2020 Virtual Compliance Institute (CI)

1. Managing Your Conflicts of Interest Process: Lessons from the IRS 990, Maryland Health System, Memorial Sloan Kettering, Michigan State, and the Physician Sunshine Act

   2020 Virtual Compliance Institute (CI)  | Presenter(s): James G. Sheehan, Roy Snell  | April 01, 2020 

   • Conflict of Interest management-risks, disclosures, confidentiality, reputation

   • Who should be responsible for managing conflicts of interest reporting and evaluation? What systems and processes should your organization have in place? How can you tell if they are working?

   • Coming attractions in conflicts of interest: industry academic partnerships, IRS 990 data crawlers, Physician Sunshine Act, research integrity

2. The 340B Program: Perspectives on How to Promote Compliance in Your Covered Entity

   2020 Virtual Compliance Institute (CI)  | Presenter(s): Sue Veer, Michael B. Glomb, Coley Deal  | April 01, 2020 

   • A CEO, a 340B program manager, a compliance officer, and an attorney will discuss how to address the real-world compliance issues in the hospital and FQHC settings, including, applying the 340B patient definition across the continuum of care

   • Responding to challenges in dispensing 340B drugs to Medicaid beneficiaries and in managed care in particular

   • Monitoring for compliance, be ready for an audit 24/7, responding to new developments and OPA and other regulatory initiatives including current “hot topics”

3. The Role of Compliance in Government Enforcement: An Exploration of Recent Enforcement Activities, Evolution of Settlement Agreements, and Insights from a Corporate Monitorship

   2020 Virtual Compliance Institute (CI)  | Presenter(s): Tamara Forys, David Ogden, Shannon N. Sumner  | April 01, 2020 

   • Recent policy changes demonstrating the DOJ’s increased Retrieving data. Approach to enforcement will be explored and discussed, recognizing the value of an effective compliance program

   • From the perspective of a former US Deputy Attorney General and corporate monitor, recent DOJ policy activities will be explored including their impact on corporation credit in False Claims Act cases

   • This session will explore the evolution of settlement agreements, such as Corporate Integrity Agreements and Deferred Prosecution Agreements and the DOJ’s and OIG’s expectations for compliance with the terms of these agreements

4. Tips for Conducting Interviews During Internal Investigations (2020 Virtual Compliance Institute)

   2020 Virtual Compliance Institute (CI)  | Presenter(s): David M. Glaser  | April 01, 2020 

   • Who should do interviews and how should you document them?

   • Recognize how some unconventional strategies, including telephone interviews, can be surprisingly effective

   • Learn how to properly educate witnesses while avoiding acts that may be considered obstruction of justice

5. Be a HIPAA ACE: Awareness, Collaborate, and Educate

   2020 Virtual Compliance Institute (CI)  | Presenter(s): Joseph A. Piccolo, Dolores (Dee) Baughman  | April 01, 2020 

   • Awareness begins at the top. Engage your senior leadership through accountability, audits and your annual workplan

   • Collaborate with IT security, risk management, human resources, and legal to develop a strong focused infrastructure to support your efforts

   • Educate using varied platforms to meet the needs of your workforce

6. Compliance Program Development: What Are the Basics from Infrastructure to Risk Assessment?

   2020 Virtual Compliance Institute (CI)  | Presenter(s): Sheryl Vacca  | April 01, 2020 

   • Describe the fundamental elements

   • Discuss the importance of structure and risk assessment

   • Identify ways to leverage current resources

7. Cybersecurity & Incident Response: The Nuts & Bolts of Avoiding and Responding to a Security Incident.

   2020 Virtual Compliance Institute (CI)  | Presenter(s): Scott Wrobel, Debra A. Geroux  | April 01, 2020 

   • Cyber risk in healthcare: Presenters will provide an update on what is trending in cyberattacks, how they are getting in, why they are targeting healthcare, what they are doing and what they are looking for

   • Incident response: Real-world examples of how to handle incident response, including the steps to take for notification, remediation, and mitigation, and what to expect when the government starts their investigations

   • Lessons learned from a major breach and best practices for healthcare providers to avoid becoming the victim of a cyberattack

8. Developing, Implementing, and Delivering Physician Audits

   2020 Virtual Compliance Institute (CI)  | Presenter(s): Kimberly G. Huey, Sandra K. Giangreco Brown  | April 01, 2020 

   • You know you need to audit, but you want to make the most of your limited resources—how do you focus on what’s most important and structure your audits for the most impact? How do you present the results so that they will make a difference?

