October 26 - 28, 2020
2020 Clinical Practice Compliance Conference
Atlanta, GA, United StatesAgenda
Monday, October 26
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08:30 AM - 09:30 AMGeneral Compliance Session: TBD
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10:00 AM - 11:00 AMBreakout Sessions#101101: Seven Elements of an Effective Provider Auditing Compliance Program Caroline Whitlock, Sr. Compliance Consultant, Health Tx Provider Network
- Billing and documentation compliance: Conducting internal monitoring and auditing
- Corrective action plans: Responding appropriately to detected offenses and developing transitional actions
- Education and training: Homegrown versus external options for reinforcement
Breakout Basic#102102: 21st Century Cures and Information Blocking for Clinical Practice Alan Fong, System Privacy Officer, CommonSpirit Health- Final rule implementation
- Information blocking, reasonable and necessary activities, and patient access to information
- Assessing APIs, mobile apps, and risks for clinical practice
Breakout Intermediate -
11:15 AM - 12:15 PMBreakout Sessions#201201: Building a Risk-Based Audit Plan Frank Cohen, Director of Analytics, Doctors Management LLC
- CMS has made it quite clear that healthcare providers need to step up their game with respect to risk-based audit methods. The day of the random probe audit is over.
- Both CMS and private payers have implemented advanced statistical systems that rely upon predictive analytics to identify high-value targets, meaning providers that are most likely to be tagged for an audit.
- In this session, attendees will learn about the Fraud Prevention System that is used by CMS to intercept payments for suspicious claims and how they can use more advanced analytics to improve their risk assessments and lower their audit risk.
Breakout Basic#202202: Uncovering Hidden Pitfalls in Medical Director Contracts Allison Pullins, Chief Strategy Officer, MD Ranger Inc Joseph Piccolo, VP Corporate Compliance, Inspira Health Brian Colonna, HIPAA Manager of Privacy, Renown Health- Every hospital, no matter the size, has medical directorship agreements that contain numerous compliance risks, which may not be obvious to even rigorous compliance teams.
- Learn best practices to mitigate risks lurking in directorships, such as commercially unreasonable agreements, stacking, “shopping” for rates, and more.
- Don't reinvent the wheel. Understand how to integrate best practice approaches to medical director contract compliance with your existing compliance and contracting program. No policy for medical directorships? Create one using simple guidelines.
Breakout Intermediate -
12:15 PM - 01:30 PMNetworking Lunch Lunch provided
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01:30 PM - 02:30 PMBreakout Sessions#301301: Clinical Documentation: Preparing Your Providers for Documentation Audits Lynn Myers, Chief Medical Officer, TX Health Organization for Physicians
- Time based code selection
- Key component documentation
- Documentation for Incident-to billing
- Documentation of commonly forgotten HCC codes
Breakout Basic#302302: Risk Matters That Merit Attention Amid A Crisis Valerie Cloud, Assistant Vice President Corporate Compliance, Atrium Health- Learn how to swiftly identify, track, and mitigate emerging risk
- Learn how monitoring questionnaires and self-reporting tools can drive better internal controls and risk management
- Learn how to manage and monitor your risk responses
Breakout Intermediate -
02:45 PM - 03:45 PMBreakout Sessions#401401: Mitigating the Risks from Opioid Prescribing: A Legal and Medical Perspective Amy Fogelman, Physician Consultant, MED LAW Consulting, LLC Jesse Caplan, Managing Director, Corporate Oversight, Affiliated Monitors, Inc.
