2019 Compliance Institute (CI)

  1. Five Strategies to Create Compliance Allies

    2019 Compliance Institute (CI)  | Presenter(s): Cindy Matson  | April 09, 2019 

    • Identify five strategies for compliance and ethics professionals to create allies within their organization

    • Discuss easy to implement tactics that can be used to put the strategies into practice and why each tactic can make a difference

    • Recognize that having allies is a win-win for both compliance and operations and learn how it positively influences the effectiveness of a compliance program

  2. Developing Compliant Physician Compensation Arrangements in the Current Enforcement Environment

    2019 Compliance Institute (CI)  | Presenter(s): Anna Grizzle  | April 09, 2019 

    • Use of case studies based upon recent cases and settlements highlighting potential compliance pitfalls associated with physician compensation arrangements

    • Discussion of regulatory framework for developing compliant physician compensation arrangements to avoid the common pitfalls leading to enforcement actions

    • Practical tips for structuring and managing physician compensation arrangements to ensure ongoing compliance

  3. Disaster Planning in Senior Living: HIPAA Still Matters

    2019 Compliance Institute (CI)  | Presenter(s): Brittany Pape, Margaret Scavotto, Scott Gima  | April 09, 2019 

    • HIPAA disaster planning

    • HIPAA temporarily waived requirements

    • Social media in a disaster

  4. Drug Diversion: A Multidisciplinary Approach

    2019 Compliance Institute (CI)  | Presenter(s): Gregory Ferrell, Edward Soyka  | April 09, 2019 

    • Creating a Drug Diversion Task Force, implementing a quick response system, tracking and trending drug diversions throughout a hospital system

    • Ensuring Best Practices: Establishing the requirements of each key stakeholder and maintaining accountability

    • Closing the Loop: Cultivating an environment that deters drug diversion while also providing resources for employees that require treatment for substance abuse

  5. Effectively Managing Risk: The Intersection of Compliance, Enterprise Risk Management and Internal Audit

    2019 Compliance Institute (CI)  | Presenter(s): Donald Sinko, Vicki Bokar  | April 09, 2019 

    • Understand the different roles each function plays in enterprise risk management and corporate strategy

    • Learn how collaboration between Compliance, Enterprise Risk, and Internal Audit improves the overall effectiveness of risk management

    • Obtain takeaways on the Cleveland Clinic approach to integrate the three risk assessment processes

  6. EHR Documentation Risks and Internal and External Reviews

    2019 Compliance Institute (CI)  | Presenter(s): Kenneth Jenkins, Shelly Denham, Colleen King-Dennis  | April 09, 2019 

    • Electronic Health Record (EHR) documentation risks (templates, copy & paste, etc.)

    • Malpractice and other risks with EHR documentation

    • Internal compliance reviews; Targeted Probe and Educate (TPE); RAC and other risks with EHR documentation

  7. EMTALA and Behavioral Health: Myths, Mired Down, and Making Sense of It All

    2019 Compliance Institute (CI)  | Presenter(s): Rebekah Stewart, Katherine Bornstein, Allison Luke  | April 09, 2019 

    • Present case scenarios and discuss compliance and risk exposures related to EMTALA (e.g. defining an EMC for psychiatric patients, complications when transferring psychiatric patients, patient acceptance and risk benefit analysis, etc.)

    • Discuss obligations for treating medical, psychiatric and substance abuse conditions in connection with EMTALA and who is qualified to perform a psychiatric medical screening exam

    • Provide examples of EMTALA documentation and audit tools (e.g. documenting capability and capacity, recipient hospital obligations workflow, EMTALA compliance self-audit tool, etc.)

  8. Effective Risk Management in Medicare Compliance: How to Detect, Prevent, and Correct Issues

    2019 Compliance Institute (CI)  | Presenter(s): Dwight Claustre  | April 09, 2019 

    • Implement a “Detect, Correct and Prevent” approach to managing the risk

    • Provide the right message to the right people to induce support

    • Identifying the root cause through a pre‑determined process

  9. Experimental Drugs, Marijuana, and Complementary Medication Use in Long-Term Care Settings: Risks and Best Practices

    2019 Compliance Institute (CI)  | Presenter(s): Aleah Schutze, Sarah Potter  | April 09, 2019 

    • Identify and address issues around who can administer experimental and complementary medications as well as marijuana and CBD/Hemp oil

    • Discussion of storage and access to marijuana, experimental, and complementary medications

    • Identify and address the legal risks associated with patient use of marijuana, experimental, and complementary medications in long‑term care facilities