   • Why physician practices don’t audit, the benefits of an audit program, what areas should be audited, the benefits of an internal auditor versus and external auditor, the protection provided by attorney-client privilege, and more

   • From timing of the audit to choosing the auditor and the audit sample to delivering the results for the most impact and educating the physicians, this session walks you through every aspect of the physician audit process

9. Focus on Compliance Officer Skills: Navigating Enforcement Actions, Investigations, and Settlements

   2020 Virtual Compliance Institute (CI)  | Presenter(s): Ana-Cristina Navarro  | April 01, 2020 

   • Through case studies, speakers will review and seek attendee points of view on how adverse events, ranging from system failures to Privacy, HIPAA, or GDPR concerns, can lead organizations down the path of government surveys to formal enforcement actions

   • Speakers will illustrate how a privacy, compliance, or integrity team can assist and facilitate action planning and implementation to overhaul pertinent areas through policy development or revision, training, and careful support of needed culture change

   • Speakers will describe, and solicit input from attendees about, lessons learned and tools and methods for supporting organization wide efforts to navigate response to enforcement actions and build preventive activities

10. Government Enforcement

    2020 Virtual Compliance Institute (CI)  | Presenter(s): Kirk Ogrosky, Brandon Moss, Amanda P. Strachan, Miranda Hooker  | April 01, 2020 

    • Learn what investigative tools are used by DOJ and HHS-OIG to initiate different types of investigations

    • Best practices for addressing governmental investigations from hold notices, document collection and production, internal investigations, and resolution

    • Understand the obligations of legal and compliance officers throughout an investigation

11. Measuring the Effectiveness of a Compliance Program Using the DOJ Guidance

    2020 Virtual Compliance Institute (CI)  | Presenter(s): Joseph F. Zielinski  | April 01, 2020 

    • Discussion and analysis of the three “fundamental questions” that according to the DOJ guidance should be asked to determine the effectiveness of a compliance program

    • How the DOJ’s guidance specifically calls out various elements associated with a compliance program and what questions are asked to further assess how well these elements are contributing to the effectiveness of a compliance program

    • See and receive a tool that you can use to apply a data driven approach to assess how effectively your compliance programs aligns with the DOJ’s guidance on the effectiveness of a compliance program

12. Health System Transformation, Fraud and Abuse Regulation, and Value-Based Purchasing: Rethinking Boundaries

    2020 Virtual Compliance Institute (CI)  | Presenter(s): Jane Hyatt Thorpe, Elizabeth A. Gray  | April 01, 2020 

    • Understand opportunities and challenges posed by the current legal framework governing healthcare fraud and abuse as applied to new delivery and payment models that rely on financial incentives to encourage cross-sector collaboration and integration

    • Explore recent proposed changes to the existing healthcare fraud and abuse legal framework and evaluate whether and how these changes would better align the framework to the goals of a value-based payment system

    • Identify themes and trends across proposed changes to the fraud and abuse framework and discover the next steps for compliance professionals navigating an uncertain environment

13. The Evolving Kickback from a Prosecutor's Perspective: Novel and Unique Arrangements Catching the Government's Attention

    2020 Virtual Compliance Institute (CI)  | Presenter(s): Jon Ferry, Jason Mehta  | April 01, 2020 

    • Attendees will learn about how the basics of the kickback statute and will understand some of the emerging financial arrangements that have been scrutinized as running afoul of the Anti-kickback Statute (AKS)

    • Attendees will develop a better sense for how the government evaluates alternative financial structures and how the government assesses such arrangements for purposes of determining possible impermissible intent

    • Attendees will leave with key compliance strategies and 5-10 tips for structuring arrangements to avoid AKS scrutiny

14. If They Can't Understand Them, They Won't Follow Them: The Art of Drafting Effective Compliance Program Policies

    2020 Virtual Compliance Institute (CI)  | Presenter(s): Tomi K. Hagan, Gary Jones  | April 01, 2020 

    • Well-drafted policies are the infrastructure of an effective compliance program

    • If employees and volunteers can’t understand compliance policies because they are too “legal,” the likelihood of them following the policies is greatly reduced

    • Well-drafted, easy to understand policies will enhance the overall effectiveness of the compliance program

15. Privacy Officer Round Table

    2020 Virtual Compliance Institute (CI)  | Presenter(s): Adam Greene, Joan M. Podleski, Marti Arvin  | April 01, 2020 

    • Highly interactive discussion of the most challenging privacy issues facing privacy officers and other privacy counsel and staff

    • Audience members will select the privacy issues they would like to discuss, and will have the opportunity to learn from each other’s experience

    • Obtain practical solutions from experts and peers on some of the toughest day-to-day health information privacy challenges

16. Surviving as a Compliance Officer Wearing Multiple Hats

    2020 Virtual Compliance Institute (CI)  | Presenter(s): Lisa L. Boston  | April 01, 2020 

    • Per OIG Guidance, compliance programs should be scalable to the entity’s size, but wearing multiple hats can be successful

