill, Director Information Systems, Dartmouth Hitchcock

 

605

Physician Compliance

How to Develop Benchmarking Scorecards to Transition to Risk-Based Physician Auditing/Monitoring

  • Explore and give examples of the critical benchmarking techniques needed to assess the risk of a physician’s coding patterns
  • Demonstrate how to organize the analysis results into one comprehensive physician compliance scorecard
  • Discuss how to apply the benchmarking results to create a proactive risk-based audit plan. (Providing actual example audit plans)

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

Handout

Jared Krawczyk, Mathematician, Nektar Analytics

Andrei M. Costantino, VP of Integrity & Compliance, Trinity Health

 

606

Compliance Lawyer

Self-Disclosure: Obligations, Options, Outcomes

  • Obligations: A review of the relevant legal requirements and environment, including the 60 Day Rule
  • Options: How to decide whether to disclose and where to disclose
  • Outcomes: What to expect in resolving the disclosure under each option

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

Frank Sheeder, Partner, Alston & Bird

Tony Maida, Partner, McDermott Will & Emery

David Fuchs, Associate Counsel, Office of Counsel to the IG, U.S. Department of Health and Human Services

 

607

Auditing & Monitoring

CMS Provider Network Accuracy: Risk Assessment and Monitoring Strategies for Medicare Advantage Plans

  • Discussion of CMS communications regarding their concerns and the impact to beneficiaries when network information is incorrect
  • How to develop auditing activities including an assessment to identify potential risk areas for ongoing monitoring
  • How to set up routine monitoring activities and documenting/disseminating results

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

Philip J. Masser, Medicare Compliance Officer, Geisinger Health Plan

 

608

Internal Audit

How to Get Audit-Ready in 7 Steps

  • Learn what it takes to get audit-ready pass an OCR audit with success, and meet compliance requirements
  • Learn why a four-factor risk assessment is one of the most important things you can do to assess your risks, determine your security holes, and make necessary patches
  • Learn how to be proactive and take control of your privacy, security, and compliance practices, including building the right team, gathering the facts, preparing your responses

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

Kimberly B. Holmes, Senior Vice President & Counsel, Cyber Insurance, Liability & Emerging Risks, ID Experts

 

609

How to Succeed as a Compliance Professional

Building Your Healthcare Compliance Resume   

  • Starting to build your healthcare compliance resume can be a daunting task. These tips and suggestions from a seasoned professional will assist you in becoming a well-rounded compliance professional and assist you in setting your career in motion
  • What do you want your career to be? What types of modalities interest you/What types of jobs should you consider as you build your resume and how do you know if they are right? Are there people you can ask? How do you evaluate your progress?
  • Learn, learn, learn all you can about your chosen profession. Develop resources, join organizations, attend conferences. Above all, get involved. Develop lifetime relationships. Become the compliance professional you admire

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

Cristine M. Miller, Partner, Mountjoy Chilton Medley LLP

 

610

General Compliance and Hot Topics

What’s Next in Washington?

  • A look at what is coming down the pipe from regulators
  • The likely impact of the new Administration on healthcare enforcement
  • What Congress is thinking about in terms of healthcare legislation

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

Kimberly Brandt, Chief Oversight Counsel, US Senate Finance Committee, Majority Staff

 

611

General Compliance and Hot Topics

Compliance Is Ruff: A Dog’s Approach

  • Techniques used in the service dog training industry to gain compliance and correct unwanted behaviors
  • Methods utilized in the service dog training industry to work through challenging or difficult situations
  • How to apply these techniques and methods to enhance the effectiveness of a compliance program

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

Kimberly A. Lansford, Chief Compliance Officer, Shriners Hospitals for Children

Carol Lansford, Service Dog Trainer

Gabe II, Service Dog, Warrior Canine Connection

 

AD5b/repeat

Advanced Discussion Groups

Pointers and Pitfalls in Managing Work-Life Balance, Stress, and Burnout in the Compliance Profession

  • To bring compliance professionals together for a professional exchange of common stress points
  • Discuss the personal impact of the electronic communication
  • Learn from each other’s knowledge and experience

No presentation or handout available

Shawn DeGroot, Global Business Process Management Compliance Officer, Navigant Cymetrix

Robert Ossoff, Maness Professor of Laryngology and Voice, Vanderbilt University Medical Center

 

AD6b/repeat

Advanced Discussion Groups

Operational Components of a Compliance Program

  • What are the fundamental safeguards and how do we monitor?
  • Share your approach to annual compliance training
  • How do you measure compliance program effectiveness?

