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You are here : Resources  >  Resource Overview  >  Past Conference Handouts  >  Compliance Institute  >  CI2018  >  tuesday
2018 Compliance Institute presentations and handouts

Tuesday

Conference session handouts are organized by the day they were presented and sorted sequentially:

Sunday   |   Monday   |   Tuesday   |   Wednesday

Choose a session block

General Sessions          500's           600's         700's

* selected documents contain over 25 pages. Printing will be disabled during the institute, you will be able to print them before and after the conference.

 CEU Application (live conference)


Did you miss a session you wanted to attend? Get a recording of a session you missed.

Attendee prices: Each session only $20 or get the whole conference for $499

(Online recordings, Attendee prices)


Track color key

General Compliance and Hot Topics

Long-Term Care

Privacy & Security

Physician Compliance

Compliance Lawyer

Auditing & Monitoring

Internal Audit

How to Succeed as a Compliance Professional

Quality of Care

Advanced Discussion Groups

Industry Immersion

Session

Title/Description

Speakers

General Sessions | 8:40 am - 9:00 am


GS3

Update from CMS

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

Kimberly Brandt, Principal Deputy Administrator for Operations, CMS


General Sessions | 9:00 am - 9:50 am


GS4

Compliance as a Strategic Business Partner: A CEO’s Perspective

No presentation or handout available

Lloyd Dean, President and CEO, Dignity Health


General Sessions | 9:50 am - 10:30 am


GS5

Ethical Vigilance Creates a WellNow Culture

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

Rashmi Airan, Ethics Speaker and Consultant



Did you miss a session you wanted to attend? Get a recording of a session you missed.

Attendee prices: Each session only $20 or get the whole conference for $499

(Online recordings, Attendee prices)


Break Out Sessions | 11:00 am - 12:00 pm


501

General Compliance and Hot Topics

Escobar and the New Compliance Cartel

  • An overview of Universal Health Services, Inc. v. United States ex rel. Escobar and the new world of False Claims Act compliance
  • We Are Living in a Material World: understanding the important nuance of materiality
  • What Are You Implying: the practical solutions for explicit and implicit compliance

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

Jeffrey Jeter, Special Counsel, Jones Walker, LLP



502

General Compliance and Hot Topics

Operationalizing Compliance with the New Nondiscrimination Requirements of Section 1557 of the Affordable Care Act

  • Section 1557 of the ACA is the first civil rights law for the healthcare field and prohibits discrimination against patients, visitors, human subjects, and in employee health benefits, on the basis of sex, race, color, national origin, disability, & age
  • Section 1557’s regulation imposes several requirements and adopts several interpretations of the law that present new and significant compliance challenges to the industry. Providers must also take immediate action for compliance
  • This presentation will summarize Section 1557 and its regulatory requirements, address potential risks for litigation, and detail practical steps that healthcare providers must take to achieve compliance and minimize exposure to discrimination claims

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

Drew Stevens, Attorney, Arnall Golden Gregory LLP

Toby K. Morgan, Director of Compliance-Section 1557, Emory Healthcare, Inc.



503

Long-Term Care

Lions, Tigers, and Bears…Oh My! Walking through the Dark Forest of the Compliance Knowns and Unknowns in Mergers, Acquisitions, and Divestitures in Post-Acute Care

  • Best practices
  • Issues to avoid
  • Once the deal is done...

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

Handout 1
Handout 2

Sarah Finnegan, VP of Compliance, Kindred Health Care

Rachel Carloch, Corporate Compliance Officer, Consulate Health Care

Shannon Drake, General Counsel, Aveanna Healthcare



504

Privacy & Security

BAM! A Sound You Want to Hear When Working with Your Business Associates

  • Understand how effective Business Associate Management (BAM) is a vital function that both Covered Entities and Business Associates should perform continuously and effectively
  • Correlate the HIPAA requirements related to Business Associates with sound business practices that enable Covered Entities and Business Associates to work as a team in their shared commitments and expectations in the safeguarding of PHI
  • Learn from case studies of Covered Entities that were successful BAM practitioners as well as from those that were not so as to identify the best strategies to design and effectively implement BAM within your organization

