2019 Compliance Institute (CI)

1. The Relationship Between Lawyers and Their Healthcare Clients: A Perspective from Both Sides of the Equation

   2019 Compliance Institute (CI)  | Presenter(s): Debra Geroux, Joan Podleski  | April 09, 2019 

   • A Lawyer’s Perspective: Discussion of the lawyer’s role as a business & legal counselor, the privileges that apply to the dual roles and the duties and obligations of the lawyer to protect the client’s information under ethical and legal consideration

   • A Provider’s Perspective: Discussion of what providers should look for and assurances they should seek when engaging outside counsel and the laws that apply to the relationship

   • Understanding the distinction between lawyers in compliance roles and lawyers in legal roles

2. Working with Integrity: Taking the Right Path

   2019 Compliance Institute (CI)  | Presenter(s): Ruth Krueger  | April 09, 2019 

   • Ethics, Integrity, & Compliance: Is there a difference?

   • Case studies that lead to taking the wrong path

   • Steps to consider to make the right choices

3. What You Need to Know to Audit and Monitor the Revenue Cycle

   2019 Compliance Institute (CI)  | Presenter(s): Kelly Nueske  | April 09, 2019 

   • Fundamentals of outpatient & inpatient revenue cycle in any provider setting

   • Understand where data is collected or managed and the pitfalls at each point

   • Assessing risk to design auditing and monitoring program

4. Using 340B Drugs Across the Continuum of Care: How to Provide Quality Service and Stay Compliant

   2019 Compliance Institute (CI)  | Presenter(s): Michael Glomb, Sue Veer  | April 09, 2019 

   • Understand the risks and rewards of dispensing 340B drugs for your patients across the continuum of care

   • Understand the impact of current federal guidance on dispensing 340B drugs to patients

   • Describe policies and self-audit procedures to minimize risk and maximize patient benefits

5. When the Patient is Biased: The Intersection of Compliance, Inclusion, and Culture

   2019 Compliance Institute (CI)  | Presenter(s): Tobi Tanzeer, Shamayne Braman  | April 09, 2019 

   • Patients who refuse care based on providers’ race, language or other personal traits present complex challenges for organizations; patient bias can impact the safety, quality and equity of care, affect employee well-being and increase compliance risks

   • Hear how one organization used principles of collaboration, organizational culture, diversity and inclusion, compliance and a patient and staff-centered approach to effectively address patient bias in ambulatory and inpatient settings

   • Learn how to evaluate and navigate patient bias in a variety of care settings and to manage organizational risk around this growing issue; improve workforce awareness; and develop tools that will support your organization’s ability to address patient bias

6. Whistleblower's Ethical Journey: A Real-Life Case Study on the Discovery of Fraud, Investigative Success, the $2.3 Million Payback, and the Retaliatory Consequences of Reporting Wrongdoing

   2019 Compliance Institute (CI)  | Presenter(s): Amy Joy  | April 09, 2019 

   • Review a real-life case study on the discovery of fraud in the workplace and the six significant risk factors that rendered the control environment ineffective

   • Learn the limitations and barriers to reporting wrongdoing that exist in current whistleblower and anti-retaliation organizational policies

   • Discuss three important steps to take before, during, and after the reporting of wrongdoing to stop retaliation before it become a second form of misconduct

7. 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

8. Compliance's New Role in the Survey Process

   2019 Compliance Institute (CI)  | Presenter(s): Paula Sanders, Karla Dreisbach  | April 09, 2019 

   • Understand the obligations of mandated compliance programs in the context of the SNF survey process

   • Discuss creating a proactive approach within the compliance committee to address survey issues

   • Analyze and understand ramifications of the new CMS survey enforcement guidances

9. Assess Your Provider-Based Clinics for Compliance with CFR 413.65: A Comprehensive Approach

   2019 Compliance Institute (CI)  | Presenter(s): Samantha Karpenko, Pali Lipoma  | April 09, 2019 

   • Learn how to turn the Provider-Based Requriements from CFR 413.65 into a compliance assessment document for auditing each element of the regulation

   • Develop a Provider-Based assessment workplan which incorporates operational owners into the compliance assessment process

   • Compile findings in a manner that supports efficient tracking and oversight to monitor gaps and corrective actions

10. Can We Let Patients Starve Themselves to Death - Even If They Have Dementia - and Can We Get Paid for It? Ethics and Reimbursement at the End of Life

