November 16 - 18, 2020
2020 Healthcare Enforcement Compliance Conference
Virtual , Central Standard Time (CST)Agenda
All conferences are listed in Central Standard Time (CST)
Monday, November 16
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-Breakout Sessions#SPONSORSponsorship
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08:50 AM - 09:00 AMOpening Remarks
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09:00 AM - 10:15 AMGS1: Government Enforcement Panel Kirk Ogrosky, Partner, Arnold & Porter Gregory Demske, Chief Counsel to the Inspector General, HHS-OIG Jamie Yavelberg, Director, Fraud Section, Commercial Litigation Branch, Civil Division, USDOJ Allan Medina, Chief of the Department of Justice, Health Care Fraud Unit, Criminal Division, U.S. Department of Justice
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10:15 AM - 10:30 AMBreak
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10:30 AM - 11:30 AMBreakout Sessions#101101: 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, Office of Inspector General, U.S. Department of Health and Human Services
- 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#102102: 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- 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#103103: 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- 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 -
11:30 AM - 11:45 AMBreak
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11:45 AM - 12:45 PMBreakout Sessions#201201: 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, Office of Inspector General, HHS Pamela Brecht, Attorney/Partner, Pietragallo Gordon Alfano Bosick & Raspanti, LLP
- 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#202202: How OIG Uses Data in its Affirmative Cases & How Data Can be Incorporated into Compliance Geoffrey Hymans, Deputy Branch Chief, Exclusions Branch , OIG Barry Grosse, V.P., Audit, Compliance, Ethics & Risk Mgmt. & CCO, Augusta University- 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#203203: 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, Independent Advisor, Adam J Klein, LLC- 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 -
12:45 PM - 01:30 PMMid Conference Break
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01:30 PM - 01:35 PMOpening Remarks
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01:35 PM - 02:35 PMGS2: Whistleblowers: Who Are They, Why Do They Bring Cases, and What Makes a Good Whistleblower Case Jeb White, President & CEO, Taxpayers Against Fraud Education Fund Sarah Alexander, Attorney, Constantine Cannon LLP Susan Gouinlock, Attorney, Wilbanks & Gouinlock Andrew Stone, Partner, Stone Law Firm LLC
- Understand why employees become whistleblowers
- Advocate compliance culture that encourages internal reporting
- Recognize concerns that devolve into whistleblower cases
- List key factors of actionable whistleblower cases
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02:35 PM - 02:50 PMBreak
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02:50 PM - 03:50 PMBreakout Sessions#301301: Federal Administrative Sanctions Jennifer Leonardis, Senior Counsel, HHS OIG Julie Kass, Lawyer, Baker Donelson
- Understand OIG enforcement actions, remedies, and appeals
- Appreciate differences between available CMS enrollment actions
- Identify new CMS program integrity rules and authorities
Basic#302302: 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- 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#303303: Lessons Learned from Stark Investigations David Glaser, Shareholder, Fredrikson & Byron PA Matthew Krueger, United States Attorney, Eastern District of Wisconsin- 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 -
03:50 PM - 04:05 PMBreak
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04:05 PM - 05:05 PMBreakout Sessions#401401: Enforcement and Compliance for Pharmacies Jennifer Krusa, Chief Compliance Officer, PharmScript, LLC Daniel Meier, Healthcare Regulatory and Transactional Attorney, Benesch Friedlander Coplan & Aronoff Josh Lichtblau, Director, Medicaid Fraud Division, NJ Comptroller's Office
