2020 Healthcare Enforcement Compliance Conference

26. Ask the Stark Professionals

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Charles Oppenheim , Lester Perling , Robert Wade  | November 17, 2020 

    • Brief overview of the Stark Law

    • Respond to pre-submitted & live questions regarding case examples of the application of the Stark Law

    • Opportunity for an open discussion for compliance officers, lawyers, and executives who have questions related to the Stark Law

27. Big Data: How Can It Be Shared and What Are the Considerations Regarding Enforcement?

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Marti Arvin , Blaine Kerr  | November 17, 2020 

    • Brief primer on the way in which individually identifiable information can be shared with regulatory parameters, both federal and state

    • Discussion of considerations when evaluating the sharing of big data sets with third parties for healthcare operations and/or research

    • Overview of the enforcement trends: Where it has been, where it is going, consumer privacy concerns, class actions and more

28. CMS Oversight and Enforcement of Safety and Quality Standards

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Peter Urbanowicz, David Wright  | November 17, 2020 

    • Learn how CMS is enhancing its oversight activities, including oversight of State Survey Agencies and accrediting organizations, in order to fulfill its critical obligation to develop and enforce essential standards for safety and quality

    • Measures providers can implement to recognize and address quality and safety deficiencies to avoid increased survey activity and enforcement actions

    • If a CMS survey is inevitable, learn how to prepare for and what to expect during the visit and how to best respond to CMS requests and findings

29. Civil and Criminal Telehealth Enforcement Matters; DME, Pharmaceutical and Other Covered Items and Services

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Jason Mehta, Colin Huntley  | November 17, 2020 

    • Understand the risks and opportunities associated with telemedicine

    • Understand the government’s increasing focus of telemedicine-related cases and what is to come

    • Understand the contours of telemedicine’s rules and how Medicare’s reimbursement paradigms have changed with COVID

30. Why Whistleblowers Matter to Healthcare

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Edward Baker, Sandra Miller  | November 16, 2020 

    • In light of recent research suggesting that companies with robust internal reporting systems are more profitable, and have lower litigation costs than those that do not, what is the best way to handle whistleblower complaints to minimize risk?

    • What is the process by which whistleblower complaints are filed, investigated, and litigated by the government?

    • Strategies and best practice techniques to evaluate, litigate, and settle FCA qui tam complaints

31. False Claims Act Liability in Post-Acute Care

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Tamar Abell, William T. Mathias  | November 16, 2020 

    • 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

32. Self-Disclosure Protocol

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Dennis Pangindian , Tony Maida  | November 16, 2020 

    • Understanding the landscape: 60 Day Overpayment Rule. The Civil Money Penalties Law (CMPL)

    • Deciding whether to disclose and where to disclose

    • Resolutions under OIG’s Self-Disclosure Protocol

33. The Secret Sauce for Complying with Privacy Regulations

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Karen Snyder, Darrell Contreras  | November 16, 2020 

    • Privacy is more of a priority than ever. Organizations must be able to react and respond quickly to increasing consumer privacy concerns, data breaches, and heavy-hitting regulations such as the CCPA and GDPR

    • The key to a successful privacy program is instituting an information lifecycle management (ILM) program that provides strong governance rooted in policy. This protects your organization from compliance risks and is vital to protecting patient privacy

    • Join us to discuss the impact of today’s privacy regulations and learn how ILM enables you to secure a unified view of patient data and related obligations, dispose of PHI in accordance with retention requirements, and reduce exposure to data breaches

34. General Session: Government Enforcement Panel (2020 Healthcare Enforcement Compliance Conference )

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Kirk Ogrosky, Greg Demsk, Allan Medina, Jamie Ann Yavelberg  | November 16, 2020 

    • Learn about DOJ Civil & Criminal Division’s enforcement efforts

    • Understand OIG current priorities

    • Learn how COVID-19 is impacting governmental investigations

    • Understand how compliance officers can be prepared to deal with DOJ and OIG

35. General Session: Whistleblowers - Who Are They, Why Do They Bring Cases, and What Makes a Good Whistleblower Case?

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Jeb White, Susan Gouinlock, Andrew Stone, Sarah "Poppy" Alexander  | November 16, 2020 

    • Understand why employees become whistleblowers

    • Advocate compliance culture that encourages internal reporting

    • Recognize concerns that devolve into whistleblower cases

    • List key factors of actionable whistleblower cases

36. How OIG Uses Data in its Affirmative Cases and How Data Can be Incorporated into Compliance

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Geoffrey Hymans, Barry Grosse  | November 16, 2020 

    • Learn how the OIG uses data to develop affirmative Civil Monetary Penalties Law and Exclusion cases

    • Learn how data can be used in unorthodox ways, such as to prove knowledge, or in quality-of-care cases