  10. Health IT Risk Roundtable

    2019 Compliance Institute (CI)  | Presenter(s): Johan Lidros, Stephanie Crabb, Kate Mullin  | April 09, 2019 

    • Experience a forum for interaction with experts in healthcare IT risk, audit and compliance. This talented group will discuss the most relevant topics in the field and address questions raised by their peers

    • The panel and participants will discuss current best practices in healthcare IT risk management, IT auditing, Health IT and provide useful recommendations to manage key related IT risk related to cyber, patient safety, resilience, information governance

    • Everyone will benefit from hearing the challenges faced by others in the community and the creative solutions they are adopting

  11. GDPR Update: Privacy Across the Pond

    2019 Compliance Institute (CI)  | Presenter(s): Brian Selfridge, Nadia Fahim-Koster  | April 09, 2019 

    • U.S.-based firms (including healthcare, health plans and business associates servicing healthcare) must determine if their organization is required to meet the GDPR compliance requirements

    • GDPR impact to U.S. health organizations includes controls around Consent, Privacy Notices and Breach Notification; Data Protection Officer assignment; client communication on Rights to Access; and Cross-Border Data Transfer protocols

    • An analysis of data security frameworks, such as HITRUST and Privacy Shield, are discussed; specifically, around how these certifications line up with GDPR requirements

  12. HCCAS and Providers: Get Paid for What You Do

    2019 Compliance Institute (CI)  | Presenter(s): D. Scott Jones  | April 09, 2019 

    • Hierarchial Coding Conditions (HCCs) capture the complexity of patient care and ensure maximum reimbursement. Are you getting paid for what you are doing?

    • CMS Risk Adjustment shifts reimbursement risk to healthcare providers through Risk Adjustment Factors and HCC capture. As Medicare plan enrollment increases, providers must meet the challenges of provider education and documentation

    • Join us to learn how Risk Adjustment, HCCs, RAFs, and the CMS Annual Miracle Cure will impact future provider, institution, and health plan compliance and reimbursement

  13. Home Health and Hospice: Enforcement Trends and Compliance

    2019 Compliance Institute (CI)  | Presenter(s): Jennifer Kildea Dewane, Kathleen McDermott, Kenny Kraft  | April 09, 2019 

    • Home health and hospice enforcement trends: Key areas of focus for audits, investigations and enforcement by the federal government

    • Behaviors that can lead to investigation and enforcement: Physician and facility relationships, marketing, sales, billing, and medical record documentation

  14. Fraud and Abuse Regulation, Compliance, and Value-Based Purchasing: The Search for Greater Alignment

    2019 Compliance Institute (CI)  | Presenter(s): Jane Hyatt Thorpe, Elizabeth Gray  | April 09, 2019 

    • Healthcare stakeholders are developing new care delivery and payment models using financial incentives to encourage healthcare stakeholders to work together to integrate care between and among providers and other healthcare organizations

    • The current legal framework was designed for fee-for-service payments where financial arrangements between and among healthcare stakeholders could encourage the overutilization of resources and inappropriately influence provider decision-making

    • This session will address potential changes to the framework that would support new care delivery and payment models while still protecting against fraud and abuse; and guidance for compliance professionals navigating this new terrain

  15. HIPAA Privacy and Social Media: How to Create a Culture of Confidentiality

    2019 Compliance Institute (CI)  | Presenter(s): Carlos Cruz, Melissa Mitchell  | April 09, 2019 

    • Attendees will hear how the explosion of social media (and smart phones) has led to increased HIPAA privacy risks. Presenters will share real world examples of breaches at other organizations originating from social media posts by employees

    • Presenters will share tactics used to create cultures of confidentiality within their respective organizations

    • Presenters will share how proactive monitoring of social media accounts has led to mitigation of potential privacy breaches and educational opportunities

  16. Labs, Recovery Homes, and Treatment Centers, Oh My! Follow Us Down the EKRA Brick Road

    2019 Compliance Institute (CI)  | Presenter(s): Tony Maida, James Cannatti  | April 09, 2019 

    • In-depth analysis of the new all-payor kickback statute, Eliminating Kickbacks in Recovery Act of 2018 (EKRA)

    • Comparison of EKRA to the federal anti-kickback statute

    • Tips for compliance strategies and risk assessment

  17. Hands On Keys Computer Lab: Computer Tips, Tricks, and Internet Hacks to Make You a More Efficient and Effective Compliance Professional