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

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

Shawn Y. DeGroot, President, Compliance Vitals



505

Physician Compliance

A Roadmap for Medical Staff Corrective Action: How to Avoid the Many Pitfalls

  • Physicians and hospitals often find themselves in a quandary when clinical or behavioral concerns result in a request for corrective action: this session will map out the essential aspects from both the hospital and the physician standpoint
  • The Health Care Quality Improvement Act provides immunity to those involved in peer review if certain parameters are followed: this session will explain those parameters in the context of real life and offer practical insight
  • The nuances of when and how to report (or not) to the National Practitioner Databank as well as state licensing boards will be explained in a way that actually makes sense!

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

Sarah Coyne, Partner, Quarles

Jon Kammerzelt, Quarles & Brady LLP



506

Compliance Lawyer

Telemedicine and Digital Health: Compliance Hot Topics for 2018 and Beyond

  • This course, focusing on a 2018 hot topics update, is a practical discussion of hot topics in telehealth law and compliance, and what lawyers and compliance professionals can do to stay abreast in this rapidly changing area
  • Attendees will learn about new telehealth billing rules, multi-state provider enrollment, international arrangements, ABNs and charging beneficiaries, interstate licensing, e-prescribing, e-health commerce, and key telemedicine fraud & abuse rules
  • Attendees will receive a 2018 toolkit with charts, checklists, and resources. Session will also discuss texting patients, e-consults, and new non-face-to-face services

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

Thomas Ferrante, Attorney, Foley & Lardner

Monica Chmielewski, Attorney, Foley & Lardner, LLP



507

Auditing & Monitoring

MYSSION: Monitoring Your Short Stays and Observation Nights

  • Overview of regulatory changes and impact of the Two-Midnight Rule. Contractor and QIO reviews of short stays
  • Claims submission requirements and reimbursement impact examples of Condition Codes 44 and W2 for stays that do not meet inpatient requirements
  • Comprehensive demonstration of trended metrics to analyze and assist in determining if your Case Management, Utilization Review and Post discharge self- audit program is working effectively. Recommendations for process improvement

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

Handout 1 (xls)

Amy M. Gendron, Dir Clinical & Regulatory Compliance, Trinity Health

Patricia J. Hamon, OI Specialist, Trinity Health



508

Internal Audit

Leveraging Internal Audit & Forensics in Your Compliance Program

  • Learn how the Internal Audit program can be used to support compliance activities
  • Gain insight on forensic activities that can benefit your compliance program
  • Learn how Cleveland Clinic structured its Integrity Office to leverage Internal Audit and Corporate Compliance resources

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



509

How to Succeed as a Compliance Professional

Preparing for a Job Search

  • How to Build a Better Resume
  • Preparing for Your Interview
  • Interview Tips

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

Beth DeLair, President, Health Care Compliance Recruiting



510

General Compliance and Hot Topics

MACRA: Not Just for Providers

  • Understand providers will look to payers and health systems to support and collaborate to achieve MACRA’s objectives
  • How payers can offer clinical decision-support tools, access to data, better integrated care teams, additional CM / DM services, and share knowledge from past experience predicting risk to show value-add services and maintain / grow market position
  • Why this is important? This helps validate value based contracts and provides differentiation in the market with better providers in their network

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

Todd M. Gower, Advisory Sr Mgr Healthcare & Risk, Ernst & Young

Lisa Alfieri, Manager- Risk and Compliance, Ernst and Young



511

General Compliance and Hot Topics

Compliance Design in a World of New Models

  • Vicki Robinson, Senior Counsel for Policy, Office of the Inspector General
  • Consider compliance risks presented by new models of payment and delivery, including the role of data and quality; as well as how human resources can drive a compliance culture Explore new regulatory flexibility for increasing access to care and reducing costs
  • Educate start-ups and non-traditional players on program integrity principles

