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Agenda

Monday

 
Registration and Continental Breakfast (provided) 7:30 – 8:00 am
Welcome / Introduction 8:00 – 8:15 am
Introduction to Healthcare Compliance 

Introduction to Compliance Practice provides a basic introduction to healthcare compliance and compliance programs. It covers the seven essential elements of a compliance program and reviews the organizational steps necessary to implement a successful compliance program. The laws, rules, and regulations pertinent to compliance programs are introduced. Challenges confronting compliance officers are discussed.
8:15 – 10:15 am
Break 10:15 – 10:30 am
Compliance Oversight and Infrastructure

This course is designed to help compliance professionals understand the components of an effective compliance infrastructure. Discussed is implementation of a compliance program, selection of qualified staff, budgeting for compliance and the overall structure of the office. Time is spent discussing the various positions needed and the qualifications for each. The auditing position along with qualifications (coding credentials) is discussed. A compliance professional should be able to use what is taught in this course to design an adequate structure to facilitate an effective compliance program.
10:30 am – 12:15 pm
Lunch (provided) 12:15 – 1:15 pm
Standards, Policies, and Procedures 

Compliance-related policies which are current to — and meet the intent of — regulatory requirements and organizational expectations are the cornerstone of an effective compliance program. They provide staff with operational guidance on dealing with compliance related functions and provide the structure to establish a working program as well as a mechanism to initiate a periodic review of such policies related to compliance with applicable regulatory requirements. Understanding the differences between policy and procedures — as well as what are the essential components of compliance policies — also assists the participant in developing, implementing, and evaluating the adequacy of their compliance program policies.
1:15 – 2:45 pm
Break 2:45 – 3:00 pm
HIPAA Privacy and Security 

This session is a detailed review of the HIPAA Privacy and Security regulations. The discussion is focused on the primary components of each set of regulations so the audience will have a basic understanding of these regulations and be able to apply this knowledge to their daily compliance activities.
3:00 – 5:00 pm
   

Tuesday

 
Continental Breakfast (provided) 7:30 – 8:00 am
CHC Certification Discussion 8:00 – 8:15 am
Risk Assessment and Internal Controls 

If there were an eighth key element of compliance program guidance, risk assessment would be it. In this session, participants will learn what risk is and how it can be assessed, who should be involved in risk assessments, ways to identify risk areas, and what to do with the results of a risk assessment
8:15 – 10:00 am
Break 10:00 – 10:15 am
Routine Auditing and Monitoring 

Auditing and Monitoring is a critical element in any compliance program. In this session, participants will learn about the basic components of Auditing and Monitoring including different considerations for developing an audit, examples of reporting formats to communicate auditing and monitoring results and developing a compliance audit plan and soliciting management’s involvement in that plan.
10:15 am – 12:00 pm
Lunch (provided) 12:00 – 1:00 pm
Education and Training 

This course is designed to aid the participant in understanding adult learning techniques, effective teaching styles, topics of interest, and evaluation of the educational programs. An in-depth discussion centers on adult learning and how to design the classroom for retention. Also discussed is the adequate length of sessions, who should be included, physicians working with coders, and how often training should be held. The class designs and participates
in skits demonstrating effective training techniques focusing on compliance-related topics.
1:00 – 2:45 pm
Break 2:45 – 3:00 pm
Organizational Ethics 

The HCCA Code of Ethics sets an important standard for those doing compliance and ethics work in the healthcare field. In this class you will learn about such points as:
• What are the duties we, as professionals, owe to the public, our clients and the profession?
• What do we do when confronted with misconduct?
• What is our duty to keep the board informed?
• How do we deal with limits placed on our professional judgment?
3:00 – 4:45 pm
Networking Dinner (optional) 5:30 pm
   

Wednesday

 
Continental Breakfast (provided) 8:00 – 8:30 am
Conflicts, Discipline, and Incentives

The discussion will focus on the nature of conflicts of interest and the various healthcare areas where conflicts of interest are of particular interest, including regulatory oversight, industry guidance, and other documents that impact compliance professionals’ oversight of this area.
8:30 – 10:00 am
Break 10:00 – 10:15 am
Stark and Anti-Kickback 

The Anti-Kickback and Stark laws are at the heart of every healthcare organization’s compliance program—severe civil and even criminal penalties can result from compliance failures involving these important healthcare legal requirements. This session provides an overview of each law including discussion of recent enforcement actions, discusses similarities and differences in the two laws, and discusses strategies that can be implemented to promote
compliance.
10:15 am – 12:00 pm
Lunch (provided) 12:00 – 1:00 pm
Enterprise-Wide Billing and Reimbursement 

The healthcare business continues to become more complex with its many rules and regulations as healthcare costs continue to climb. The enterprise-wide billing reimbursement across the continuum curriculum provides compliance officers with a basic understanding of Medicare and Medicaid services and healthcare claims submission. The class covers basic compliance terminology as it relates to Evaluation and Management (E & M) code selection and billing terms; presents information on compliance billing risk areas that have been identified by the Office of Inspector General (OIG); and provides an overview of government activities to combat healthcare fraud and abuse.
1:00 – 2:45 pm
Break 2:45 – 3:00 pm
Internal and External Investigations 

This session identifies the many government agencies that can be involved in an investigation of a healthcare provider. It also provides in-depth discussion of the many factors that compliance professionals and their organizations must consider before, during, and after an internal investigation. It addresses the use of experts and consultants, and provides details about the attorney-client privilege and attorney work product doctrine. It offers
practical advice on how to conduct investigations.
3:00 – 4:45 pm
   

Thursday

 
Continental Breakfast (provided) 7:30 – 8:00 am
Legal Issues, Risk Factors, and Disclosure Issues 

This session focuses on the legal risks involved in compliance functions (in the circumstances of doing the right thing, and not doing so). It also addresses voluntary disclosures and the government’s expectations when providers identify instances of non-compliance. The session is practical and oriented toward addressing the many considerations that compliance professionals must address when designing, implementing, and practicing compliance functions, policies, and procedures.
8:00 – 9:30 am
Break 9:30 – 9:45 am
Effectiveness and Evaluation 

Since the early 1990s government agencies have indicated that credit would be given in the context of criminal and civil law enforcement actions to organizations that operate effective compliance programs. This session provides a historical review of what various government agencies consider when determining what makes a compliance program effective, reviews industry research and best practices related to effectiveness and evaluation, and  discusses methodologies for evaluating and measuring the effectiveness of a compliance program.
9:45 – 11:30 am
Academy Ends 11:30 am
CHC Exam Check-In Time 12:45 pm
Exam Time — Certified in Healthcare Compliance (CHC)® Exam (optional)

The CHC exam is optional. You must apply and pay for the exam separately from the Academy.
1:00 – 4:30 pm

Agenda is subject to change