Kansas City Regional Conference
September 21, 2018
Kansas City, KS
Discussion of OIG Work Plan Priorities
Patrick J. Cogley, CPA, Regional Inspector General for Audit Services, HHS OIG-OAS, Region VII
- Describe major ongoing OIG audits and evaluations
- Discuss focus areas for the OIG in the upcoming years
- Discuss changes to the OIG work planning process
A Strategic Approach to Physician Financial Arrangements
Susan Thomas, Consulting Manager, PYA
Shannon Sumner, CPA, CHC, Principal, PYA
- Identify physician arrangement review goals and discuss importance of reviews.
- Present critical components of physician contract compliance reviews.
- Identify key contracting, documentation and compensation-related issues including specific “real world” examples.
- Describe corrective actions and detail ongoing physician contract monitoring and “best practice” processes.
Handout (2 slides/page)
Current Trends in Data Privacy and Security Enforcement
Steve Mitchell, Regional Manager, HHS OCR Midwest Region
Iliana Peters, Shareholder, Polsinelli
- Current trends in HIPAA enforcement, including lessons learned from settlement agreement cases and civil money penalties
- Recent important guidance from OCR
- Latest statistics on breaches reported to OCR
- Phase 2 audit results
Denials Management and Revenue Integrity—Where Does Compliance Fall?
Diana Adams, RHIA, Independent Healthcare Auditor, RRA, Inc
Kim Enriquez, RHIA, CCS, CHC, DRG Validation Specialist, OmniClaim
- Defining denials management and revenue integrity
- Identify and correct root causes of denials to keep the claims “clean”
- Compliance- helping to reduce regulatory risk
CAHPS Compliance and Requirements in 2018
Kelsi Remmert, MHSA, Regional Patient Experience Advisor, Press Ganey Associates-Advisory Services
- Current CAHPS survey requirements and a look at what’s to come
- Dos and Don’ts when it comes to official CMS surveying
- Patient anonymity for surveys: should it be honored?
Achieving Internal Efficiencies by Aligning Compliance, IT and Audit
Sam Abadir, Vice President, Industry Solutions
- Internal Audit’s role as a third line of defense in an organization requires the highest level of independence and objectivity within the organization
- Operationally, this often results in Audit working in silos from the rest of the organization and a misunderstanding of the relationship between Audit and other business functions
- Technology and process improvements can now integrate and streamline the interactions between audit and the business functions making the internal audit less costly and more efficient while delivering higher value