#101

101: Preparing for the On-Site Regulatory Inspection Lela Goldwyn, Senior Compliance Analyst, Seattle Children's Hospital View Description

• Completing an on-site regulatory inspection of your practice from the front door signage to the hazardous waste pick-up. A simple method to assure your practice is protected against the myriad of regulatory requirements.
• Shared lessons from the field and Bernie Madoff too! How to conduct an invasive inspection without being intrusive. Ask the right questions before the inspectors do!
• Spotting discrepancies quickly, using an on-site survey for new acquisitions and how to conduct corrective actions.

General Compliance

#102

102: Ensuring Medical Necessity: The Overarching Criteria of Evaluation and Management Documentation Caroline Whitlock, Sr. Compliance Consultant, Health Tx Provider Network Jennie Moody, Supervisor, Physician Coding Compliance, Health Texas/Baylor Health View Description

• Clear and Present Danger: How EMRs contribute to lack of medical necessity
• True Grit: How to have the difficult discussions when the volume of documentation is the primary influencer
• The Pursuit of Clarity: Learn key concepts that every coder should do to accurately code Medical Necessity

General Compliance

#201

201: Do the Right Thing: Leading a Federally Qualified Health Center's Response to a Medicare Targeted Probe & Educate (TPE) Audit Robyn Hoffmann, Corp. Compliance Officer and QI Liaison, Fair Haven Community Health Clinic, Inc. View Description

• How to articulate the key requirements and potential outcomes of a Medicare Targeted Probe & Educate (TPE) audit to a Federally Qualified Health Center's Administration, clinical leadership, and Board of Directors
• How to develop an inter-departmental timeline and workflow to ensure a Federally Qualified Health Center's timely response to the Medicare Administrative Contractor (MAC)
• How to address Medicare TPE Round 1 findings pertaining to treatment plan documentation in the electronic health record (EHR) and ensure that Medicare enrollees are only booked with providers that meet Medicare's "core practitioner" requirements

General Compliance

#202

202: Identifying Compliance Problems in Your Practice Betzaida Shands, VP Regulatory Affairs/CCO, Univ Physician's Assoc Jerry Willis, VP of Operations & COO, University Physicians' Association View Description

• Assessing current workflow and compliance standards

• HHS (OCR, OIG) Physician Practice Roadmap

• Compliance standard implementation and beyond

General Compliance

#301

301: Timed Psychotherapy under the Revised CPT Construct: Looking Back on the First Year of the New Billing Standards vs the Standard of Care David Hoffman, Chief Compliance Officer, Carthage Area Hospital View Description

• The new requirement for timed billing has posed a compliance and ethical challenge for Billers and clinicians alike. In this session you will learn how to honor the therapist's obligation to the patient, and the coders duty to verify medical necessity
• Learn how to conduct chart reviews that verify adequate documentation for in-person and telemedicine encounters with patients young and old, and the caregiver's perspectives that influence treatment plans and prognosis
• The session will include a discussion of the use of experts to evaluate the indication for psychotherapy in special needs populations, and the role of "informants" in guiding the clinical judgments necessary to promote high quality care

General Compliance

#302

302: Physician Recruitment Agreements: the Dos and Don'ts of Income Support Cathy Bodnar, Chief Compliance and Privacy Officer, Cook County Health James Munz, Clinical Professor, Associate Director, MHA Program, Health Adminsitration , Governors State University View Description

• Consider the regulatory environment with a focus on Stark mandates and IRS scrutiny
• Establish oversight to avoid breach; tools and protocols for eligibility and monitoring compliance
• Solutions to remain compliant through remedies and corrective actions

General Compliance

#401

401: Incident-To Billing: The Convergence of Access, Documentation, and the Bottom Line Lynn Myers, Chief Medical Officer, TX Health Organization for Physicians View Description

• Review Definitions adn Requirements
• Get clear on "Incident-To" vs. Direct Billing
• Learn best documentation practices to support payment at the physician fee schedule

General Compliance

#402

402: Can the Provider Dismiss the Patient from their Practice? Michelle Pinter, Corp Dir Medical Group Compliance, McLaren Health Care Diana Nalett, Regional Director of Operations, McLaren Medical Group View Description

• The basics in patient dismissals
• The compliance professional's role and the role of other staff members
• How to handle patient dismissals once approved or denied

General Compliance

#501

501: DEA Compliance Bootcamp 101 with Case Studies Dennis Wichern, Partner, Prescription Drug Consulting View Description

• Learn what triggers a DEA audit and what investigators are seeking when they visit a hospital, medical office or pharmacy
• Recognize important and recurring opioid risk areas by a review of multiple case studies involving hospitals, pharmacies, and prescribers
• Learn practical strategies and tips to reduce opioid risk at your medical organization while complying with federal law

General Compliance

#502

502: CMS Audit Success: Prescriber Oversight and Documentation Strategies Michelle Rigby, Director, BluePeak Advisors, LLC Crescent Moore, Senior Consultant, BluePeak Advisors View Description

• Overview of CMS Audits and how Prescribers are impacted
• Recent changes in Medicare Guidance: What does that mean for Prescribers and how will these changes impact Prescriber documentation and oversight?
• How should Plans and Prescribers interact to be more compliant

General Compliance

#601

601: Evolution of Monitoring Tools in Physician Practice to Identify Risk Valerie Cloud, Assistant Vice President Corporate Compliance, Atrium Health View Description

• Design and implement tools that monitor risk in practice
• Develop computer based training and education on data analytics
• Share lessons learned on the improved experience from the physician practice constitutes

General Compliance

#602

602: Identifying Unexpected and Practice-Saving Clinical Risk Exposures: A Case Study Donna Nicholson, VP Risk Management, Curi - A Medical Mutual Co. View Description

• Using insights from a recent comprehensive clinical and operational risk assessment, this session will review unexpected risks and inconsistencies identified for a multi-location and multi-specialty healthcare organization
• Learn how to identify common areas of clinical and organizational risk and changes that can help ensure compliance -Take away risk management advice and processes to consider in the ever-shifting landscape

General Compliance

#701

701: Integrity without Ignorance Eric Christensen, Director of Client Services, Healthcare Compliance Pros View Description

• Learn how to educate staff in a process of honesty and accuracy with patient care, billing, coding, and with interpersonal relationships with co-workers and patients
• Understand how to address and report breaches, and how these are learning opportunities for your practice
• Educate yourself to be a leader in regard to whistleblowers and compliance hotlines

General Compliance

#702

702: Compliance in a time of crisis Dave Wortman Ron Pelletier, Founding Partner, Pondurance View Description

• In 2018, Hancock Health in Greenfield, IN was the victim of a cyberattack and ransom that took down their EHR, internet service, patient portal and email for four days. Two companies, Diagnotes and Pondurance, helped Hancock through the crisis
• Company founder and CEO Dave Wortman will explain why Diagnotes, a secure, HIPAA-compliant clinical communication platform, was not affected by the attack and how Hancock’s providers used Diagnotes to coordinate care and share system-wide crisis updates
• Ron Pelletier, the founder of Pondurance, will detail how his firm identified the point of entry for the attack, closed it down, worked with the FBI to help Hancock navigate the tricky Bitcoin ransom negotiations, and restored all systems

General Compliance