25th Annual Compliance Institute

  1. H1E Program Integrity Compliance & FWA Innovation Using Data Intelligence

    25th Annual Compliance Institute  | Presenter(s): Matthew Berls, Kristen Vigoren, Michael Jurmu  | April 22, 2021 

    • What is Program Integrity Compliance role (vs business role)

    • The new frontier in prevention

    • Using data intelligence to support regulatory compliance

  2. H1B Compliance and Liability Considerations for Physicians and Organizations Employing Physician Assistants and Nurse Practitioners: A Review of Case Law and Complaints

    25th Annual Compliance Institute  | Presenter(s): Kevin Hickman  | April 22, 2021 

    • Discuss compliance concerns arising from changes to the BBA and SSA related to the use of PAs and NPs

    • Identify case law involving PAs, NPs, physicians, and organizations demonstrating compliance risks

    • Describe strategies to reduce risks of violating the AKS and FCA when employing PAs and NPs

  3. H1D How to Become a Data-Driven Compliance Professional

    25th Annual Compliance Institute  | Presenter(s): Joseph Zielinski, James Rough  | April 22, 2021 

    • Discussion of how to incorporate data and metrics into your compliance program using DOJ's Guidance on the Effectiveness of a Compliance Program and OIG-HCCA Measuring Compliance Program Effectiveness as a foundation

    • See how to use the data you are already collecting to measure the effectiveness of your program

    • Attendees will have the opportunity to review and receive a tool that they can use to apply a data-driven approach to measuring their compliance program's effectiveness and demonstrate how their compliance program aligns with government requirements

  4. H1F PDPM Year One: Insights from the Auditors

    25th Annual Compliance Institute  | Presenter(s): Karyn Kurth, Amie Martin, Shelly Maffia, Stacy Baker  | April 22, 2021 

    • Understand system, coding, and documentation risk areas identified by auditors in year one of PDPM

    • Discuss work plan auditing and monitoring recommendations to mitigate PDPM risks

    • Describe strategies employed by successful providers to overcome key PDPM compliance challenges

  5. H4G Compliance Program Transformation: Opportunities, Strategies, and Creative Approaches

    25th Annual Compliance Institute  | Presenter(s): Dhara Satija, Thomas Delegram  | April 22, 2021 

    • Discuss ways to assess, innovate and transition from reactive to proactive mode of managing risks

    • Learn how to apply agile approach in compliance operations with clearly-defined goals and priorities

    • Gain insights into various value levers for reimagining and transforming day-to-day compliance operations

  6. H1G Conducting a Rehab-Focused Risk Assessment: Identifying & Mitigating Your Risks

    25th Annual Compliance Institute  | Presenter(s): Yolunda Dockett, Holly Hester  | April 22, 2021 

    • Identify key elements of a rehab-focused compliance risk assessment

    • Discuss prioritization of risk assessment results

    • Describe a sample mitigation plan for identified risks

  7. H1H Pandemics, Politics, and Value-Based Models, Oh My!

    25th Annual Compliance Institute  | Presenter(s): Elizabeth Mills, Kristen Woodrum, Justin Chamblee  | April 22, 2021 

    • The current status of value based models: what’s new, what’s in, what’s out, what the future may hold

    • An in-depth practical, legal and financial analysis of the impact recent events have had and/or may have on these models: COVID-19, Stark and AKS changes, CMS 2021 Final Rule

    • Real-world challenges organizations face in effectively implementing value-based models and practical strategies to mitigate those challenges

  8. H1I The Roles of the Compliance Officer and the General Counsel

    25th Annual Compliance Institute  | Presenter(s): Laura Ellis, Cynthia Patton, Jack Rovner  | April 22, 2021 

    • The role of the compliance officer and the general counsel in the organization

    • The reasons why healthcare entities have different people fill these roles

    • The importance of a collaborative working relationship between compliance and legal that respects their separate roles

  9. H3F Executive Compensation in Nonprofit Healthcare Compliance Issues and Strategies

    25th Annual Compliance Institute  | Presenter(s): James Sheehan  | April 22, 2021 

    • Learn to apply the rules governing "reasonable compensation" benefits/perks and expense reimbursement to executives under IRS and state law

    • Develop and review compliant plans and review processes for nonprofit executive compensation, including roles of compliance consultants, board compensation committees, and HR staff

    • Learn recent initiatives and executive compensation vulnerabilities from regulatory perspective, including employee loans, split interest life insurance, severance and change of control payments, terminal consulting agreements, and "poison pill" contracts

  10. H1J Health Compliances Role in Multi-Unit, Cutting Edge AMC Investigations

    25th Annual Compliance Institute  | Presenter(s): Hoyt Sze, Kimberly Gillespie  | April 22, 2021 

    • Understand the mechanics of AMC investigations regarding high-risk issues affecting multiple units through discussion of a detailed case study

    • Apply strategies for ensuring investigation integrity while properly coordinating with other units

    • Identify privilege issues that might arise and how to address them

  11. H3G Weathering the Compliance Storm Forecast for the Future!

    25th Annual Compliance Institute  | Presenter(s): Debra Phillips, Steven Sample  | April 22, 2021 

    • Develop an approach for identifying, evaluating, responding to, and monitoring risks and opportunities. This method helps you develop a systematic approach to analyze both the internal and external environmental factors impacting your enterprise

    • How to partner with clinical stakeholders to identify risks impacting the enterprise and discover ways to develop a risk response strategy and cascade these risks and mitigation strategies throughout the organizational structure with C-Suite buy-in

    • Demonstrate an enterprise risk management model to include a risk register, risk assessment tool, sample interview questions, and risk project plan. These tools will help illustrate a method to methodology implement a comprehensive enterprise risk plan

