26th Annual Compliance Institute

26. Audit Framework for a COVID-19 Admissions Audit from Start to Finish

    26th Annual Compliance Institute  | March 29, 2022 

    • Defining Scope and Determining What to Audit Through Data

    • Pulling It All Together, Quantification of Any Overpayments and Accountability

    • Reporting the Results

27. Compliance Needs Project Management Too!

    26th Annual Compliance Institute  | March 29, 2022 

    • Understand what project management is and why it is important for effective compliance work

    • Review overlaps in roles and responsibilities between project management and compliance activities

    • Showcase effective and commonly used project management tools in compliance projects and share case studies

28. The CMS Comparative Billing Report (CBR) Program: Compliance Tools for Physicians and Other Outpatient Providers

    26th Annual Compliance Institute  | March 29, 2022 

    • Learn about the Comparative Billing Report CBR program created by CMS to provide education

    • CBRs offer provider peer to peer comparison data for Medicare Part B claims

    • CBRs support the auditing component of internal compliance programs

29. Drive Down Risk: New Strategies for Internal Audits

    26th Annual Compliance Institute  | March 29, 2022 

    • Identify ways to enhance your internal audit process for compliance improvement and risk

    • Analyze proven best practices implemented at Dana-Farber Cancer Institute to reduce risk and cost

    • Define specific business intelligence data and analytics used to identify and resolve risks

30. Program Integrity: How Fraud and Abuse Has Evolved as a Result of the Pandemic

    26th Annual Compliance Institute  | March 29, 2022 

    • Post-pandemic fraud and abuse trends

    • Best practices to detect, investigate, mitigate, and deter fraud and abuse

    • How counter fraud technology has evolved and is being incorporated

31. Your Audit Plan Is on Point...but How Is Your Monitoring Game?

    26th Annual Compliance Institute  | March 29, 2022 

    • So many audits, so little time: Why do we keep monitoring?

    • Deciding where to focus attention and why

    • Managing time and leveraging resources: Make it work for you

32. Navigating the Challenges of "Other Duties as Assigned"

    26th Annual Compliance Institute  | March 29, 2022 

    • Discuss challenges that can develop when compliance professionals are asked to perform other roles

    • Understand examples of roles that can present conflicts of interests for compliance professionals

    • Identify tactics for navigating requests for performing other organizational roles and duties

33. Caution Ahead: Hot Point Home Health Compliance Issues

    26th Annual Compliance Institute  | March 29, 2022 

    • Discuss current types of home health compliance issues and enforcement trends

    • Review home health operational compliance issues: medical director agreements and marketer payments

    • Cover key issues in UPIC audits and kickbacks to discharge planners and case managers

34. Compliance Risks for Speakers' Programs

    26th Annual Compliance Institute  | March 29, 2022 

    • Provide an in-depth description of Speakers' Programs and the compliance risks identified by HHS OIG

    • Describe strategies for educating physicians, identifying risky activities, and protecting patients

    • Identify policy approaches for managing compliance and conflicts of interest with Speakers' Programs

35. Mitigating Risks: A Primer on Understanding Government Contracting Compliance

    26th Annual Compliance Institute  | March 29, 2022 

    • Healthcare organizations looking for revenue growth frequently pursue federal contracts as either a prime or subcontractor for sources of new revenue. These contracts contain unique and sometimes burdensome compliance requirements contractors must follow

    • While healthcare organizations understand the requirements of 42 CFR, federal contracts include further provisions and clauses required by 48 CFR. Organizations must recognize the related administrative challenges and the financial and compliance risks

    • It is critical for organizations to understand, develop, and maintain internal controls and the systems necessary to mitigate risks associated with federal contract provisions. By not doing so, an organization's exposure to risk may outweigh expected benefits

36. Security Incident Response: How to Prevent a Breach

    26th Annual Compliance Institute  | March 29, 2022 

    • Learn about common information security incidents, how they occur, and how they can lead to a breach

    • Develop or improve your current incident response policy and procedure

    • Train employees to better identify security incidents and follow your incident response procedures

37. Enforcement Liability and Insolvency

    26th Annual Compliance Institute  | March 29, 2022 

    • Enforcement Liability and Bankruptcy and Insolvency: Responsive Strategy or Fantasy