    2019 Compliance Institute (CI)  | Presenter(s): David Hoffman  | April 09, 2019 

    • As the incidence of dementia increases there is growing awareness among patients of their ability to make decisions about care including explicit refusal of assisted oral feeding, even while receiving symptom management through hospice or palliative care

    • Why are clinicians and institutions often reluctant to support a patient's decision to refuse oral feeding, particularly in the presence of dementia? It is often due to misunderstanddings about the CMS definitions of Abuse, Neglect and Immediate Jeopardy

    • The session will examine regulatory and reimbursement challenges including CMS charges of failure to provide adequate nutrition and hydration to support and maintain life, which providers and institutions must contront with patients who do not want to

11. Can't We All Just Get Along? Physician Satisfaction and Compliance Are Not Mutually Exclusive in Physician Arrangements

    2019 Compliance Institute (CI)  | Presenter(s): Gail Peace, Kelly Walenda, Eugene McMahon  | April 09, 2019 

    • Physician arrangements are a highly regulated business. Compliance can feel big brother to physicians if not presented as part of the culture

    • When time studies are needed, physicians often don’t understand the significance of compliance for the organization and for themselves. Strategies and best practices to manage arrangements that align priorities

    • Capital Health System Case Study. Physician leader and CMO of system will present their path in engaging physicians. Jefferson Health Case Study. SVP legal will present how they dialog with physicians about work performed to drive clinical agenda

12. Charge Master and Charge Management Risk: What Compliance Professionals Need to Know

    2019 Compliance Institute (CI)  | Presenter(s): Rosemary Holliday  | April 09, 2019 

    • Learn the compliance-oriented work flow processes, risks, and monitoring requirements that drive health system charge data (often referred to as Charge Management, Charge Master, Charge Description Master, or CDM)

    • Eliminate the mystique of Charge Master Management, and learn why charge data auditing and monitoring should be a concern for healthcare organizations of all sizes

    • Learn how properly-performed Charge Master audits (whether internally or externally-performed) can identify unforeseen compliance risk

    • Discuss the various types of audits and how to determine the best audit focus for your organization

13. Coding Experts and Attorneys: From the Trenches, a Collaborative Approach to Audit Response

    2019 Compliance Institute (CI)  | Presenter(s): Maggie Mac, Michael Igel  | April 09, 2019 

    • Here comes trouble! Request for medical record documentation! Who’s requesting? Insight on the regulatory landscape surrounding audits, and tools for a proactive response to a request for records

    • Medicare audits: Proper response is essential. To appeal or not to appeal—the recipe for a collaborative approach to audit response by the healthcare attorney and coding and compliance expert

    • Best practices! Tools and strategy for healthcare attorney and coding & compliance expert to minimize risk for future audits

14. Compliance Challenges and Tips for American Indians and Alaskan Natives (AI or AN)

    2019 Compliance Institute (CI)  | Presenter(s): Andrea Treese Berlin, Dale Robinson, Jr., Casey Moore  | April 09, 2019 

    • This panel will look at compliance initiatives involving AI/AN communities

    • It will address both healthcare (including P.L. 638 programs) and human services (including LiHeap, HeadStart, TANF, and other programs)

    • It will include tips for maximizing the services available for your communities while minimizing vulnerabilities to fraud, waste, and abuse

15. Compliance Engagement: How to Meet the Compliance Program of Your Dreams

    2019 Compliance Institute (CI)  | Presenter(s): Kym Creekmore, Scott Intner  | April 09, 2019 

    • Build your brand: assertive and approachable

    • Get and keep compliance at the table

    • Engage the workforce by moving beyond the regulations

16. Compliant Billing for Inpatient Rehab: How to Avoid Documentation Perils

    2019 Compliance Institute (CI)  | Presenter(s): Danielle E. Gordet, Judy Ringholz  | April 09, 2019 

    • Explore recent changes in CMS documentation requirements that were implemented in FY 2019

    • Identify specific components of documentation that CMS requires in order for IRF services to be considered reasonable and necessary

    • Discuss the OIG’s increased scrutiny of IRF documentation, including items on the current OIG Work Plan

17. Frankly Speaking

    2019 Compliance Institute (CI)  | Presenter(s): Frank Sheeder  | April 09, 2019 

    • Unplugged and unvarnished observations about compliance

    • What works and what doesn’t as a compliance professional

    • How to deal with those who don’t embrace compliance

18. Drip Drop: Infusion Auditing Made Simple

    2019 Compliance Institute (CI)  | Presenter(s): Kelly Loya  | April 09, 2019 

    • Explore fundamental rules and concepts of infusion & injection therapy reporting

    • Investigate common weaknesses causing risk when coding and reporting supplies

    • Deploy coding concepts to real‑time therapy examples even non-coders can use easily!