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

Kristen M. Lilly, Healthcare Consultant, PYA

Fatema Zanzi, Partner, Drinker Biddle Reath

Vicki Robinson, Senior Counsel for Policy, Office of the Inspector General



512

Industry Immersion

Out of the Shadows: Behavioral Health Compliance and Legal Issues for Every Provider

  • With the opioid crisis reaching unprecedented levels, integrated treatment is more important than ever. But 42 CFR part 2 limits the scope of information that treating providers can receive about a patient’s addiction history.
  • How can treatment providers navigate tension between obligations such as their duty to warn, mandated reporting, and maintaining privacy obligations?
  • Regulatory agencies and litigants are increasingly focusing on prescriber practices. What risks do prescribers face, and how can they reduce those risks if they may not have the patient’s whole medical history?

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

Gerald Fornwald, Attorney, Winthrop & Weinstine, P.A.

Jennifer Lohse, General Counsel, Hazelden Betty Ford Foundation



AD3b/repeat

Advanced Discussion Groups

Let’s Talk Shop

  • Compliance projects/activities (investigations, measuring program effectiveness, etc.)
  • How you solved it or how can your peers in this discussion group help, and
  • Lessons learned

No presentation or handout available

Al Josephs, Compliance Consultant


AD4b/repeat

Advanced Discussion Groups

Compliance Officer Ethics Scenarios

  • Discuss 5 ethics scenarios that the compliance officer may encounter
  • Review the role of ethics in compliance programs
  • Identify ethics frameworks to use in decision-making

No presentation or handout available

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



AD5b/repeat

Advanced Discussion Groups

The Intersection of Compliance and Quality Management

  • Discuss ways to effectively and positively collaborate with quality management on mitigating risks to improve organization outcomes
  • List the key role differences between quality and compliance
  • Discuss methods to bridge any “turf” gaps with quality or other operational units when implementing compliance program

No presentation or handout available

Lynda Hilliard, Healthcare Compliance Professional, Hilliard Compliance Consulting



Did you miss a session you wanted to attend? Get a recording of a session you missed.

Attendee prices: Each session only $20 or get the whole conference for $499

(Online recordings, Attendee prices)


Break Out Sessions | 1:30 pm - 2:30 pm


601

General Compliance and Hot Topics

Dealing with Legalized Medical Marijuana: The Dilemma Created by Conflicting Federal and State Laws

  • This presentation will address the current conflict between state laws permitting the use of medical marijuana and the federal prohibition
  • Discuss issues that healthcare providers need to consider when determining how to deal with emplolyees for whom medical marijuana has been prescribed
  • How to deal with patients for whom medical marijuana has been prescribed

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

Stephen H. Siegel, Of Counsel, Broad and Cassel



602

General Compliance and Hot Topics

Medicare Managed Care Compliance Standards for FDRs: Is Your Organization’s Compliance Program Adequate?

  • Develop an understanding of FDR compliance program requirements;
  • Learn about audit tools and protocols used by CMS and how Medicare Advantage Organizations use these to assess the compliance programs of their FDRs; and
  • Explore different strategies for achieving compliance with the requirements and responding to Medicare Advantage Organizations compliance program inquiries, attestation requests, and audits
Presentation (2 slides/page)
Presentation (3 slides/page)
Handout 1
Handout 2 * will not print on site
Handout 3
Handout 4 * will not print on site
Handout 5
Handout 6
Handout 7 * will not print on site

 

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

Rachel Haltiwanger



603

Long-Term Care

Compliance and Risk Management: A Marriage Made in LTC Regulatory Heaven

  • This session provides tips on developing compliance and risk management programs with limited resources. We will compare and contrast the requirements of compliance programs and enterprise risk management programs, in the LTC community
  • Who should be involved? Who is best to coordinate the efforts and can be "drafted" to assist? Presenters will touch a number of ways this can be approached by evaluating current activities through a compliance and risk lens
  • Is it possible to marry current activities with a compliance program? We will describe the activities, functions, and programs which can be leveraged to meet the regulatory challenges of a compliance program and an enterprise risk management program

