#SPONSOR

Sponsorship View Description

#101

101: Anti-Kickback Statute Case Studies and OIG’s Regulatory Flexibilities During the COVID-19 Pandemic Benjamin Wallfisch, Senior Counsel, Industry Guidance Branch, U.S. Department of Health and Human Services, Office of Counsel to the Inspector General Susan Edwards, Industry Guidance Branch-Chief (OIG), U.S. Dept of Health and Human Services View Description

• Review challenging real-world scenarios applying the anti-kickback statute
• Understand OIG’s pandemic-related regulatory flexibilities and guidance
• Awareness of OIG’s COVID-19 strategic goals

Intermediate

#102

102: False Claims Act Liability in Post-Acute Care Claudia Reingruber, Shareholder, Saltmarsh, Cleaveland & Gund Tamar Abell, CEO, TBA Consultant William Mathias, Shareholder, Baker Ober Health Law View Description

• A review of recent False Claims Act cases, both civil and criminal, and current enforcement focus areas in Medicare for SNF, home health and hospice providers
• Challenges facing post-acute providers, including those associated with new payments systems and regulatory requirements, and new claim audit initiatives
• Current enforcement trends, including potential liability for providers and management, sources of data to manage risk, expectations from CMS that providers have effective compliance programs, and enhanced focus on “worthless care” concerns

Intermediate

#103

103: Preventing Enforcement Actions in Clinical Research - Operational Strategies for Avoiding Financial Frauds Katherine Cohen, Chief Compliance Officer, Southern Illinois University Medicine Sarah Couture, Managing Director, Ankura Consulting Group View Description

• Billing errors in Clinical Research can and have resulted in large settlements arising from False Claims Act violations
• Accurate billing for research activities is dependent on an multi-step process involving numerous players, departments, and functions. Breakdowns at any point in the process can result in large fines, settlements, and CIAs
• This presentation will show how successful clinical research billing (CRB) revolves around ensuring your clinical research operations team is effectively communicating and that the rules are properly interpreted and applied

Advanced

#201

201: Managed Care Enforcement and Compliance Benjamin Singer, Partner, O’Melveny & Myers LLP Barbara Fonte, Vice President of Managed Care and Population Health, Jackson Health System Sarah Kessler, Senior Counsel, HHS-OIG Pamela Brecht, Attorney/Partner, Pietragallo Gordon Alfano Bosick & Raspanti, LLP View Description

• Consider examples of managed care fraud using past enforcement actions as a guide
• Recognize compliance risks in managed care
• Design & Implement bi-directional education & training between Managed Care and Compliance

Basic

#202

202: How OIG Uses Data in its Affirmative Cases & How Data Can be Incorporated into Compliance Geoffrey Hymans, Senior Counsel, Office of Inspector General, US Health and Human Services Barry Grosse, V.P., Audit, Compliance, Ethics & Risk Mgmt. & CCO, Augusta University View Description

• Learn how the OIG uses data to develop affirmative Civil Monetary Penalty Law and Exclusion cases
• Learn how data can be used in unorthodox ways, such as to prove knowledge, or in quality-of-care cases
• Learn how both large and small entities can incorporate data analysis into their compliance programs

Intermediate

#203

203: The Myth(s) of Median to 75th: New Perspectives on Assessing, Managing and Monitoring Physician Compensation Arrangement Risk James Sheehan, Chief, Charities Bureau, NY Attorney General Heather Fields, Shareholder, Chair - Hospital/Health Systems Practice, Reinhart Boerner Van Deuren s.c. Adam Klein, Managing Principal, Etza Consulting View Description

• Impact of USA ex rel. Bookwalter v. UPMC 938 F.3d 397 (3d Cir. December 20, 2019) the new Stark burden of proof is on the hospital
• Lessons from litigated cases about improving your organization’s physician compensation arrangement risk assessment process and strategies and resources for identifying and managing outlier arrangements at an enterprise level
• Innovative, lower cost, and more effective risk management alternatives for determining and monitoring FMV and commercial reasonableness, including tips for mitigating risks inherent in relying on survey data and “independent” FMV reviews

Intermediate

#301

301: Federal Administrative Sanctions Jennifer Leonardis, Senior Counsel, HHS OIG Julie Kass, Lawyer, Baker Donelson View Description

• Understand OIG enforcement actions, remedies, and appeals
• Appreciate differences between available CMS enrollment actions
• Identify new CMS program integrity rules and authorities

Basic

#302

302: DOJ Updated Guidance: June 2020 Judy Ringholz, VP of Compliance and Ethics & Chief Compliance Officer, Jackson Health System Sally Molloy, Chief, Strategy, Policy and Training Unit, U.S. Department of Justice, Criminal Division, Fraud Section View Description

• Review DOJ’s areas of focus when evaluating corporate compliance programs
• Recognize specific changes that have been made to DOJ’s guidance document as it has evolved
• Explore processes compliance officers can design to engender confidence in their program’s effectiveness

Intermediate

#303

303: Lessons Learned from Stark Investigations David Glaser, Shareholder, Fredrikson & Byron PA Matthew Krueger, United States Attorney, Eastern District of Wisconsin View Description

• A U.S. attorney and defense lawyer discuss how cooperation between the government and defendants can lower the cost of an investigation
• Analysis of Stark’s complexities, including how regulatory definitions can undermine arguments for both parties
• Exploration of the limitations in salary survey data and why it can be difficult to evaluate fair market value compensation

Advanced

#401

401: Enforcement and Compliance for Pharmacies Jennifer Krusa, Chief Compliance Officer Daniel Meier, Healthcare Regulatory and Transactional Attorney, Benesch Friedlander Coplan & Aronoff Josh Lichtblau, Director, Medicaid Fraud Division, NJ Comptroller's Office View Description

• Medicaid Enforcement Behind the Scenes: Identifying a healthcare provider/supplier with a focus on comparing claims, data mining and oddities
• Pharmacy’s Response: How to prepare for a state Medicaid review/audit, seek guidance and address the issues
• Resolution: Counsel’s role in considering options such as paybacks to MACs, use of the self-disclosure protocol or proceeding to litigation after appeals are exhausted, including discussion about cases and documentation

Basic

#402

402: Why Whistleblowers Matter to Healthcare Compliance Edward Baker, Counsel, Constantine Cannon LLP Sandra Miller, Partner, Womble Bond Dickinson (US) LLP View Description

• In light of recent research suggesting that companies with robust internal reporting systems are more profitable, and have lower litigation costs, than those that do not, what is the best way to handle whistleblower complaints to minimize risk?
• What is the process by which whistleblower complaints are filed, investigated, and litigated by the government?
• Strategies and best practice techniques to evaluate, litigate, and settle FCA qui tam complaints

Intermediate

#403

403: Trends and Best Practices in Healthcare Privacy and Security Investigations Jonathan Skrmetti , Chief Deputy Attorney General, Office of Tennessee Attorney General Brian Stimson, Partner Timothy Noonan, Deputy Director, Health Information Privacy Division, U.S. Department of Health and Human Services Office for Civil Rights View Description

• Trends in management and reporting of health information privacy and security incidents
• Emerging federal and state enforcement priorities regarding health information privacy and security
• Best practices for regulated entities involved in health information privacy or security investigations

Intermediate

#501

501: Self-Disclosure Protocol