- 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#402402: Why Whistleblowers Matter to Healthcare Compliance Edward Baker, Counsel, Constantine Cannon LLP Sandra Miller, Partner, Womble Bond Dickinson (US) LLP- 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#403403: Trends and Best Practices in Healthcare Privacy and Security Investigations Jonathan Skrmetti , Chief Deputy Attorney General, Office of Tennessee Attorney General Brian Stimson, Partner, McDermott, Will & Emery LLP Timothy Noonan, Deputy Director, Health Information Privacy Division, U.S. Department of Health and Human Services, Office for Civil Rights- 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 -
05:05 PM - 05:20 PMBreak
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05:20 PM - 06:20 PMBreakout Sessions#501501: Self-Disclosure Protocol Dennis Pangindian, Associate Counsel , HHS Office of Inspector General Tony Maida, Partner, McDermott Will & Emery
- Understanding the landscape; 60 day overpayment rule, The Civil Money Penalties Law (CMPL)
- Deciding whether to disclose and where to disclose
- Resolutions under OIG's Self-Disclosure Protocol
Basic#502502: The Secret Sauce for Complying with Privacy Regulations Karen Snyder, Dir Healthcare & Life Sciences Channels Solutions, Iron Mountain Darrell Contreras, Chief Compliance Officer, Millennium Health- Privacy is more of a priority than ever. Organizations must be able to react and respond quickly to increasing consumer privacy concerns, data breaches, and heavy-hitting regulations such as the CCPA and GDPR
- The key to a successful privacy program is instituting an information lifecycle management (ILM) program that provides strong governance rooted in policy. This protects your organization from compliance risks and is vital to protecting patient privacy
- Join us to discuss the impact of today’s privacy regulations and learn how ILM enables you to secure a unified view of patient data and related obligations, dispose of PHI in accordance with retention requirements, and reduce exposure to data breaches
Basic#503503: Encryption: Policy to Practice, Lower Risk, Increase Compliance! Uday Ali Pabrai, CEO, ecfirst- Examine encryption mandates defined in HIPAA Security, HITECH Act, PCI DSS, state regulations and more
- Review specific areas that encryption can have a significant impact in lowering enterprise risk, while improving compliance posture
- Step through core elements of an encryption policy to address both at-rest and in-motion requirements and understand how to simplify the use of encryption in your organization and do so consistently
Intermediate
Tuesday, November 17
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08:55 AM - 09:00 AMOpening Remarks
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09:00 AM - 10:00 AMGS3: CMS Update Kimberly Brandt, Partner, Tarplin, Downs & Young
- Overview of CMS COVID-19 response and flexibilities: waivers and interim final rules
- Update on CMS strategic initiatives, including Patients Over Paperwork and Interoperability
- Review of proposed updates to the Physician Self-Referral or Stark Law
- Learn about CMS program integrity initiatives and reforms
- CMS efforts to combat the opioid epidemic, including SUPPORT Act initiatives
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10:00 AM - 10:15 AMBreak
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10:15 AM - 11:15 AMBreakout Sessions#601601: Negotiating CIAs: What’s New, What’s Different, What Do You Need to Know? Mary Findley, Sr. Director, Alvarez & Marsal Healthcare Industry Group Felicia Heimer, Senior Counsel, Office of Counsel To the Inspector General, U. S.
- New provisions and requirements in the CIA
- Provisions OIG is willing to negotiate
- Top 10 FAQs
Intermediate#602602: Civil and Criminal Telehealth Enforcement Matters; DME, Pharmaceutical and Other Covered Items and Services Jason Mehta, Partner, Bradley Arant Boult Cummings Colin Huntley, Assistant Director, Commercial Litigation Branch, Fraud Section, Civil Division, U.S. DOJIntermediate#603603: Understanding and Preserving Privilege During Compliance Investigations Anna Grizzle, Partner, Bass, Berry & Sims PLC Aleah Schutze, Of Counsel, Steptoe & Johnson PLLC LeToia Crozier, Chief Compliance Officer, naviHealth- Compliance professionals periodically discover regulatory violations while undertaking their compliance duties. It is extremely important that compliance professionals work closely with their organization’s legal department when such matters arise
- This presentation will discuss the various types of privilege and will help compliance professionals identify when and how they should involve their organization’s legal department in an investigation in order to establish and maintain privilege