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

Handout 1
Handout 2

Dawn Michelle Kinneer, Sr. Risk and Patient Safety Consultant, MMIC

Sharon L. Taylor, Dir Risk Management/AccreditationSvcs, Burgess Health Center



604

Privacy & Security

Unforeseen Vulnerabilities in Healthcare Mergers and Acquisitions

  • Mergers, integrations, and acquisitions are rapidly on the rise. While such healthcare integrations may be profitable, they introduce many challenges from an IT security and compliance standpoint
  • This session will cover specific steps organizations can take before and after an acquisition. Timing considerations and integration of toolsets is also a focus
  • Learning objectives include identifying and addressing security and compliance risks after a merger, formulating action plans for security plan implementation, and establishing a framework for pre-merger due diligence steps

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

Ryan Freeman-Jones, IT Risk Management Manager, Meditology Services

Martin Ignatovski, Chief Compliance Officer



605

Physician Compliance

The Dx on HCC: How Medicare Advantage Plans and ACOs Create New Compliance Risk for Physicians

  • Let’s delve into the CMS Hierarchical Condition Categories (HCC) Risk Adjustment system which is a primary driver of Medicare Advantage and Accountable Care Organization payments
  • Explore how HCC coding can expose physicians to financial and regulatory requirements, as well as have an impact on their professional fee billing
  • Learn how HCCs have impacted physician documentation and work flow, and the compliance risks that must be managed under this system

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

Kevin McPoyle, Director of Compliance, Jefferson Community Physicians - Northern Division



606

Compliance Lawyer

Real World Repayment Dilemmas: DRG Validation v. Clinical Validation v. Quality Measures v. Government Audit Findings

  • Background: Understanding Metrics for DRG Validation compared to Clinical Validation, Quality Metrics, Government Audits and how conflicting interpretations arise
  • Practical Considerations when faced with reported discrepancies including paradigms for conducting internal reviews and addressing potential repayment issues
  • Case reviews and examples

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

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

Nancy Hirschl, VP HIM Services, Streamline Health Inc.



607

Auditing & Monitoring

An Ounce of Prevention: Adding Cybersecurity Tabletop Exercises to Your Compliance Toolkit

  • Attendees will get a brief history of the evolution of tabletop exercises and their emergence as a valuable tool in testing cybersecurity preparedness and compliance with the HIPAA Security Rule and other regulatory requirements
  • A tabletop exercise overview will be presented and compared with other types of testing such as drills, functional exercises, and full-scale exercises.
  • Attendees will then participate in a live tabletop exercise and hotwash wrap-up of the exercise
  • The session will conclude with questions and answers on the exercise. Attendees will leave with a broad understanding of tabletop exercises and an insight into the effectiveness of this tool that can only be gained through active participation

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

Allyson J. Labban, Partner, Smith Moore Leatherwood LLP

Steve Snyder, Smith Moore Leatherwood LLP



608

Internal Audit

Identifying, Assessing and Auditing IT Risks in Health

  • Understand the implication of IT risks to key business strategies, objectives and processes
  • How to identify, assess and report IT risks to executives and integrate with enterprise risk management (ERM) and compliance
  • Review a sample of key IT risks (Cyber, IT provider and payer implementation etc.), controls and considerations for auditing them

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

Vishal Suchdev, Senior Manager, Ernst & Young



609

How to Succeed as a Compliance Professional

How to Change the Perception of Compliance from Obstacle to Business Partner   

  • Learn strategies to gain respect and buy-in for the compliance program in the organization
  • Learn how to build stronger relationships with leaders and overcome the defensive ones
  • Learn strategies for creating solutions that are compliant and business friendly