    2019 Compliance Institute (CI)  | Presenter(s): Frank Ruelas, Rachel Buchanan  | April 09, 2019 

    • How to unlock some of the unused potential of your computer using functions and tools that you may not be aware of and how these functions can increase your effectiveness in your time management efforts

    • Learn how to identify daily processes and workflows so as to identify if they may present opportunities for you to automate various tasks while also increasing the overall accuracy of your work product

    • Participate in hands on exercises during the session to make your use of the internet more productive while also learning how to maximize the use of Internet-based resources

  18. Home Health Agency: Audit Strategies and Common Red Flag Findings

    2019 Compliance Institute (CI)  | Presenter(s): Shawn Stevison  | April 09, 2019 

    • Understand types of HHA internal audits

    • Define methodology for conducting the internal audit

    • Discuss common findings

  19. How Vendor Oversight Should Lead the Charge for Contracting with a New FDR

    2019 Compliance Institute (CI)  | Presenter(s): Jennifer Justine Phillips, Tammy Sanchez  | April 09, 2019 

    • Assessing Internal Risk: Gauging similar vendors, specific needs, and breakdown of oversight program and responsibilities between the functional areas and vendor oversight and establishing oversight workflows

    • Exposure Risk of Vendor: How the risk assessment shapes your program. Involving functional areas in understanding what the vendor does (and doesn't do) for your organization and how past, present, and potential risks affect oversight responsibilities

    • Ongoing Risk: Talk. Oversee. Audit. All aspects contribute to managing successful relationships. Grooves are great, but don't let it become a rut you can't get out of. Being comprehensive without surprises

  20. Internal Audit's and Compliance's Role in Addressing Enterprise Risk: Behavioral Health

    2019 Compliance Institute (CI)  | Presenter(s): Kimberly Jordan, Lorrie Ghose  | April 09, 2019 

    • ERM Risk Identification: explanation of the process for identification and ownership of enterprise risk (includes risk assessment tools and heat maps)

    • Key Areas of Focus and Process Improvement: Collaboration with clinical, executive and front-line leadership to implement identified improvements—restraint/seclusion, face-to-face assessments, ligature risks, status individual observation, and safety

    • Governance, Execution and Sustainability: Engagement of the board in risk identification, monitoring and sustainability, redundant leadership, metrics, continuous monitoring (includes LEAN tools such as A3)

  21. Internal Investigations: Refining Your Interviewing Skills

    2019 Compliance Institute (CI)  | Presenter(s): Melissa Edson, Jackie Stemwedel, Jacki Waltman  | April 09, 2019 

    • Interviewing questions, skills, and processes

    • Investigation documentation

    • Mock interviews

  22. Investigational Device Exemption (IDE) and Humanitarian Device Exemption (HDE) Device Coverage & Billing: Compliance Insights

    2019 Compliance Institute (CI)  | Presenter(s): John Dortero  | April 09, 2019 

    • The key FDA and CMS regulations affecting IDE and HDE device use and coverage, and the corresponding roles and the responsibilities across a health system - including Compliance, Providers, IRB, Clinical Trials Office, Supply Chain, and Billing

    • Tips for how Compliance departments can promote collaboration and successful partnerships across a health system (such as education and outreach, task forces, and policy review) to reduce regulatory risk and promote system-wide compliance

    • Sample process for analyzing IDE and HDE devices as they enter a health system to help ensure compliant device usage and billing

  23. It's Time For a Revolution: Assessing the Effectiveness of Your Code of Conduct

    2019 Compliance Institute (CI)  | Presenter(s): Darrell Contreras  | April 09, 2019 

    • Review the Guidance and Effectiveness Measures related to the Code of Conduct to establish the requirements and goals for the Code of Conduct

    • Bring your Code of Conduct (or follow along) to draft new standards that provide meaningful guidance that can be remembered and recalled by employees

    • Discuss mechanisms to publicize the new standards for guidance, high visibility, and reinforcement for employees

  24. Managed Care Fraud: Enforcement and Compliance

    2019 Compliance Institute (CI)  | Presenter(s): Megan Tinker, Banjamin D. Singer  | April 09, 2019 

    • Compliance for Hospice and Home Care

      2019 Compliance Institute (CI)  | Presenter(s): Randi Seigel, Annie Miyazaki  | April 09, 2019 

      • Understanding the key compliance and fraud, waste, and abuse risk areas in hospice and home care

      • Developing a robust compliance program to prevent and detect non-compliance and fraud, waste, and abuse in hospice and home care

      • Ensuring that senior management and boards of directors remain well-informed of compliance risk areas facing a hospice or home care organization