Welcome and Announcements

Complex, Crazy, and Challenging Privacy Issues Marti Arvin, VP, Chief Compliance Officer, Erlanger Health System

• Complex privacy issues involved in the use of big data sets
• Challenge of ensuring end users understand proper accesses, uses and disclosures of health information
• Crazy combination of privacy laws and the implications for today’s healthcare entity

Break

What is Records Management... And Why Should I Care? Barbara Benson, Director, Records Management Services, University of Washington

• The ROI of records management
• Accountability and the establishment of standards to minimize risk
• There must be some rules we have to follow - compliance responsibility

Break

Math and Mayhem Larissa Payne, Director Medicaid Fraud Division, Washington Attorney General's Office Matthew Kuehn, Assistant Attorney General, Washington State Attorney General Melody Crick Peters, Assitant Attorney General , WAMFCU

• Overview of the Washington Medicaid Fraud Control Division, including authority, jurisdiction and organization
• Highlights of recently prosecuted cases around the State of Washington demonstrating the types of fact patterns and trends we are seeing and some investigative strategies
• Highlights of recent civil cases locally and national, demonstrating the types of fact patterns and trends we are seeing and some investigative strategies

Lunch (provided)

Consent Issues with Minors Denise Atwood, Chief Risk Officer, District Medical Group

• Minors accessing health care – required consent
• Status of the minor and guardianship issues
• Three steps to comply with mature minor rule
• Case studies - open discussion with participants

Break

The Art of Benchmarking for Risk: How to Target Your Outliers Without Needing a Math Degree Jared Krawczyk, Director of Analytics, Nektar Analytics

• Explore benchmarking techniques needed to assess the risk of a physician’s coding patterns (E/Ms, Modifiers, Productivity, Procedural Billing)
• Demonstrate how to organize the analysis results into one comprehensive physician compliance scorecard
• Discuss how to apply the benchmarking results for the entire medical group into a singular prioritized audit plan (Providing actual example audit plans)

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Attorney Contacts, Subpoenas, Depositions, & Testimony - How Having a Legal Proceedings Consultant Can Protect Your Institution Brandy Bewley, Legal Proceedings Consultant, University of Washington

• Understand a treating provider’s role in a patient’s legal matter as well as the provider’s rights, obligations, and options related to attorney requests
• Understand the HIPAA requirements that must be met to ensure a healthcare provider and institution are complying with applicable laws
• Understand how a legal proceedings consultant can benefit a healthcare institution and play an important role in protecting it from liability exposure by helping its providers better understand applicable laws and policies to facilitate cooperation with the legal process