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

Jay P. Anstine, President, Bluebird Healthlaw Partners


610

General Compliance and Hot Topics

Managing Ethical Issues in FCA and Other Enforcement Actions

  • This panel will discuss best practices for conducting effective, efficient and cost-appropriate internal investigations as well as address ethical dilemmas that often arise in litigation
  • Panelists will review 2017 healthcare enforcement trends and offer an early outlook for 2018
  • This presentation will examine parallel investigations and negotiation of global resolutions, including requests for cooperation credit

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

Precious Gittens, Partner, Hooper, Lundy & Bookman PC

Roger Wenthe, Civil Deputy Chief, Civil Health Care Fraud Coordinator, U.S. Attorney’s Office, District of Nevada


611

General Compliance and Hot Topics

Are You Ready to Weather the Storm: Aftermath of Hurricanes Harvey and Irma

  • How governmental agencies have historically changed their regulations in emergency situations
  • Real life examples of working with governmental agencies during disaster situations
  • What provisions a compliance program should include to weather a disaster situation

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

Brian Beard, Senior Director Compliance, McKesson Specialty Health

Judy Ringholz, Vice President of Compliance and Ethics & Chief Compliance Officer, Jackson Health System


612

Industry Immersion

Key Issues an AMC Privacy Officer Should Know

  • Key monitoring that a privacy officer should consider
  • Considerations of access to EHR by non-clinicians and external parties
  • Approaching breach analysis when multiple covered entities are involved

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

Mildred L. Johnson, Compliance Director, Baylor College of Medicine

Colleen Shannon, Chief Compliance & Privacy Officer, Duke University Health System



AD6b/repeat

Advanced Discussion Groups

Stark: Mitigating the Battle Scars

  • Discuss who are the enemies and what are we doing to make them allies
  • Discuss and share mitigating processes
  • Discuss and share tools used to ease the battle scars

No presentation or handout available

Dwight Claustre, Managing Director, Ankura Consulting Group, LLC



AD7b/repeat

Advanced Discussion Groups

Strategically Shape Compliance & Ethics Outcomes

  • Create a forum of discussion with participants regarding the key strategies that help drive a compliant and ethical culture
  • Provide sample documents, methods and resources that can be used to leverage change and impact organizational results
  • Discuss best practices that participants are utilizing to foster networking and an opportunity to learn from one another

No presentation or handout available

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



AD8b/repeat

Advanced Discussion Groups

Privacy Officer & Researcher: The Reluctant Partnership

  • What are the differences in HIPAA requirements in the research world?
  • What are the HIPAA requirements that are the same as in the clinical world, but still a challenge for Researchers and their Covered Entities?
  • How does a Privacy Officer become their Researchers’ best friend?

No presentation or handout available

Joan Podleski, Senior Director & Chief Privacy Officer, Children’s Health



Did you miss a session you wanted to attend? Get a recording of a session you missed.

Attendee prices: Each session only $20 or get the whole conference for $499

(Online recordings, Attendee prices)


Break Out Sessions | 2:30 pm - 3:30 pm


701

General Compliance and Hot Topics

Current State, HRSA Audit Enhancements and What the Future Holds

  • Leveraging experiences from the 340B auditor/consultant and 340B attorney perspectives, discuss recent enhancements to the HRSA audit process, including areas of increased focus, and best practices to adequately prepare
  • Present the most frequently identified audit issues, root causes, and potential corrective actions to mitigate the risks moving forward
  • Provide an overview of the proposed regulation changes that may impact 340B programs and outline potential next steps covered entities should consider performing

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

Chris Wasik, National 340B Solution Leader, CHAN Healthcare

Kyle Vasquez, Shareholder, Polsinelli PC



702

General Compliance and Hot Topics

Creating Effective Compliance Program at Your Community Health Center

  • Compliance Program Effectiveness for FQHCs and similar community health centers
  • This focus will geared towards preparing for and passing a HRSA FQHC site visit
  • Each of the 7 elements will be included in the 19 program requirements for an all encompassing community health presentation that will be a nice primer for new compliance officers at community health centers