  12. H2B Got Comparative Data? CBRs for Physicians or Other Outpatient Providers

    25th Annual Compliance Institute  | Presenter(s): Annie Barnaby, Kimberly Hrehor  | April 22, 2021 

    • Utilize CMS' provider-specific comparative data reports (CBRs) to focus on Medicare vulnerabilities. CMS produces CBRs on a national level in support of their efforts to protect the Medicare trust fund

    • Understand how to interpret a CBR and the potential benefits to an internal compliance program. The CBR supports adherence to coding guidelines, integrity of claims submission, and compliant operations

    • Access additional educational resources to support further compliance activities, such as training materials, a sample CBR, and national- and state-level aggregate data

  13. H3E Achieving Revenue Cycle Success Through Compliance

    25th Annual Compliance Institute  | Presenter(s): Kelsey Lawson, Rachel Pugliano  | April 22, 2021 

    • Connect compliance and the revenue cycle to best support operational success

    • Examine the differences and similarities between compliance and charge capture functions

    • Share examples that incorporate revenue cycle improvements as part of the compliance review

  14. H2C Anti-Kickback and Stark Law Developments: Where Are We Now and Where Are We Going?

    25th Annual Compliance Institute  | Presenter(s): Tony Maida, Amy Kearbey  | April 22, 2021 

    • Review policy clarifications and changes in the proposed (or final) AKS and Stark rules

    • Examine COVID-19 AKS and Stark waivers and planning for when they expire

    • Learn how to protect your organization and strengthen your compliance program on AKS and Stark

  15. H3B Physician Arrangements Compliance: Identifying, Assessing and Mitigating Physician Arrangements Risk

    25th Annual Compliance Institute  | Presenter(s): Steven Pratt, Kenneth Zeko, Jerry Lear  | April 22, 2021 

    • Identifying and assessing key physician arrangement risk areas

    • The types of compliance activities the government might expect to see

    • Practical steps to mitigate physician arrangements risk

  16. H2D Congratulations New Compliance Officer and Risk Manager and Infection Control and Accreditation, and those Other Duties

    25th Annual Compliance Institute  | Presenter(s): Sharon Taylor, D. Michelle Kinneer  | April 22, 2021 

    • Compare the skills and alignment when the compliance officer is responsible for more than one role

    • Describe the benefits and drawbacks when one has multiple roles and learn how to be successful

    • Critique presented scenarios identifying key aspects depending on the particular role or lens

  17. H2E Self-Audits: Are You Looking at the Right Data?

    25th Annual Compliance Institute  | Presenter(s): Tonja Wise  | April 22, 2021 

    • Planning the work: How do we decide where to audit?

    • Leveraging your resources: What do we really need?

    • Process and methodology: How much is too much?

  18. H4J 42 CFR Part 2 In Complex Service Settings

    25th Annual Compliance Institute  | Presenter(s): David Nelson  | April 22, 2021 

    • How to determine if you must implement 42 CFR

    • Electronic record access decisions

    • Framework for making documentable decisions

  19. H2F Laboratory Risk Assessment: The Top Risks and What to Audit

    25th Annual Compliance Institute  | Presenter(s): Andrea Treese Berlin, Barbara Senters, Michael Loucks  | April 22, 2021 

    • Discuss top laboratory fraud and abuse risks including recent cases

    • Review suggested audit protocols

    • Learn the foundation for an effective laboratory compliance program

  20. H4C Lab Testing During the COVID Pandemic

    25th Annual Compliance Institute  | Presenter(s): Kathy Nucifora, Robert Mazer  | April 22, 2021 

    • Understand requirements related to SARS CoV-2 Results Reporting, avoid related CMPs

    • Learn about changes in enforcement of CLIA authorities, blanket waivers of Stark Law liability

    • Avoid adverse financial/legal consequences related to payment claims for COVID -19 testing

  21. H2G Cost Effective and Practical Solutions to Compliance Risk Management

    25th Annual Compliance Institute  | Presenter(s): Wendy Trout, Frank Mesaros  | April 22, 2021 

    • Identify Risks: There are many sources of risk. We present one team approach to identify risks

    • Prioritize and Tackle Risks: We will review a method for tracking and prioritizing risks

    • Manage Risk: We will describe audit plan development, engaging others, and communicating risks

  22. H4E OIG Mandated Six-Year Look Back Audits

    25th Annual Compliance Institute  | Presenter(s): Jim Rough, Chad Eckhardt  | April 22, 2021 

    • Use of statistical sampling and extrapolation

    • Recent updates and perspectives

    • Drivers of efficient and diligent analysis

  23. H2H Read (Hidden) Emotions: Know What Others are Thinking and Feeling

    25th Annual Compliance Institute  | Presenter(s): Dan Seidman  | April 22, 2021 

    • Read suppressed (hidden) emotions in the faces of others by experiencing a special video tool

    • Receive coaching to see facial movements and know what others are really feeling

    • Work through scenarios where knowing another’s feelings gives you useful insights into credibility

  24. H2J Oh No! What? Another Risk Assessment? A Fraud Risk Assessment

    25th Annual Compliance Institute  | Presenter(s): Sonal Shah  | April 22, 2021 

    • Learn how to conduct a fraud risk assessment (FRA); combine it with other assessments

    • Design preventive and detective controls, and explore the use of data analytics

    • Study three recent case studies/enforcement actions

  25. H3H Understanding and Meeting Language Access Requirements for Services to LEP Persons

    25th Annual Compliance Institute  | Presenter(s): Jack Branum, Ashlie Heald  | April 22, 2021 

    • Discuss the importance of an established language access plan for providing services to LEP persons

    • Discuss the challenges of meeting language access requirements with available resources

    • Learn tips and tools for providing engaging and effective education on language access obligations