No presentation or handout available

Alvin Josephs, Senior Director, Risk Assessment and Culture, Tenet Healthcare Corporation

Ryan Whitehill, Manager Ethics & Compliance Training, Tenet Healthcare Corporation

 

AD7b/repeat

Advanced Discussion Groups

Compliance Programs for Provider-owned Health Plans and Alternative Payment Programs

  • Providers operating Medicare Advantage plans or participating in Medicare's Accountable Care Organization or other alternative payment programs (e.g. bundled payments)
  • Compliance Program implications and expectations
  • Regulatory oversight and areas of audit and enforcement focus

No presentation or handout available

Jenny M. O’Brien, Chief Compliance Officer, UnitedHealthcare

Michael Holper, SVP Integrity & Audit Services, Trinity Health

 

Break Out Sessions 


701

General Compliance and Hot Topics

Helpful Tips for Value Based Payment (VBP) Compliance Programs

  • Identifying the Compliance Program nuances under various VBP Programs (i.e. MSSP ACO, DSRIP, Bundle Payments)
  • Tips on leveraging your existing Compliance Program to compliment the VBP Compliance Program requirements
  • How best to engage participants and providers to participate in VBP compliance programs

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

Handout

Aaron J. Lund, Director of Compliance & Privacy Officer, Northwell Health

Greg Radinsky, VP, Chief Corporate Compliance Officer, Northwell Health

 

702

General Compliance and Hot Topics

Strategic Considerations in Resolving Voluntary Disclosures to CMS, OIG, and DOJ

  • Review relevant legal authorities, the final 60-day Overpayment Rule, and the CMS, OIG, and DOJ disclosure protocols
  • Discuss key benefits, risks, and implications of voluntary repayment and self-disclosures to different government entities
  • Learn practical strategies regarding damages calculation methodologies, scope of releases, penalties, and other considerations when determining how to make and resolve a disclosure to the government

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

Patrick Garcia, Associate Counsel, Hall, Render, Killian, Heath & Lyman, P.C.

Kenneth Kraft, Senior Counsel, OIG HHS

 

703

Long-Term Care

Cybersecurity in the Post-Acute Arena

  • Security 101 for a Compliance Officer
  • What are the most important areas to be monitored by a Compliance Officer?
  • Easy metrics for a Compliance Officer to monitor

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

Amy Brantley, EVP, Chief Compliance Officer, Golden Living

Lisa Spears, Chief Information Officer, Golden Living

          

 

704

Privacy & Security

Bored with Your Board’s Lack of Interest?

This session will discuss methods for engaging the Board in the Information Security and Privacy Programs:

  • Understanding the basics for why the Board must be involved
  • What the Board needs to know
  • Being a translator for the Board

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

Joseph Dickinson, Counsel, Tucker Ellis

Marti Arvin, Vice President of Audit Strategy, CynergisTek

 

705

Physician Compliance

Physician Training on Medical Necessity: What Is Important for Clinical Trials and How Does It Impact Revenue Integrity?

  • Create a sustainable monitoring program for PIs
  • Auditing and monitoring to help the cause not hinder it
  • Leverage expertise and tools to do so

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

Kelly M. Willenberg, Owner, Kelly Willenberg, LLC

 

706

Compliance Lawyer

Kickback and Stark Law Developments

  • Enforcement trends and other recent developments in kickback and Stark Law
  • What changes to expect from the Trump administration
  • Practical tips for navigating kickback and Stark Law compliance

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

Katherine Lauer, Partner, Latham & Watkins, LLP

Charles B. Oppenheim, Partner, Hooper Lundy Bookman, PC

Heather Westphal, OIG HHS

 

707

Auditing & Monitoring

Risk Assessments and Work Plans: Key Spokes in the Circle of Compliance

  • Why risk assessments are essential
  • A simple approach to conducting a Risk assessment
  • Compiling and reporting findings

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

Al Josephs, Senior Director, Risk Assessment and Culture, Tenet Healthcare Corporation

Laura Range, Vice President, Deputy Chief Compliance Officer, Tenet Healthcare Corporation

Kate Dunn, Compliance Officer, Tenet Healthcare Corporation

 

708

Internal Audit

Conducting an Internal Compliance Investigation When the Government Claims You Have False Claims

  • Learn when and how you should conduct an internal investigation; How to get started; Who to interview; Preserving the Attorney Client Privilege; Working with Government Attorneys
  • What are the major pitfalls to avoid during internal investigations?
  • How the recent U.S. Supreme Court Decision in Escobar will impact internal investigations, the government and qui tam relators

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

Joan W. Feldman, Partner, Shipman & Goodwin, LLP

 

709

How to Succeed as a Compliance Professional

Strategies for Professionalism When Tantrums Aren’t an Option

  • Learn strategies for remaining professional under challenging circumstances such as conducting investigations and consulting to defensive leaders
  • Learn strategies for communicating professionally with physicians and healthcare leaders
  • Learn how to better manage yourself in order to reduce your overall stress

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

Jay P. Anstine, President, Bluebird Healthlaw Partners, LLC

 

710

General Compliance and Hot Topics