2019 Clinical Practice Compliance Conference

1. Evolution of Monitoring Tools in Physician Practice to Identify Risk

   2019 Clinical Practice Compliance Conference  | Presenter(s): Valerie T. Cloud  | October 29, 2019 

   • Design and implement tools that monitor risk in practice

   • Develop computer-based training and education on data analytics

   • Share lessons learned on the improved experience from the physician practice

2. Identifying Unexpected and Practice-Saving Clinical Risk Exposures: A Case Study

   2019 Clinical Practice Compliance Conference  | Presenter(s): Donna H. Nicholson  | October 29, 2019 

   • Insights from a recent comprehensive clinical and operational risk assessment; review unexpected risks and inconsistencies identified for a multi-location and multi-specialty healthcare organization

   • Learn how to identify common areas of clinical and organizational risk and changes that can help ensure compliance

   • Take away risk management advice and processes to consider in the ever-shifting landscape

3. Compliance in a Time of Crisis

   2019 Clinical Practice Compliance Conference  | Presenter(s): Dave Wortman, Ron Pelletier  | October 29, 2019 

   • In 2018, Hancock Health in Greenfield, Indiana was the victim of a cyberattack and ransom that took down their EHR, internet service, patient portal, and email for four days; two companies — Diagnotes and Pondurance — helped Hancock through the crisis

   • Why Diagnotes — a secure, HIPAA-compliant clinical communication platform — was not affected by the attack and how Hancock’s providers used Diagnotes to coordinate care and share system-wide crisis updates

   • How Pondurance identified the point of entry for the attack, closed it down, worked with the FBI to help Hancock navigate the tricky Bitcoin ransom negotiations, and restored all systems

4. DEA Compliance Bootcamp 101 with Case Studies

   2019 Clinical Practice Compliance Conference  | Presenter(s): Dennis Wichern  | October 29, 2019 

   • Learn what triggers a DEA audit and what investigators are seeking when they visit a hospital, medical office, or pharmacy

   • Recognize important and recurring opioid risk areas by a review of multiple case studies involving hospitals, pharmacies, and prescribers

   • Learn practical strategies and tips to reduce opioid risk at your medical organization while complying with federal law

5. Integrity without Ignorance

   2019 Clinical Practice Compliance Conference  | Presenter(s): Eric Christensen  | October 29, 2019 

   • Learn how to educate staff in a process of honesty and accuracy with patient care, billing, coding, and interpersonal relationships with co-workers and patients

   • Understand how to address and report breaches, and how these are learning opportunities for your practice

   • Educate yourself to be a leader in regard to whistleblowers and compliance hotlines

6. CMS Audit Success: Prescriber Oversight and Documentation Strategies

   2019 Clinical Practice Compliance Conference  | Presenter(s): Michelle Rigby, Crescent Moore  | October 29, 2019 

7. GENERAL SESSION HHS Cybersecurity Top Threats and Best Practices

   2019 Clinical Practice Compliance Conference  | Presenter(s): Christopher M. Gibson  | October 29, 2019 

   • The 405(d) task group — comprising more than 150 information security officers, privacy experts, medical professionals, and industry leaders — was convened by HHS to strengthen the healthcare and public health cybersecurity posture

   • In January of 2019, the group produced applicable and voluntary guidance that seeks to cost effectively reduce cybersecurity risk

   • This session will provide users with a working knowledge and resources to address the top 5 threats and 10 best practices for mitigating those threats in small, medium, and large healthcare organizations

8. GENERAL SESSION Lessons Learned from Recent Physician Practice Enforcement Actions

   2019 Clinical Practice Compliance Conference  | Presenter(s): Anna M. Grizzie, Shannone Raybon  | October 29, 2019 

   • Review of recent enforcement actions, including billing/coding and compensation arrangements, as hypotheticals to understand potential issues and lessons learned from the settlements

   • Discussion of potential individual liability physicians and other leaders of physician practices can face and recommendations for obtaining buy-in by thought leaders on the compliance initiatives to prevent enforcement actions

