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Handouts

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Government Update

  • A holistic review of OIG’s current priorities
  • Anticipated OIG evaluation, audit, and enforcement work
  • A deeper dive into drug pricing, opioid misuse, and nursing homes.

Presentation 

Evaluation

Karen Schandler Glassman, Senior Counsel, Office of Counsel to the IG, DHHS

Ruth Ann Dorrill, Inspector General, Office of Evaluation and Inspections

 

20 Years as a Compliance Professional: Hard Lessons Learned and Ideas for Improvement

  • Sharing lessons from 60+ compliance program assessments
  • The importance of the Three Lines of Defense and compliance programs
  • Thriving vs. surviving as a compliance officer/department

Presentation

Evaluation

Ken Zeko, SVP, Compliance and Risk Services, Crowe Healthcare Risk Consulting, LLC

 

Integrity Matters

  • Encourage developing a culture of integrity
  • Understanding the Targeted Probe
  • Educate process Demonstrate the importance of returning ADRs

Presentation 

Evaluation

Janet Hunter, CMS/Novitas

 

How to Stay Synchronous with Telehealth Compliance Rules

  • Compliance opportunities in the telehealth regulatory landscape
  • Changes to CMS telehealth regulations – opening the gates
  • Controlled substance prescribing – the DEA
  • Results of the 2018 OIG audit of CMS telehealth payments

Presentation 

Evaluation

David Ellenbogen, Vice President Legal Counsel, Scott & White Healthcare

Julian Rivera, Partner, Husch Blackwell LLP

 

OCR Enforcement and HIPAA Highlights

  • Policy development
  • Breach notification
  • Enforcement
  • Audit

Presentation 

Evaluation

Erica Broussard, Investigator, OCR
 

Program Integrity: Fraud Prevention, Detection and Correction and Collaboration with Government Agencies

  • Learn about what Program Integrity means from a payer’s perspective
  • Understand how payers interact with government agencies related to fraud, waste and abuse
  • Learn about real world examples of fraud, waste and abuse prevention, detection and correction activities

Presentation 

Evaluation

Kelly Tobin, Director, UHC Special Investigations Unit

Amy Petschauer, Director, UHC Compliance