The Accidental Compliance Professional (Stories and Lessons Learned)
Roy Snell Former CEO SCCE & HCCA Gerry Zack CEO SCCE & HCCA
• Fill every hole that the rats might get through
• Sowing the seeds of compliance around the world
• College pranks gone wrong
• Compliance activism belongs in a rodeo
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2019 Regulatory and Compliance Highlights
Felicia Sze Founding Partner Athene Law
• Track recent updates on regulatory compliance trends for providers and plans, including how you may tailor your compliance program in light of the updated DOJ Guidance on an Effective Compliance Program
• Recent enforcement and False Claims activity
• OIG work plan updates
• Practical tips for strengthening your compliance program
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Medicare and Other ValueBased Payment Programs and Compliance Oversight
Margia Corner Principal Counsel, University of California Office of General Counsel
Hilary L. Isacson Associate General Counsel Sutter Health
• Secretary Azar has repeatedly emphasized that moving to value-based healthcare payment and delivery system is one of the Trump Administration’s top priorities and that experimentation—testing mandatory alternative payment models—is a critical pathway to that transformation
• 2019 brought significant changes in program rules and policies for two of the largest value-based payment programs in Medicare: the Medicare Shared Savings Program and the Merit-Based Incentive Payment System (MIPS) for physicians and other non-physician practitioners
• The presentation will provide an update on policy changes for these two programs, focusing on the compliance oversight opportunities and challenges associated with the new requirements, and also will address proposals for new mandatory Medicare valuebased payment models in radiation oncology and other changes
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Cyber Security Risks Facing Healthcare
Eric M. Liederman, MD, MPH, FACP Director of Medical Informatics The Permanente Medical Group National Leader, Privacy, Security and IT Infrastructure, The Permanente Federation
• Who is attacking us
• What cyber tools they are using against us
• How we can defend ourselves
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How Does Your Organization’s Compliance Program Stack Up in the Healthcare vs. Financial Services Industries?
Leyla Erkan Global Compliance Practice Lead Protiviti
Tom Giltrow Director Protiviti
• Description of the Office of Inspector General’s 7 elements of an effective compliance program
• Evaluating program maturity based on leading practices from financial services and other industries
• Explanation of why auditing a compliance program for effectiveness is critical in today’s environment
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Physician Arrangement Monitoring: Legal and Audit Perspectives for Practical Application
Patrick Matchell Compliance Officer Sutter Health
Laura Wilson Assistant General Counsel Sutter Health
The process for establishing a physician arrangement monitoring protocol can be confusing and cumbersome. Please join an attorney and an auditor for a discussion on physician arrangement monitoring, the critical importance of cross professional collaboration, and an overview of practical steps to establishing a physician arrangement monitoring program.
• Learn why physician arrangement monitoring is important and what types of agreements should be included in a monitoring program
• Hear the legal and audit considerations that are included in a functioning monitoring program
• Explore the various steps for standing up a monitoring protocol and reporting out the results to your organization
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