   • Practical tips for operationalizing lessons learned into physician practice compliance programs, including suggestions for training, auditing/monitoring options, and recommendations for correcting identified issues

9. Timed Psychotherapy Under the Revised CPT Construct: Looking Back on the First Year of the New Billing Standards vs. the Standard of Care

   2019 Clinical Practice Compliance Conference  | Presenter(s): David N. Hoffman  | October 28, 2019 

   • The new requirement for timed billing has posed a compliance and ethical challenge for billers and clinicians alike; learn how to honor the therapist’s obligation to the patient, and the coder’s duty to verify medical necessity

   • Learn how to conduct chart reviews that verify adequate documentation for in-person and telemedicine encounters with patients young and old, and the caregiver’s perspectives that influence treatment plans and prognosis

   • A discussion of the use of experts to evaluate the indication for psychotherapy in special needs populations, and the role of “informants” in guiding the clinical judgments necessary to promote high quality care

10. Physician Recruitment Agreements: The DOs and DON'Ts of Income Support

    2019 Clinical Practice Compliance Conference  | Presenter(s): Cathy Bodnar, James Munz  | October 28, 2019 

    • Consider the regulatory environment with a focus on Stark mandates and IRS scrutiny

    • Establish oversight to avoid breach; tools and protocols for eligibility and monitoring compliance

    • Solutions to remain compliant through remedies and corrective actions

11. Identifying Compliance Problems in Your Practice

    2019 Clinical Practice Compliance Conference  | Presenter(s): Betzaida L. Shands, Jerry Willis  | October 28, 2019 

    • Assessing current workflow and compliance standards

    • HHS (OCR, OIG) Physician Practice Roadmap

    • Compliance standard implementation and beyond

12. Preparing for the On-Site Regulatory Inspection

    2019 Clinical Practice Compliance Conference  | Presenter(s): Lela A. Goldwyn  | October 28, 2019 

    • Completing an on-site regulatory inspection of your practice from the front door signage to the hazardous waste pick-up; a simple method to assure your practice is protected against the myriad of regulatory requirements

    • Shared lessons from the field (and Bernie Madoff, too!); how to conduct an invasive inspection without being intrusive; ask the right questions before the inspectors do!

    • Spotting discrepancies quickly, using an on-site survey for new acquisitions and how to conduct corrective actions

13. Can the Provider Dismiss the Patient from Their Practice?

    2019 Clinical Practice Compliance Conference  | Presenter(s): Michelle L. Pinter, Diana Nalett  | October 28, 2019 

    • The basics in patient dismissals

    • The compliance professional’s role and the role of other staff members

    • How to handle patient dismissals once approved or denied

14. Do the Right Thing: Leading a Federally Qualified Health Center's Response to a Medicare Targeted Probe & Educate (TPE) Audit

    2019 Clinical Practice Compliance Conference  | Presenter(s): Robyn M. Hoffmann  | October 28, 2019 

    • How to articulate the key requirements and potential outcomes of a Medicare Targeted Probe & Educate (TPE) audit to a Federally Qualified Health Center’s Administration, clinical leadership, and Board of Directors

    • How to develop an inter-departmental timeline and workflow to ensure a Federally Qualified Health Center’s timely response to the Medicare Administrative Contractor (MAC)

    • How to address Medicare TPE Round 1 findings pertaining to treatment plan documentation in the electronic health record (EHR) and ensure that Medicare enrollees are only booked with providers that meet Medicare’s “core practitioner” requirements

15. Ensuring Medical Necessity: The Overarching Criteria of Evaluation and Management Documentation

    2019 Clinical Practice Compliance Conference  | Presenter(s): Caroline Whitlock, Jennie E. Moody  | October 28, 2019 

    • Clear and Present Danger: How EMRs contribute to lack of medical necessity

    • True Grit: How to have the difficult discussions when the volume of documentation is the primary influencer

