2021 Healthcare Enforcement Compliance Conference

  1. Recent Developments: Kickback and Stark Law (2021 HECC)

    2021 Healthcare Enforcement Compliance Conference  | November 08, 2021 

    • Overview of Anti-Kickback or Stark Law developments and settlements

    • Summary of recent regulatory developments including value-based payment arrangements

    • Review and developments in all-payer kickback statue (EKRA 2018)

  2. CIAs and IROs

    2021 Healthcare Enforcement Compliance Conference  | November 08, 2021 

    • Corporate integrity agreements and requirements for an Independent Review Organization (IRO)

    • Obligations and role of an IRO

    • Keys to successful IRO engagements

  3. Anatomy of a False Claims Act Case (2021 HECC)

    2021 Healthcare Enforcement Compliance Conference  | November 08, 2021 

    • The investigation phase: Subpoenas/CIDs, data analysis, witness interviews, and more

    • The negotiation phase: Initiation, ADR, scope of release, monetary, and other issues

    • The resolution phase: Settlement agreements, individual liability, CIAs/OIG, and relator issues

  4. False Claims Act Liability and Post-Acute Care

    2021 Healthcare Enforcement Compliance Conference  | November 08, 2021 

    • A review of recent False Claims Act cases, both civil and criminal, and current enforcement focus areas in Medicare for SNF, home health, and hospice providers

    • Challenges facing post-acute providers, including those associated with new payments systems and regulatory requirements, and new claim audit initiatives

    • Current enforcement trends, including potential liability for providers and management, sources of data to manage risk, expectations from CMS that providers have effective compliance programs, and enhanced focus on "worthless care" concerns

  5. Negotiating and Mediating False Claims Act Cases (2021 HECC)

    2021 Healthcare Enforcement Compliance Conference  | November 08, 2021 

    • False Claims Act settlements and DOJ policy and procedure

    • Negotiating and mediating False Claims Act cases

    • Drafting False Claims Act settlement agreements

  6. Cybersecurity in Healthcare Privacy

    2021 Healthcare Enforcement Compliance Conference  | November 08, 2021 

    • Assessing the current cybersecurity and privacy legal landscape and enforcement actions

    • Emerging technologies: Cybersecurity and privacy risks for healthcare-related entities

    • Addressing risks from supply chain and third-party vendors

  7. Compliance Experts and Compliance Program Effectiveness

    2021 Healthcare Enforcement Compliance Conference  | November 08, 2021 

    • What to ask and look for in effectiveness evaluation proposals

    • Things to consider as your effectiveness review is being conducted

    • Using review results to improve your compliance program's performance

  8. Hot Topics in Retail Pharmacy

    2021 Healthcare Enforcement Compliance Conference  | November 08, 2021 

    • Trends in False Claims Act enforcement{br/}

    • Compliance strategies for retail pharmacy

    • Pharmacy usual and customary pricing

  9. General Session 1: Government Enforcement Panel

    2021 Healthcare Enforcement Compliance Conference  | November 09, 2021 

    • Overview of DOJ criminal and civil enforcement priorities

    • Discussion of OIG and CMS enforcement initiatives

    • Discussion of Medicaid fraud enforcement priorities

  10. Ask the Stark Professionals (2021 HECC)

    2021 Healthcare Enforcement Compliance Conference  | November 09, 2021 

    • General overview of the Stark Law

    • Bring your Stark Law questions and the panel will analyze and discuss "real-time" potential Stark Law risks

    • "Live" answers to your Stark Law operational questions

  11. Federal Administrative Sanctions (2021 HECC)

    2021 Healthcare Enforcement Compliance Conference  | November 08, 2021 

    • Understand OIG enforcement actions, remedies, and appeals

    • Appreciate differences between available CMS enrollment actions

    • Identify new CMS program integrity rules and authorities

  12. Privacy Breach Response (2021 HECC)

    2021 Healthcare Enforcement Compliance Conference  | November 09, 2021 

    • Things organizations should consider prior to the occurrence of a data security breach (such as ransomware)

    • Information regarding who does what when a data security breach occurs that involves a business associate and a covered entity

    • Ways to examine what was learned after a data security breach response

  13. Internal Investigation and Self-Disclosure

    2021 Healthcare Enforcement Compliance Conference  | November 09, 2021 

    • Authority and practical considerations for conducting internal investigations

    • Procedures and best practices for internal investigations

    • Evaluation and report and potential self-disclosure

  14. Enforcement and Compliance and Electronic Health Records

    2021 Healthcare Enforcement Compliance Conference  | November 09, 2021 

    • Enforcement actions related to electronic health records

    • Compliance obligations and electronic health records and meaningful use

  15. Enforcement, Compliance Officer, and General Counsel

    2021 Healthcare Enforcement Compliance Conference  | November 09, 2021 

    • General counsel and compliance officer response to enforcement action

    • Discussion of managing compliance risks and avoiding enforcement action

    • Best practices for compliance officers and general counsel

  16. Litigating a False Claims Act Case (2021 HECC)

    2021 Healthcare Enforcement Compliance Conference  | November 09, 2021 

    • Define and discuss key provisions of the False Claims Act that regularly get litigated