- Healthcare providers who engage in inappropriate opioid prescribing are increasingly subject to discipline by professional medical and nursing boards, civil medical malpractice liability, and, in the most egregious cases, criminal prosecution
- Healthcare organizations should be proactive in ensuring they have effective opioid prescribing compliance programs that incorporate all relevant laws, regulations, CDC guidelines, and applicable standards of practice
- This program provides detailed information on the risks of opioid prescribing and the associated elements of an effective compliance program from a former healthcare regulator and a physician with expertise in opioid prescribing practices
Breakout Intermediate#402402: HIPAA Security: Common Mistakes Made by Physician Practices Marti Arvin, Executive Advisor, CynergisTek, Inc.- Failure to conduct adequate user access monitoring
- Lack of an adequate disaster recovery process, including a strong incident response plan
- Deficient basic security measures on devices and networks
Breakout Advanced -
04:00 PM - 05:00 PMGeneral Session: The Seasoned Professionals’ Guide to Building Resilience and Avoiding Burnout Sharon Grossman, Psychologist, Coach, Consultant, Author, Speaker, Coaching by Sharon
- Identify burnout’s symptoms for early intervention
- Develop self-awareness to increase stress management and prevent burnout
- Build up mental discipline to make you resilient to stress and burnout bulletproof
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05:00 PM - 06:00 PMWelcome Reception
Tuesday, October 27
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08:30 AM - 09:30 AMBreakout Sessions#501501: The Physicians in My Practice Want to Get Involved in Clinical Research: What Do I Need to Know and Do? Jennifer Sartor, Vice President, Compliance, National Spine and Pain Centers Sarah Couture, Managing Director, Ankura Consulting Group
- Research compliance basics for physician practice compliance officers
- How to develop a simple research compliance plan
- Best practices in implementing the research compliance plan while engaging physicians and practice administration
Breakout Basic#502502: HIPAA and Social Media Cathy Jefferson, Compliance Officer, University Hospitals- HIPAA and social media are very challenging for our physician offices; this presentation will define this new era of communication.
- This presentation will help physician offices to make sure they are not violating HIPAA regulations as they relate to social media and what to do if you find yourself sitting in front of OCR
- This presentation will provide tips and tricks to help educate your providers on how to participate in social media without violating HIPAA regulations
Breakout Intermediate -
09:45 AM - 10:45 AMBreakout Sessions#601601: Providers Coding and Documentation Audits. Data Mining and Collaborative Approach: The Key to Success Peiman Saadat, Vice President, Corporate Compliance Officer, AdvantageCare Physicians
- Create a constantly evolving program
- Use ongoing data mining, benchmarking, and trending alongside sampling reviews
- Offer post audit education and follow-ups
Breakout Intermediate#602602: Do the Right Thing: A Federally Qualified Health Center’s Response to a Randomized Audit by the Office of Inspector General Robyn Hoffmann, Corp. Compliance Officer and QI Liaison, Fair Haven Community Health Clinic, Inc.- Provide an overview of the goals of the Health Resources and Services Administration’s Access Increases in Mental Health and Substance Abuse Services (AIMS) award of $200 million in supplemental funding to Federally Qualified Health Centers (FQHCs) in 09/17
- Describe one FQHC’s approach in coordinating its response to the Office of Inspector General (OIG) randomized audit of AIMS grantees in May 2019
- Outline the lessons learned by the FQHC at the close of the OIG’s on-site audit and the anticipated timeline for the OIG’s release of its final report
Breakout Intermediate -
11:00 AM - 12:00 PMBreakout Sessions#701701: Reviewing Recent Activities Within the Opioid Crisis: Providers, Healthcare Entities and Pharmaceutical Companies Karyn Holley, Director, Corporate Compliance and Ethics, Inspira Health
- Review government agencies’ involvement, national statistics, scheduled substances, and indications for use of opioids
- Examine recent events involving pharmaceutical companies, providers, and healthcare entities within the opioid crisis
- Anti-Kickback Statute compliance tips for your program
Breakout Basic#702702: Why Clinicians Should be Concerned About the Stark Law and What to do About It Now Steven Ortquist, Founder & Principal, Arete Compliance Solutions, LLC- Review the Stark Law, Anti-Kickback Statute, exceptions, and safe harbors
- Discuss recent enforcement actions against physicians and physician practices
- Examine critical compliance processes you can implement to mitigate Stark Law & Anti-Kickback Statute risk
Breakout Intermediate -
12:00 PM - 01:15 PMNetworking Lunch Lunch provided