    • Different role scenarios and how to mitigate conflict of role

    • Building relationships to make it work

17. Managed Care Enforcement Trends and Compliance Risks

    2020 Virtual Compliance Institute (CI)  | Presenter(s): John Kelly, Sarah Kessler, Benjamin D. Singer  | March 31, 2020 

    • Review enforcement trends against Medicare and Medicaid managed care organizations and providers

    • Key risk areas and best practices for minimizing exposure will be discussed to help identify and remediate compliance concerns

    • Explain how compliance deficiencies in managed care processes and risk adjustment data create exposure under the false

18. 60-Day Repayment Rule: Discussion of Examples, Sampling Methods, and Strategies

    2020 Virtual Compliance Institute (CI)  | Presenter(s): Tracy M. Field  | March 31, 2020 

    • Developments in 60 day rule process—including new statistical sampling guidelines

    • Review of hypotheticals for which no voluntary repayment indicated

    • Review of hypotheticals, including sampling analysis/consideration where voluntary refund may be appropriate

19. Auditing Ahead of the Auditors: A RAC, CERT, and TPE Prevention Program

    2020 Virtual Compliance Institute (CI)  | Presenter(s): D. Scott Jones  | March 31, 2020 

    • Audit ahead of the RAC, CERT, and TPE audits and denials! Learn how to develop a pre-audit program designed to identify risks and improve processes before denials take place

    • CMS and their contractors send signals about their audit targets. Learn how to identify the next wave of audits before they appear

    • Turn compliance into a revenue center. Successful preparation leads to successful RAC, CERT, and TPE audits and appeals that retain or regain lost revenue

20. Medical Necessity & The False Claims Act: An Ever-Moving Target

    2020 Virtual Compliance Institute (CI)  | Presenter(s): Christopher A. Melton, Rosalind Cordini  | March 31, 2020 

    • The current way the False Claims Act is being used in litigation, with a focus on whether a doctor’s certification that a procedure is reasonable and necessary matches up with the government’s definition of the phrase

    • Understand current False Claims Act case law for what must be alleged in order to deem medical necessity of a procedure/service false, and learn from examples of recent FCA cases that are being filed

    • Gain insight on various court decisions regarding the government’s burden in these cases, along with tangible advice on how to make sure that medical necessity is justified

21. Auditing Compliance Effectiveness through a Lean Lens

    2020 Virtual Compliance Institute (CI)  | Presenter(s): LaQuenta Clarke  | March 31, 2020 

    • Establish two methodologies for developing an audit program for a compliance effectiveness review. Attendees will review programs for a well-established compliance program and a compliance program in its infancy stages

    • Discuss the requirements for an effective compliance program and provide best practices for mitigating key risks in high areas of vulnerability based upon the compliance program’s maturity level

    • Provide practical advice and tangible resources for incorporating lean methodologies into your compliance program practices

22. Merger and Acquisition: Compliance Due Diligence

    2020 Virtual Compliance Institute (CI)  | Presenter(s): Isaac M Willett, Steve Lokensgard  | March 31, 2020 

    • This session will briefly review the federal sentencing guidelines and help a small company understand whether a compliance program is voluntary or mandatory for your company

    • Understand options for implementing an effective compliance program in a small company, and that one size does not fit all

    • Understand some of the minimum expectations a large company will have with respect to compliance when acquiring a small, startup company

23. Auditing the Trifecta: Compliance, Privacy, Security

    2020 Virtual Compliance Institute (CI)  | Presenter(s): Debi Weatherford, Debra A. Muscio  | March 31, 2020 

    • Rapid expansion and overlapping responsibilities in the trifecta of compliance, privacy, and security have impacted the risks and opportunities for collaboration. These area leaders will discuss risks that have an overarching role

    • Provide updates on key regulations affecting the trifecta areas. Review key trends and risks associated with the areas and expanded opportunities for collaboration

    • Discuss strategies for monitoring/auditing and effective governance and control processes. Evaluate self-monitoring and audit programs and strategies to perform self-reviews or independent audits

24. GENERAL SESSION: Artificial Intelligence Compliance Risks and Applications in Healthcare

    2020 Virtual Compliance Institute (CI)  | Presenter(s): Vincent Walden, Caryl N. Brzymialkiewicz, Jim Passey, Julie Ward  | March 31, 2020 

    • Improving Compliance: Demystifying artificial intelligence (AI) into practical compliance monitoring applications

    • Managing Risk: Avoiding unintentional biases and outcomes with AI initiatives within your organization

    • Case Examples: Regulatory and organizational uses of advanced data analytical techniques, including AI

25. Beyond Checking the Box: Best Practices for Compliance Training Design, Delivery, and Evaluation

    2020 Virtual Compliance Institute (CI)  | Presenter(s): Gregory S. Rider  | March 31, 2020 

    • Learn how a large healthcare entity has applied the principles of adult learning and technology to advance their training efforts

    • Identify instructional design strategies and differences between in-person and online training approaches

    • Explore methods for evaluating the effectiveness of training