    • Enforcement and/or Overpayments: Insolvency and Successor Liability

    • Twomey Hospital: Catastrophic Judgment and Resolution

38. EMTALA and Beyond: How to Create and Maintain an EMTALA Compliance Program to Address Unique Challenges

    26th Annual Compliance Institute  | March 29, 2022 

    • Know what EMTALA requires and when and where it applies

    • Appreciate the importance of a clear EMTALA policy and a dynamic training program

    • Understand how to structure an EMTALA compliance program when a hospital has multiple EDs and sites

39. 2021 and 2022 New E and M Changes: Simplifications, Challenges, and Other Risk Areas of Physician Practices

    26th Annual Compliance Institute  | March 29, 2022 

    • Identify the methods to improve the documentation appropriateness of 2021 E and M changes

    • Present the proper documentation strategies with examples to maintain compliance and avoid red flags

    • Understand the four key risk areas affecting the physician practices as outlined by OIG CPG

40. Casting Your Vendor Risk Management Net Wide Enough: Are You on the Hook?

    26th Annual Compliance Institute  | March 29, 2022 

    • Identify challenges in your third-party risk processes and your enterprise risk management

    • Identify a framework, program elements, and technology to assess your third-party risk

    • How to incorporate risk quantification and risk reduction into your decision-making

41. Telehealth: Billing Compliance Updates

    26th Annual Compliance Institute  | March 29, 2022 

    • Identify appropriate telehealth CPT codes based on documentation

    • Apply the appropriate regulations to telehealth services

    • Understand nuances between CMS physician fee schedule guidelines v. waivers provided for the PHE

42. Why Health Systems Should Treat Compliance Like Preventive Care

    26th Annual Compliance Institute  | March 29, 2022 

    • A discussion about the current security threats to your organization's patients' data

    • Impact of COVID-19 on preventive compliance monitoring programs

    • Hear a success story about compliance monitoring best practices at the University of Miami

43. False Claims Act and Medical Necessity

    26th Annual Compliance Institute  | March 29, 2022 

    • Review the definition of medical necessity

    • Discuss how a "Medically Unnecessary" becomes a False Claim

    • Examine types of "Medically Unnecessary" FCA cases

44. Retro Fraud: 25 DOs and DONTs from 25 Years in Compliance

    26th Annual Compliance Institute  | March 29, 2022 

    • List compliance red flags for HHS/OIG special agents and the legal counsel for monitors

    • How to ensure compliance with Stark and Anti-Kickback; learn how to spot when compliance is ignored

    • List key statements, data trends, and referral patterns to indicate fraudulent activity

45. Enhancing the Value of Corporate Compliance to the C-Suite

    26th Annual Compliance Institute  | March 29, 2022 

    • Connect corporate compliance to organizational goals

    • Understand the importance of framing compliance metrics to the audience

    • Implement a process to add value to the corporate compliance program

46. Successful Completion of a Corporate Integrity Agreement: Compliance and Audit Lessons Learned

    26th Annual Compliance Institute  | March 29, 2022 

    • Identify key actions the OIG is looking for in successful close to a corporate integrity Agreement (CIA)

    • Leverage flexibility of CIA to limit audit universe and develop risk-based recommendations

    • Illustrate successful completion of CIA final report and continuation of key compliance elements

47. Information Blocking: A Page from the Patient Access Playbook - CI 26

    26th Annual Compliance Institute  | March 29, 2022 

    • Understanding the eight exceptions to information blocking

    • Ensuring prompt patient access, exchange, and use

    • Implementing an information blocking and exceptions policy

48. Reportable Events: How to Investigate, Respond, Self-Report, and Alternatives to Self-Reporting

    26th Annual Compliance Institute  | March 29, 2022 

    • Sources of compliance discovery

    • Internal investigation considerations

    • Self-reporting considerations: Payers, CMS, OIG, DOJ

49. The Certified Community Behavioral Health Clinic (CCBHC): What You Need to Know to be in Compliance

    26th Annual Compliance Institute  | March 29, 2022 

    • Understand the purpose behind the CCBHC demonstration program authorized under Section 223 of the Protecting Access to Medicare Act (PAMA) and provide an overview of its objectives

    • Learn from one provider's experience with implementation of the CCBHC model of care and securing compliance with CCBHC requirements

    • Raise awareness of potential risks and compliance hotspots

50. Evolving Auditing Methodologies Are a Game Changer for Effective Compliance

    26th Annual Compliance Institute  | March 29, 2022 

    • Discuss the pros and cons of traditional documentation review methodologies

    • Identify alternate and innovative auditing strategies to improve auditing results

    • Apply real-life lessons learned to elevate your compliance program effectiveness