Agenda

Friday, December 10

  • 07:30 AM - 08:25 AM
    Registration and Continental Breakfast
    HoustonTX
  • 08:25 AM - 08:30 AM
    Welcome and Annoucements
    HoustonTX
  • 08:30 AM - 09:30 AM
    Partnering to Reduce Healthcare Fraud and OIG Healthcare Fraud Trends Derek Simmons, Special Agent, OIG, HHS
    • Inform participants on the mission of HHS and HHS organizational structure
    • Discuss resources available to assist in the detection and prevention of healthcare fraud
    • Provide participants with an overview of current healthcare fraud schemes/trends impacting the healthcare industry
    HoustonTX
  • 09:30 AM - 09:45 AM
    Break
    HoustonTX
  • 09:45 AM - 10:45 AM
    Enforcement Update Sean McKenna, Partner, Spencer Fane LLP
    • Hear from a former prosecutor and regulator regarding the state of affairs for healthcare providers, operational, and compliance professionals
    • Catch-up on recent theories, trends, and outcomes in a variety of liability settings
    • Gain insights into current state and federal enforcement initiatives
    HoustonTX
  • 10:45 AM - 11:00 AM
    Break
    HoustonTX
  • 11:00 AM - 12:00 PM
    Kicking tires and being at the right table: Delegation of Authority, Screening Vendors and Due Diligence Kenneth Zeko, Principal Advisor, Hall Render Advisory Services
    • Identifying and scrutinizing 3rd party relationships
    • Screening tips for vendors and other third parties
    • Due diligence for vendors and other third parties
    HoustonTX
  • 12:00 PM - 01:00 PM
    Lunch (provided)
    HoustonTX
  • 01:00 PM - 02:00 PM
    Considering how Compliance Programs are Like the Weather Karen Spillar, VP, Enterprise Risk Management & Chief Compliance Officer, The University of Texas Health Science Center at Houston
    • Understanding the importance of creativity and simplicity
    • Implementing risk-based, easily-relatable measurement tools
    • Using proactive tools to detect future risks
    HoustonTX
  • 02:00 PM - 02:15 PM
    Break
    HoustonTX
  • 02:15 PM - 03:15 PM
    What you need to know about price transparency and surprise billing – then how should you monitor? Lori Laubach, Partner, Moss Adams, LLP Kinal Patel, Senior Counsel, Foley & Lardner LLP
    • Understand the scope, risk, and impact of Federal price transparency rules
    • Identify the provider requirements under the Federal No Surprises Act and Texas analogies
    • Develop compliance strategies and audit processes to address price transparency and surprise billing requirements; and what compliance should consider if complaints are reported
    HoustonTX
  • 03:15 PM - 03:30 PM
    Break
    HoustonTX
  • 03:30 PM - 04:30 PM
    Flying Under the Radar: Case Study in Data Driven Fraud Detection Ally Montillo, Investigator/IA, OIG, HHS
    • Learn about the False Claims Act and national investigation into an alleged nationwide improper billing scheme
    • Examine how enforcement actions can stem directly from the use of data analytics
    • Identify and proactively combat fraud risks early in the healthcare context through the use of data analytics
    HoustonTX
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