    • The Pursuit of Clarity: Learn key concepts that every coder should do to accurately code Medical Necessity

16. GENERAL SESSION Emotional Intelligence: How to Develop and Use These Skills to Build Mutual Success

    2019 Clinical Practice Compliance Conference  | Presenter(s): Adam L. Myers  | October 28, 2019 

    • How to develop EI capabilities

    • Principles of applying these skills to real-world situations

    • How to preserve your own sense of wholeness in difficult situations

17. GENERAL SESSION GS1 HHS-OIG Compliance Priorities: Trends, Technology, and Takeaways

    2019 Clinical Practice Compliance Conference  | Presenter(s): Andrew VanLandingham  | October 28, 2019 

    • OIG Update on Fiscal Year 2019

    • Trends in oversight and enforcement related to the opioid epidemic, home and community-based settings, telemedicine, integrity agreements, and recent work plan additions

    • Emerging compliance and enforcement issues related to health technology

    • OIG’s recent Regulatory Sprint to Coordinated Care proposed rule for the anti-kickback statute

18. Incident-To Billing: The Convergence of Access, Documentation, and the Bottom Line

    2019 Clinical Practice Compliance Conference  | Presenter(s): Lynn M. Myers  | October 28, 2019 

    • Review Definitions and Requirements

    • Get clear on “Incident-To” vs. Direct Billing

    • Learn best documentation practices to support payment at the physician fee schedule

19. All About Appeals and Grievances: Review of the Regulations and How to Navigate Your Way Through These Processes at a Medicare and Medicaid Health Plan

    2019 Clinical Practice Compliance Conference  | Presenter(s): Gail Kinkead, Anthony H. Choe  | October 27, 2019 

    • Review of Medicaid and Medicare Appeal and Grievance regulatory requirements, including how Plans are audited by CMS and Medicaid State Agencies on adhering to these rules

    • Discuss the Appeal and Grievance process and scenarios from both the Plan and Provider perspective: What are Best Practices?

    • Explore options after the Appeal or Grievance is denied at the Health Plan level: What happens next?

20. "Yes, a Physician May Bill Medicare for Incident-To Services of Another Physician" and Answers to Other Questions about Incident-To Policy

    2019 Clinical Practice Compliance Conference  | Presenter(s): Paul W. Kim  | October 27, 2019 

    • Learn the Medicare incident-to rule as presented by the former CMS employee who drafted the 2002 regulation

    • Implement protocols to comprehensively and compliantly bill Medicare for incident-to services

    • Identify and address areas of risk before Medicare auditors do

21. Navigating the Compliance Pitfalls of Telemedicine

    2019 Clinical Practice Compliance Conference  | Presenter(s): C.J. Wolf, Jay McVean  | October 27, 2019 

    • Address misconceptions among clinicians of the differences between the reality of current telemedicine delivery methods and the future possibilities of telemedicine

    • Discuss the compliance risk associated with IT Security, HIPAA, coding, and reimbursement

    • Explore how some states are approaching legislation and regulations for telemedicine, with a deeper dive into how the state of Texas is approaching telemedicine as an example

22. Patients Over Paperwork: E&M Options?

    2019 Clinical Practice Compliance Conference  | Presenter(s): Bess Ann Bredemeyer  | October 27, 2019 

    • Discuss optional documentation changes in 2019

    • Review 2021 proposed changes

    • Consider impact of potential changes to continuity of care & payment

23. Supporting Clinical Excellence and Co-Location Compliance

    2019 Clinical Practice Compliance Conference  | Presenter(s): Anne Daly, Clara Fordham, Tanvi Gupta  | October 27, 2019 

    • Clinical integration and multidisciplinary care drive quality and efficacy in healthcare

    • Regulations and payor rules set limits and boundaries on what services may be billed when performed in which space and by whom

    • Careful consideration of clinical initiatives and the space in which they will be provided and by whom can enable collaborative, interactive care that meets billing compliance requirements