    • Identify emerging issues that often arise during FCA litigation

    • Learn strategies for maximizing discovery in FCA cases

  17. Enforcement Actions, Investigations, and Settlements

    2021 Healthcare Enforcement Compliance Conference  | November 09, 2021 

    • Adverse events, government surveys, and enforcement actions

    • Compliance professionals and enforcement actions

    • Lessons learned from responding to enforcement actions

  18. Criminal and Civil Enforcement and Telehealth

    2021 Healthcare Enforcement Compliance Conference  | November 09, 2021 

    • Telemedicine Fraud and Enforcement Efforts by DOJ and HHS-OIG

    • COVID-19 Fraud Schemes - Examples and Warning Signs

    • Genetic Testing, Urine Drug Testing and Other Lab Fraud Schemes

  19. Collateral Consequences to Audits and Adverse Enrollment Actions in a Post COVID-19 World

    2021 Healthcare Enforcement Compliance Conference  | November 09, 2021 

    • Enrollment, claims audits, and False Claims Act liability

    • Responding to adverse enrollment actions

    • 60-day rules and investigations related to Covid-19 related services

  20. Using Data in Enforcement and Compliance

    2021 Healthcare Enforcement Compliance Conference  | November 09, 2021 

    • How OIG uses data to fulfill its mission

    • Why OIG recommends compliance officers have access to all the data

    • How to find and use the data healthcare providers have

  21. General Session 2: Healthcare Regulatory, Enforcement and Policy Issues

    2021 Healthcare Enforcement Compliance Conference  | November 09, 2021 

    • Provide an overview of current Congressional actions impacting healthcare providers

    • Summary of CMS CY 2022 payment rules and the impact on providers

    • Discussion of the public health emergency and how long the CMS flexibilities granted by the waiver will continue

    • CMS policy priorities and overview of the new CMS team under the Biden Administration

    • Enforcement outlook for the new Administration

  22. General Session 3: An Update from OIG's Division of Data Analytics

    2021 Healthcare Enforcement Compliance Conference  | November 10, 2021 

    • Get to know OIG's data shop: who we are, what we do, and who we collaborate with

    • Learn more about DDA's analytic methods, approaches, and capabilities to protect HHS programs and beneficiaries

    • Hear about examples of how OIG data analytics contributed to recent audits, evaluations, and enforcement actions

  23. Criminal and Civil Liability and Medical Necessity

    2021 Healthcare Enforcement Compliance Conference  | November 10, 2021 

    • We will discuss what medical necessity means and how it is established

    • We will discuss how medical necessity cases are enforced and the primary factors for distinguishing a civil medical necessity case from a criminal case

    • Do robust compliance measures prevent medical necessity cases, and how to respond when a medical necessity matter arises within your organization

  24. Enforcement and Compliance in Clinical Research

    2021 Healthcare Enforcement Compliance Conference  | November 10, 2021 

    • Clinical trial fraud

    • Billing and clinical trials

  25. Attorney-Client Privilege and Internal Investigations

    2021 Healthcare Enforcement Compliance Conference  | November 10, 2021 

    • Corporate compliance programs may produce data that, in some instances, could be used as evidence of regulatory violations against healthcare organizations and their officers and directors.

    • At the same time, CCOs are bound to obtain and communicate much of that data to relevant stakeholders both inside and outside healthcare organizations as part of effective compliance efforts.

    • Often, evidentiary privileges may protect this information from disclosure. The scope and use of these privileges, however, is often misunderstood. This presentation will explore the application of different privileges within the compliance framework

About SCCE

The Society of Corporate Compliance and Ethics (SCCE) is a non-profit, member-based professional association. SCCE supports our members' work with education, news, and discussion forums. We are a community of leaders, defining and shaping the corporate compliance environment across a wide range of industries and geographic regions. In developing and maintaining effective ethics and compliance programs, our members strengthen and protect their companies.

952.933.4977

About HCCA

The Health Care Compliance Association (HCCA), is a 501(c)6 non-profit, member-based professional association. HCCA was established in 1996 and is headquartered in Minneapolis, MN. We provide training, certification, and other resources to over 10,000 members. Our members include compliance officers and staff from a wide range of organizations, including hospitals, research facilities, clinics and technology service providers.

952.988.0141

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