    • Learn how both large and small entities can incorporate data analysis into their compliance programs

37. Lessons Learned from Stark Investigations

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): David Glaser, Matthew Krueger  | November 16, 2020 

    • A U.S. attorney and defense lawyer discuss how cooperation between the government and defendants can lower the cost of an investigation

    • Analysis of Stark’s complexities, including how regulatory definitions can undermine arguments for both parties

    • Exploration of the limitations in salary survey data and why it can be difficult to evaluate fair market value compensation

38. Managed Care Enforcement and Compliance (2020 Healthcare Enforcement Compliance Conference )

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Benjamin Singer, Barbara Fonte, Sarah Kessler, Pamela C. Brecht  | November 16, 2020 

    • Consider examples of managed care fraud using past enforcement actions as a guide

    • Recognize compliance risks in managed care

    • Design and implement bi-directional education and training between Managed Care and Compliance

39. The Myth(s) of Median to 75th: New Perspectives on Assessing, Managing and Monitoring Physician Compensation Arrangement Risk

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): James G. Sheehan , Heather L. Fields, Adam Klein  | November 16, 2020 

    • Impact of USA ex rel. Bookwalter v. UPMC (938 F.3d 397 (3d Cir. December 20, 2019)). The new Stark burden of proof is on the hospital

    • Lessons from litigated cases about improving your organization’s physician compensation arrangement risk assessment process and strategies and resources for identifying and managing outlier arrangements at an enterprise level

    • Innovative, lower cost, and more effective risk management alternatives for determining and monitoring FMV and commercial reasonableness, including tips for mitigating risks inherent in relying on survey data and “independent” FMV reviews

40. Trends and Best Practices in Healthcare Privacy and Security Investigations

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Timothy Noonan, Jonathan Skrmetti , Brian Stimson  | November 16, 2020 

    • Trends in management and reporting of health information privacy and security incidents

    • Emerging federal and state enforcement priorities regarding health information privacy and security

    • Best practices for regulated entities involved in health information privacy or security investigations

41. 103 Preventing Enforcement Actions in Clinical Research: Operational Strategies for Avoiding Financial Frauds

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Kate Cohen , Sarah Couture  | November 16, 2020 

    • Billing errors in Clinical Research can and have resulted in large settlements arising from False Claims Act violations

    • Accurate billing for research activities is dependent on an multi-step process involving numerous players, departments, and functions. Breakdowns at any point in the process can result in large fines, settlements, and CIAs

    • This presentation will show how successful clinical research billing (CRB) revolves around ensuring your clinical research operations team is effectively communicating and that the rules are properly interpreted and applied

42. Federal Administrative Sanctions

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Jennifer Leonardis, HHS , Baker Donelson  | November 16, 2020 

    • Understand OIG enforcement actions, remedies, and appeals

    • Appreciate differences between available CMS enrollment actions

    • Identify new CMS program integrity rules and authorities

43. Anti-Kickback Statute Case Studies and OIG's Regulatory Flexibilities During the COVID-19 Pandemic

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Benjamin WallFisch, Susan Edwards  | November 16, 2020 

    • Review challenging real-world scenarios applying the anti-kickback statute

    • Understand OIG’s pandemic-related regulatory flexibilities and guidance

    • Awareness of OIG’s COVID-19 strategic goals

44. Enforcement and Compliance for Pharmacies

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Jennifer Krusa, Daniel Meier, Josh Lichtblau  | November 16, 2020 

    • Medicaid Enforcement Behind the Scenes: Identifying a healthcare provider/supplier with a focus on comparing claims, data mining and oddities

    • Pharmacy’s Response: How to prepare for a state Medicaid review/audit, seek guidance and address the issues

    • Resolution: Counsel’s role in considering options such as paybacks to MACs, use of the self-disclosure protocol or proceeding to litigation after appeals are exhausted, including discussion about cases and documentation

45. Encryption: Policy to Practice, Lower Risk, Increase Compliance!

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Uday Ali Pabrai  | November 16, 2020 

    • Examine encryption mandates defined in HIPAA Security, HITECH Act, PCI DSS, state regulations and more

    • Review specific areas where encryption can have a significant impact in lowering enterprise risk, while improving compliance posture

    • Step through core elements of an encryption policy to address both at-rest and in-motion requirements and understand how to simplify the use of encryption in your organization and do so consistently

46. DOJ Updated Guidance (June 2020)

    2020 Healthcare Enforcement Compliance Conference  | Presenter(s): Judy Ringholz, Sally Molloy  | November 16, 2020 

    • Review DOJ’s areas of focus when evaluating corporate compliance programs

    • Recognize specific changes that have been made to DOJ’s guidance document as it has evolved

    • Explore processes compliance officers can design to engender confidence in their program’s effectiveness