- We will provide specific examples and practical advice regarding how to communicate information within an organization, while still maintaining privilege
Intermediate -
11:15 AM - 11:30 AMBreak
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11:30 AM - 12:30 PMBreakout Sessions#701701: Laboratory Enforcement and Compliance Brandy Frey, Chief Compliance and Privacy Officer, HNL Lab Medicine Ryan Stumphauzer, Partner, Stumphauzer & Sloman Karen Glassman, Senior Counsel, Office of Counsel to the IG, DHHS
- Recent case studies, with a discussion of what those cases tell us about risks related to medical necessity and arrangements
- Practical solutions and best practices for mitigating risk
- Updates on the Eliminating Kickbacks in Recovery Act
Basic#702702: 340 B Compliance Cindy Bartlett, VP Chief Compliance Officer, St. Charles Health System Barbara Williams, Partner, Powers Pyles Sutter & Verville- Understand significant 340B program requirements and need for a robust 340B compliance program
- Obtain practical advice on implementing a 340B compliance program and key issues to target
- Hear 340B experts’ views on hot topics in the 340B program
Intermediate#703703: Three Competing Perspectives on Federal Healthcare Enforcement Trends: Federal Prosecutor, In-House Counsel, Outside Counsel Scott McBride, Partner, Lowenstein Sandler, LLP Bernard Cooney, Assistant United States Attorney, Office of the United States Attorney, District of New Jersey Joseph Mack, Senior Compliance Counsel, Bayer U.S- The panel will discuss current enforcement trends in the federal health care arena. Topics will include recent enforcement cases involving the False Claims Act, speaker programs, and the Anti-Kickback Statute
- The panel will discuss how the recent election may influence Department of Justice priorities and trends in healthcare enforcement
- The panel will discuss how in-house attorneys and compliance professionals can help their business leaders understand areas of enforcement and give practical tips on how best to partner with internal stakeholders in this regard
Advanced -
12:30 PM - 01:15 PMMid Conference Break
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01:15 PM - 01:20 PMOpening Remarks
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01:20 PM - 02:20 PMGS4: DOJ’s Consumer Protection Branch: Safeguarding Americans from Dangerous Drugs and Devices Gustav Eyler, Director, Consumer Protection Branch, U.S. Department of Justice
- Learn about the work and enforcement priorities of the U.S. Department of Justice’s Consumer Protection Branch
- Understand enforcement aims in the COVID-19 regulatory environment
- Identify risks and compliance considerations associated with clinical trial fraud, reporting requirements, and data privacy
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02:20 PM - 02:35 PMBreak
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02:35 PM - 03:35 PMBreakout Sessions#801801: Get 'Em Where it Hurts - Using Compensation to Influence Compliance Steve Schoenly, Chief Compliance and Privacy Officer, Refresh Mental Health Alyssa Lawrence, Senior Director, UHealth Compliance, University of Miami Health System
- Carrot or the stick: determining reward or consequence shapes human behavior
- Governance impacts ability: how compliance can work with management to achieve goals
- Money talks: if you can equate compliance with compensation, you’re in the gold
Basic#802802: Enforcement and Compliance Risks Associated with the Opioid Crisis: Who's to Blame Will Cast a Wide Net Robert Trusiak, Compliance Officer, Catholic Charities Diocese of Rochester Natalie Waites, Senior Trial Counsel for Health Care Fraud, U.S. Department of Justice- How do compliance professionals manage, and not overmanage, mismanage or not manage the crisis
- Government and responses to the opioid crisis
- Next steps for tomorrow morning
Intermediate#803803: Ask the Stark Professionals Charles Oppenheim, Partner, Hooper Lundy Bookman, PC Lester Perling, Partner, Nelson Mullins Riley & Scarborough, LLP Robert Wade, Partner, Barnes & Thornburg LLP- Brief overview of the Stark Law
- Respond to pre-submitted & live questions regarding case examples of the application of the Stark Law
- Opportunity for an open discussion for compliance officers, lawyers, and executives who have questions related to the Stark Law
Advanced -
03:35 PM - 03:50 PMBreak