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

Trent Stechschulte, Compliance Officer & Legal Counsel, Equitas Health



703

Long-Term Care

How to Conduct a Compliance Risk Assessment

  • Compliance baseline audits and annual risk assessments will soon be mandatory for nursing home chains, and are a best practice for all nursing homes. Yet many homes have not completed the process, due to resources issues or not knowing where to start
  • In this session, we will take the mystery out of the compliance risk assessment process and walk through approaches you can take to conduct your own assessment - or oversee an assessment performed by a contractor
  • Special emphasis will be placed on strategies for evaluating compliance culture, board and Compliance Committee engagement, audit integrity, quality of reporting, and the program's ability to spot and address new compliance issues

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

Margaret Scavotto, President, Management Performance Associates

Scott Gima, COO & Executive VP of Compliance & Management, Management Performance Associates

          


704

Privacy & Security

Encryption Is Not Enough

  • What Privacy Officers need to know about encryption: review of how encryption protects data-at-rest and data-in-motion
  • Beyond encryption: explore ways a breach can occur even though data is encrypted
  • Questions to ask: review questions Privacy Officers can ask Security Officers and vendors to assess the protection of data

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

Andrew Rodriguez, Corporate Privacy and Security Officer, Shriners Hospitals for Children



705

Physician Compliance

When Physicians Work with Non-Physician Practitioners: Compliance Risks of Collaborative Practices

  • Increase in use of PAs and NPs is leading to more collaboration between physicians and non-physician practitioners. Review of some of the more common collaborative practice models
  • Overview of the regulations and guidelines governing how services should be documented and billed when physicians see patients collaboratively with non- physician practitioners
  • Review of common risk areas of collaborative practices and strategies for identifying and resolving these concerns in your organization

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

Brenden O’Neal, Regional Compliance Officer, Intermountain Healthcare



706

Compliance Lawyer

Ask the Stark Law Professionals: Q&A Session

  • General overview of the Stark Law
  • Bring your Stark Law questions and the panel will analyze and discuss "real time" potential Stark Law risks
  • "Live" answers to your Stark Law operational questions

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

Robert A. Wade, Partner, Barnes & Thornburg LLP

Lester J. Perling, Partner, Broad and Cassel LLP

Daniel Melvin, Partner, McDermott Will & Emery, LLP



707

Auditing & Monitoring

Physician Arrangement Auditing 101

  • Conduct a mock audit of a physician arrangement by reviewing key areas of focus as defined by the Stark law
  • Define and interpret audit findings
  • Discuss the role distinctions between the compliance officer and legal counsel when issues are identified

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

Handout

Anne E. Brummell, Compliance Program Manager, Honor Health

Juliette Stancil, Regional Compliance Officer, Presence Health



708

Internal Audit

Intersection of Internal Audit and Compliance

  • Identify opportunities to more efficiently and effectively monitor current and emerging areas of risk using the Lines of Defense as reference
  • Align Compliance and Internal Audit behind a common language for risk; promote strategic auditing of internal and external threats and harmonize monitoring activities
  • Promote Compliance and Internal Audit as trusted resources to help Operations keep pace with the evolving risk landscape and regulatory requirements

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

Maria Toribio, Director, PricewaterhouseCoopers

Jack Flaherty, Director, PricewaterhouseCoopers



709

How to Succeed as a Compliance Professional

David & Goliath: Compliance Investigations in the Era of Social Media

  • Building on Investigative Skills: intake, planning, online tools, and developing a final investigative report
  • Emerging Forensic Resources: tools, social media tips and tricks, consulting and legal support, efficiency, opportunities, and effective coordination with other key stakeholders (such as HR, Internal Audit, Legal, and IT) and their tools
  • Legal & Compliance: Effective Partnership & Coordination: attorney client privileges, privacy, policy and procedure development, competing legal issues (employment law, privacy, compliance, and associated case law discussion