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01:15 PM - 02:15 PMBreakout Sessions#801801: Integration of Safety Culture Training to Increase Compliance Awareness Pat Zawko, Director of Quality Resources and Risk Management, Little Falls Hospital
- Add compliance training to safety culture training to increase compliance awareness
- Imbed compliance training in safety culture training to increase reporting
- Integrate compliance training in safety culture training to make safer organizations and decrease patient harm
Breakout Intermediate#802802: Incident to and Shared Visit Policy in Plain English David Glaser, Shareholder, Fredrikson & Byron PA- Recognize why the statement “new problems cannot be billed incident to” is incorrect; in fact, the test is whether care is in the course of treatment
- Recognize how private payers may apply different rules regarding shared visits and incident to
- Learn to distinguish between “best practices” and “regulatory requirements”
Breakout Intermediate -
02:30 PM - 03:30 PMBreakout Sessions#901901: Building a Physician Practice Audit Program (That Your Physicians Will Appreciate!) Mary Curry, Healthcare Compliance Officer, SIU School of Medicine Sarah Couture, Managing Director, Ankura Consulting Group
- Risk assessment: The foundation of your audit plan
- Best practices for a physician practice audit plan
- Essentials for physician and leadership engagement
Breakout Basic#902902: Best Practices in Managing Third-Party Valuations Christopher Carnahan, President, Carnahan Group Inc Daniel Stech, Senior Director, Carnahan Group Inc Gary Herschman, Chair, Health and Hospital Law Practice Group, Epstein Becker & Green PC- Define, categorize, and scope types of valuations
- Create internal standards, benchmarks, and valuation thresholds
- Establish internal process flow, project management, and approval systems
Breakout Intermediate -
04:00 PM - 05:00 PMGeneral Session: Short of Ventilators: How We Wound Up Here Again, and Probably will in the Future David Hoffman, Chief Compliance Officer, Carthage Area Hospital
- When the COVID-19 pandemic passes, numerous task forces, workgroups, and blue-ribbon panels will be formed to draw lessons from the successes and failures of our current response efforts. But why were we so unprepared this time?
- We know how we will respond after the pandemic passes because in each earlier public health emergency, we fell into the same scripted response
- In this session, the presenter will describe his involvement in hospital planning in response to the SARS, MERS, H1N1 and Ebola events, and how compliance officers must make sure that lessons learned are implemented and not forgotten
Wednesday, October 28
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-Breakout Sessions
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08:00 AM - 09:30 AMP1: Compliance and the Board: Challenges and Best Practices Brian Annulis, Sr Managing Director, Ankura Consulting Group
- Understanding challenges to effective board engagement
- Using best practice communication with the board
- Further enhancing the compliance/board connection
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09:45 AM - 11:15 AMP2: From Provider to Researcher and Patient to Subject: Responsibility and Role Changes in the Conduct of Practice-Based Human Subjects Research John Baumann, Associate Vice President for Research Compliance, Indiana University
- Explore the responsibility and role transformations that occur when health care providers conduct research with their patients
- Identify best practices for when health care providers conduct research with their patients
- Avoid common mistakes when the provider/researcher and patient/subject roles are blended
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11:15 AM - 12:45 PMLunch Lunch on your own today.
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12:45 PM - 02:15 PMP3: Billing and Coding Cases Gone Wrong Jay McVean, Director, UT Health C.J. Wolf, Director, Conflict of Interest, Intermountain Healthcare
- Modifier -25 woes: Examine cases of government settlements with providers who had problems with modifier -25 usage
- Incident-to billing: Discuss the details of enforcement examples when incident-to rules are not followed
- Coding the highest levels of codes: Investigators who mine data often hone in on aberrant patterns and outliers who report the highest level of E/M and other codes; we will examine examples and scenarios of where this can go wrong
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02:30 PM - 04:00 PMP4: The New Normal: Benefits of Successfully Navigating Change in a Fast-Paced Health Care Workplace Scott Lesnick, President, Successful Business Solutions llc
- Demonstrate a greater ability to successfully lead through and navigate a culture of change
- Prepare a stronger vision to stay productive, engage as a leader, and develop stronger relationships at all levels, and three key factors that allow individuals to stress less, grow engagement, and produce even during challenging times
- Improve your change management and communication skills to build a stronger, more agile staff/team, and learn to grow, mentor, and lead even during times of significant change