19. Everything Under The Sun(shine)

    2019 Compliance Institute (CI)  | Presenter(s): Rebecca Scott, Andrew Hill, C.J. Wolf  | April 09, 2019 

    • Best practices, tools, and getting the most out of Open Payments data for your organization

    • Developing, monitoring, and auditing conflict of interest management plans to optimize compliance for your organization

    • Tracking current legislation and potential impact on the Sunshine Act: How your institution can prepare for what lies ahead

20. Compliant Physician Documentation in an Electronic World

    2019 Compliance Institute (CI)  | Presenter(s): Kimberly Huey, Sandra Fiangreco Brown  | April 09, 2019 

    • The Documentation Guidelines for physicians were written over twenty years ago, before the widespread use of electrnic records. CMS hasn't updated these guidelines, but in some cases, Medicare Administrative Contractors have

    • This session will explore the compliance risks and common mistakes found in physician documentation in electronic records. We will review each type of service and give tips for documenting appropriately in an electronic record

    • We will review the findings of governmental and payor audits that found fraud and abuse in the use of electronic records. Learning from these cases to protect your organization!

21. Criminal and Civil Liability for Overpayments

    2019 Compliance Institute (CI)  | Presenter(s): Gabriel Imperato, David Fuchs, James Hearty  | April 09, 2019 

    • The statutory obligation to return a “known overpayment” and its application in criminal and civil enforcement proceedings

    • The basis for liability for “retention of a known overpayment” under the United States False Claims Act

    • The “identification” of a “known overpayment” and the time requirements for disclosure and return of overpayment

22. Culture Is King: Strategies for Developing and Maintaining a Culture of Ethics and Compliance

    2019 Compliance Institute (CI)  | Presenter(s): Steven Ortquist, Marianne Jennings  | April 09, 2019 

    • What is a Culture of Ethics? A Culture of Compliance? Can you measure and monitor your culture? What are red flags to watch for?

    • Who is responsible for maintaining an appropriate organizational culture? What is the compliance officer’s role? How can a compliance officer and compliance staff best work to impact and/or help others understand the importance of culture?

    • How do the concrete obligations of a CCO (e.g., to maintain a “seven elements” compliance program) relate to the creation and maintenance of an ethical culture? Who should the CCO partner with to best impact the culture of an organization?

23. Experiencing the Unimaginable: A Compliance Case Study of the Mass Shooting in Las Vegas

    2019 Compliance Institute (CI)  | Presenter(s): Susan M. Pitz, Keith Slade, Rani Gill  | April 09, 2019 

    • A panel of legal, privacy and compliance professionals from University Medical Center of Southern Nevada (UMC) will describe their experiences, the impact, and the aftermath of the largest mass shooting in U.S. history through their unique perspectives

    • Explore the challenges experienced and lessons learned

    • Investigate key questions: Can you be prepared for such an event? How are compliance boundaries pushed in an emergency of this magnitude? How long afterwards are the impacts of mass casualty events felt?

24. Cultures of Integity: We Know What They Are and What They Should Look Like, But How Do We Get There?

    2019 Compliance Institute (CI)  | Presenter(s): Mary Shirley  | April 09, 2019 

    • Discussion of behaviors that define a good culture in healthcare companies and what initiatives compliance can lead to inspire those behaviors

    • Mood in the middle - how to get middle management to buy into demonstrating a culture of compliance and integrity

    • Examples of what other companies just like yours are doing to build and establish a strong culture

25. Cutting Through the Noise: Determining Whether Your Vendor's Security Incident Is a Breach

    2019 Compliance Institute (CI)  | Presenter(s): David Holtzman, Thora Johnson, Shari Lewison  | April 09, 2019 

    • Look beneath the surface of your vendor’s security incident report to identify if there is a reportable breach and the roles your privacy, compliance, security professionals, in-house counsel, outside consultants and advisers should play

    • Explore the questions that need to be asked to identify the root cause of the incident. How to determine the extent of information needed to assess the risk of data compromise. How to view the vendor’s own assessment critically

    • Answer these questions through scenarios applying not only a HIPAA lens but also the patchwork of state health information privacy rules, for a complete picture on what is a reportable breach, who must be notified by whom, and when it must be reported