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

Regina F. Gurvich, Vice President, Chief Compliance Officer, OMNI Ophthalmic Management Consultants, LLC

Christie A. Moon, Legal Counsel, Sutter Health

Brian Callihan, Director of Special Projects, Sutter Health



710

General Compliance and Hot Topics

Coding & Documentation Compliance Risks: Hints & Tips for the Compliance Professional

  • This presentation will provide an in-depth walk through the different healthcare settings that carry greatest and most frequent risks. The attendee will receive tips and hints to assist in their compliance work towards accuracy and data integrity
  • Accurate clinical documentation to support a true picture of patient illness is important to the revenue cycle, data analytics, and overall compliance.
  • Absence of accuracy carries great risk for any practice, facility or organization
  • Compliance professionals need to be on top of the many risk areas. Areas to be reviewed in this presentation are documentation and coding in the inpatient, outpatient, emergency and clinic. Additionally, CDI and chargemaster will also be reviewed

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

Dana L. Brown, President, Reimbursement Management Consultants, Inc.

Gloryanne H. Bryant, HIM Coding Specialist



711

General Compliance and Hot Topics

CIA Success Story: Settlement, Implementation, Effectiveness

  • Hear the former Amerigroup Chief Compliance Officer, IRO representative, and OIG attorney-monitor discuss how, after challenging settlement negotiations,
  • Amerigroup embraced its CIA, worked with OIG, and improved the effectiveness of its Compliance Program

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

Laura E. Ellis, Senior Counsel, Office of Counsel to the Inspector General, U.S. Department of Health and Human Services

Rita Isnar, Senior Vice President, Strategic Management Services, LLC



712

Industry Immersion

Barriers to Sharing Health Information in Behavioral Health

  • An overview of barriers to information sharing in behavioral health
  • Approaches to compliance with HIPAA and 42 CFR Part 2 in substance abuse treatment, particularly in an integrated care environment
  • Addressing operational challenges encountered in sharing PHI among health care providers and managed care organizations

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

Tim Timmons, Privacy and Security Officer, Greater Oregon Behavioral Health

Kelly T. Hagan, Attorney, Schwabe Williamson & Wyatt PC



AD9b/repeat

Advanced Discussion Groups

Risk Assessments: The Critical Role of Assessing and Managing Risk in Today’s Enforcement and Compliance Environment

  • Explore developments emphasizing the role of an active and effective enterprise wide risk management program and discuss wide ranging authority and other best practices for enhancing an organization’s ability to effectively assess and manage risk
  • Examine the role of various stakeholders in the risk management process (including compliance, legal, internal audit, senior leadership and governing bodies)
  • Identify challenges commonly experienced by organizations attempting to enhance risk management programs and consider potential solutions

No presentation or handout available

Sara Kay Wheeler, Partner, King & Spalding




AD10b/repeat

Advanced Discussion Groups

Navigating the Gray Zones of the Anti‑Kickback Statute

  • Review the boundaries of the Anti‑Kickback Statute, Special Fraud Alerts and Advisory Opinions
  • Identify techniques for applying the Anti‑Kickback Statute to situations that fall outside of the specific guidance
  • Discussion to analyze and apply the techniques to specific case scenarios

No presentation or handout available

Darrell Contreras, Chief Compliance Officer, Millennium Health



AD11b/repeat

Advanced Discussion Groups

Engaging your Executive Team and Board in a Strategic Vision for Your Compliance Program

  • Compliance program strategies? Is that an oxymoron?
  • Soup Nazi, Servpro or Smoky Bear? Creating and changing perceptions
  • What Drucker really said: the balancing act. Establishing objectives/measuring outcomes and building/nurturing relationships

No presentation or handout available

Steve Ortquist, Senior Managing Director, Ankura Consulting Group, LLC


Did you miss a session you wanted to attend? Get a recording of a session you missed.

Attendee prices: Each session only $20 or get the whole conference for $499

(Online recordings, Attendee prices)