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03:50 PM - 04:50 PMBreakout Sessions#901901: CMS Oversight and Enforcement of Safety and Quality Standards Peter Urbanowicz, Managing Director, Alvarez & Marsal David Wright, Director, Consumer Protection Branch , U.S. Department of Justice
- Learn how CMS is enhancing its oversight activities, including oversight of State Survey Agencies and accrediting organizations, in order to fulfill its critical obligation to develop and enforce essential standards for safety and quality
- Measures providers can implement to recognize and address quality and safety deficiencies to avoid increased survey activity and enforcement actions
- If a CMS survey is inevitable, learn how to prepare for and what to expect during the visit and how to best respond to CMS requests and findings
Intermediate#902902: Big Data: How Can It Be Shared and What Are the Considerations Regarding Enforcement? Marti Arvin, Executive Advisor, CynergisTek, Inc. Blaine Kerr, Sr. Director of Security and Privacy Compliance, Ensemble Health Partners- Brief primer on the way in which individually identifiable information can be shared with regulatory parameters, both federal and state
- Discussion of considerations when evaluating the sharing of big data sets with third parties for healthcare operations and/or research
- Overview of the enforcement trends: Where it has been, where it is going, consumer privacy concerns, class actions and more
Intermediate#903903: Hot OIG Target Area: Device Reporting & Related Outlier Payments Michael Calahan, V.P. Compliance, HealthCare Consulting Solutions- Review the newest OIG-favored target area for hospital audits and learn the 2020 rules & regulations as well as Medicare Program changes for medical device credit reporting!
- Hospital Inpatient, Hospital Outpatient and ASC: Do you know how to identify which devices get reported when a credit is received? Do you know how to correctly report the credits in each of these settings?
- Clouding the picture for accurate reporting: Newly invigorated OIG audits with a specific target of APC outlier payments related to medical device credits-do you know if you are receiving additional outlier payments?
Intermediate -
04:50 PM - 05:00 PMBreak
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05:00 PM - 06:00 PMVirtual Social Event - Live Piano Show
- Interact and engage with your fellow attendees at this request-driven piano show
- Bring your song requests and favorite beverage for this musical variety show with thousands of songs to choose from spanning many decades and genres
Wednesday, November 18
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09:00 AM - 10:30 AMBreakout Sessions#W01W1: Compliance, Internal Investigations and Self Disclosure: Building the Team, Process, and Resolution Gabriel Imperato, Managing Partner, Nelson Mullins Riley & Scarborough Nancy Hayt, VP, Corporate Responsibility, AdventHealth
- Identifying potential non-compliance through an effective compliance program
- Organizational governance and internal investigations; authority and practical considerations
- Methodology for internal investigations; establishment, personnel and resources, probable cause and preponderance of evidence, privilege, and findings of fact
- Practical tips; investigation workplan, conducting interviews, collecting documents and e-data, establishing facts and final report
- Resolution; remedial action and self-disclosure and managing the risk
- Compliance professionals and best practices
Advanced#W02W2: Medical Necessity and Civil and Criminal Liability Judy Ringholz, VP of Compliance and Ethics & Chief Compliance Officer, Jackson Health System Jeffrey Dickstein, Partner, Phillips & Cohen LLP Brian Bewley, Partner - Healthcare & Life Sciences, Manatt, Phelps & Phillips, LLP Alison Rousseau, Senior Trial Counsel for Health Care Fraud, U.S. Department of Justice- Medical necessity cases are very much alive in the FCA world, though the environment is ever-changing. This panel, consisting of an attorney in DOJ’s Civil Division, a health system chief compliance officer, defense counsel and relator’s counsel will examine the evolving landscape
- We will consider the primary legal issues involved in medical necessity cases, recent relevant court rulings, as well as the regulations typically in play in common questions of medical necessity
- We will discuss when fraudulent conduct becomes criminal conduct in cases alleging medically unnecessary testing and/or procedure
- Do robust compliance measures prevent medical necessity cases, do aggressive defense tactics head them off, We will examine the effect of compliance and defense strategy on DOJ investigations of allegations of lack of medical necessity
Intermediate#W03W3: Electronic Health Records Fraud Enforcement: What, Why, and Thoughts for Compliance Professionals Joshua Boxer, Chief Compliance Officer, Chief Privacy Officer, Integra Connect Ryan OQuinn, Chair Litigation Department, Miami, DLA Piper LLP Karen Stewart, Surveillance Program Manager, Drummond Group (ONC-ACB)- Overview of government enforcement actions related to EHR providers. A new era in enforcement: software meets false claims
- Accreditation and ongoing compliance obligations related to EHR providers and those providers who use them for incentive reporting
- Proactive measure for compliance professionals to prevent and mitigate exposure
Intermediate -
10:30 AM - 10:45 AMBreak
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10:45 AM - 12:15 PMBreakout Sessions#W04W4: Negotiating and Mediating False Claims Act Cases Sean O'Connell, Counsel, Hunton Andrews Kurth LLP Janice Symchych, Mediator and Arbitrator, JAMS Marc Raspanti, Partner, Pietragallo Gordon Alfano Bosick & Raspanti, LLP David Cohen, Senior Trial Counsel, U.S. Department of Justice
- The increased difficulties in negotiating and settling False Claims Act cases
- Understanding the roles of the different stakeholders in False Claims Act cases and what they’re entitled to
- Understanding the risks of going to trial and why it may be the best option
Advanced#W05W5: Compliance Officers, General Counsel and Enforcement Kirk Ogrosky, Partner, Arnold & Porter Mara Senn, Director and Senior Counsel of Global Compliance Investigations, Zimmer Biomet Jeffery Hessekiel, Executive Vice President and General Counsel, Exelixis Pharma- Discover DOJ’s current 2020 enforcement priorities
- Understand how conflicts of interest impact investigations
- Learn the GC’s and CCO’s roles in conducting internal investigations
- Hear when companies and providers need to retain outside counsel
- Apply best practices to issue spot in today’s enforcement environment
Advanced#W06W6: W6: Data Analytics and AI to Detect and Defend Fraud Samantha Badlam, Counsel, Ropes & Gray LLP Emily Treanor, Enterprise Relationship Executive, Lextegrity- Kickbacks and fraud can hide in dark corners of your organization. Data analytics and AI can provide powerful tools to prevent and detect such behaviors. Join an interactive panel using sample data and visualizations
- Learn from a former in-house compliance counsel and current outside counsel with enforcement expertise about how data analytics and AI can transform the risk management efforts of healthcare organizations of any size
- Learn how shifting expectations of government agencies mean that not using data analytics and AI to prevent and detect kickback and fraud risks is no longer a viable option for healthcare organizations
Intermediate -
12:15 PM - 01:00 PMMid Conference Break
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01:00 PM - 02:30 PMBreakout Sessions#W07W7: Anatomy of a False Claims Act Case Michael Morse, Partner, Pietragallo Gordon Alfano Bosick & Raspanti, LLP Lisa Re, Assistant Inspector General for Legal Affairs, Office of Inspector General, Department of Health & Human Services Sean O'Connell, Counsel, Hunton Andrews Kurth LLP Arthur Di Dio, Senior Trial Counsel, U.S. Department of Justice Gabriel Imperato, Managing Partner, Nelson Mullins Riley & Scarborough
- The Investigation Phase: subpoenas/ CIDs, data analysis, witness interviews and more
- The Negotiation Phase: initiation, ADR, scope of release, monetary and other issues
- The Resolution Phase: settlement agreements, individual liability, CIAs/ OIG and relator issues
Intermediate#W08W8: Medicaid Fraud Enforcement Update Jack Wenik, Partner, Epstein Becker & Green PC Josh Lichtblau, Director, Medicaid Fraud Division, NJ Comptroller's Office- Recent developments in Medicaid fraud/abuse enforcement at the state level, including regarding managed care organizations
- Focus on home health, adult day care and other providers receiving extra scrutiny
- Government and defense perspectives in responding to Medicaid fraud and abuse investigations
Basic#W09W9: Litigating a False Claims Act Case Scott Grubman, Partner, Chilivis, Grubman, Dalbey & Warner, LLP Linda McMahon, Senior Trial Counsel, U.S. Department of Justice- Define and discuss key provisions of the False Claims Act that regularly get litigated
- Identify emerging issues that often arise during FCA litigation
- Learn strategies for maximizing discovery in FCA cases
Advanced -
02:30 PM - 02:45 PMBreak
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02:45 PM - 04:15 PMBreakout Sessions#W10W10: CIA's and IRO's- What Are They and Why Do They Matter? Bert Lacativo, Partner, Stone Turn Steven Ortquist, Founder & Principal, Arete Compliance Solutions, LLC Laura Ellis, Senior Counsel, Office of Inspector General, HHS
- An introduction to Corporate Integrity Agreements (CIAs) and the requirement for the settling organization to engage an Independent Review Organization (IRO)
- Receive an overview of who can become an IRO along with a discussion of the IRO function
- Learn how an IRO interfaces with the organization, its expectations and reporting responsibilities
Intermediate#W11W11: Is your Conflicts of Interest Program Effective? Debra Berns, Senior Vice President and Chief Risk Officer, as Memorial Sloan Kettering Cancer Center Colleen Curran, Managing Director, Alvarez & Marsal Healthcare Industry Group Julie Hamilton, Managing Director, Deloitte & Touche, LLP- Highlights of regulatory and enforcement activity related to conflicts of interest (COI)
- Components of an effective COI program
- Lessons learned and tactical steps for assessment and enhancement of COI programs
Intermediate#W12W12: Understanding the Components of a Comprehensive Compliance Risk Assessment Process Anne Daly, Chief Compliance & Integrity Officer, Ann & Robert H. Lurie Children's Hospital of Chicago Thomas Herrmann, Senior Managing Consultant, Strategic Management Services- Review the importance of risk assessment in health care compliance, including an overview of historical and recently published health care regulator guidance and enforcement (DOJ, OIG, OCR etc.)
- Outline and discuss the core components for a credible compliance risk assessment process
- Elaborate on processes, tips, and best practices for implementing and supporting compliance risk identification and mitigation
Intermediate -
04:15 PM - 04:30 PMBreak
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04:30 PM - 06:00 PMBreakout Sessions#W13W13: Strategies and Best Practices for Responding to Enforcement Activities Gabriel Imperato, Managing Partner, Nelson Mullins Riley & Scarborough David Glaser, Shareholder, Fredrikson & Byron PA
- Responding to criminal, civil or administrative enforcement actions
- Best practices for interaction with government attorneys, agents and auditors
- Preparing current and former employees for government contacts
Intermediate#W14W14: Handling a Criminal Healthcare Fraud Case Ralph Caccia, Partner, Wiley Rein LLPAdvanced#W15W15: Root Cause Analysis Workshop Dwight Claustre, Retired Compliance Professional Rosalind Cordini, Senior Vice President, Coding & Compliance Services, Coker Group- Participants will review and understand the Department of Justice’s 2020 guidance pertaining to the performance of root cause analyses
- Participants will understand the root cause analysis structure and purpose
- Participants will perform a root cause analysis pertaining to a [mock] serious compliance issue to learn skills for the performance of a root cause analysis in their institutions/organizations
Intermediate
All breakout sessions have a knowledge level associated with them, these levels are just guidelines and you are free to attend sessions of any level.
Basic: Program knowledge level most beneficial to Compliance Professionals new to a skill or an attribute. These individuals are often at the staff or entry level in organizations, although such programs may also benefit a seasoned professional with limited exposure to the area.
Intermediate: Program knowledge level that builds on a basic program, most appropriate for Compliance Professionals with detailed knowledge in an area. Such persons are often at a mid-level within the organization, with operational or supervisory responsibilities, or both.
Advanced: This level focuses on the development of in-depth knowledge, a variety of skills, or a broader range of applications. Advanced level programs are often appropriate for seasoned professionals within organizations, and professionals with specialized knowledge in a subject area.