HCCA 27th Annual Compliance Institute

1. Compliance: The Basics - CI0423

   HCCA 27th Annual Compliance Institute  | April 23, 2023 

   • Understand the seven elements and how to implement them

   • Discuss compliance program implementation

   • Understanding the effectiveness attributes of a compliance program

2. Conducting a Privacy Program Review and a HIPAA Security Self-Audit - CI0423

   HCCA 27th Annual Compliance Institute  | April 23, 2023 

   • Using the 8 Elements of an Effective Compliance Program to Review Your Privacy Program

   • Why conducting a HIPAA compliance self-audit is critical to your compliance program

   • Key areas for compliance efforts based on the OCR's recent HIPAA reports and resolution agreements

3. Calling All Compliance Officers! Setting Up for Success from Day One - CI0423

   HCCA 27th Annual Compliance Institute  | April 23, 2023 

   • Assess the organization's culture, break down silos, identify compliance partners, and integrate compliance into strategic initiatives

   • Conduct a high-level compliance risk assessment to establish priorities

   • Implement different strategies to leverage limited resources to achieve compliance goals

4. Swimming with Sharks: A Compliance Officer's Guide on Working with Legal Counsel - CI0423

   HCCA 27th Annual Compliance Institute  | April 23, 2023 

   • Friend or Foe: Navigating the different roles and approaches by exploring the different perspectives that compliance and legal counsel bring and how to navigate the relationship

   • Aquarium and Ocean: Navigating the differences between working with in-house vs. outside legal counsel

   • A Symbiotic Relationship: The why, when and how to partner with legal counsel to conduct investigations under the attorney-client privilege

5. Don't Be Surprised! How Ambulatory Care Providers Can Streamline Compliance with the No Surprises Act - CI0423

   HCCA 27th Annual Compliance Institute  | April 23, 2023 

   • Define key components of the No Surprises Act requiring provision of a Good Faith Estimate, the anatomy of a compliant GFE, and HHS enforcement mechanisms for non-compliance

   • Discuss the panoply of applicable laws and regulations to consider in addition to NSA when developing financial assistance and cost-sharing policies, such as state balance billing laws, Beneficiary Inducement, Fair Credit Reporting, MFN rules, and ERISA

   • Apply standardized methodologies and the tools shared by the presenters to develop patient-friendly, NSA compliant, scalable workflows for any size or specialty medical practice or ambulatory services provider

6. Best Practices for New/Expanded Managed Care Program Implementations - CI0423

   HCCA 27th Annual Compliance Institute  | April 23, 2023 

   • Ensure that your implementation balances new requirements with existing business operations

   • Address Privacy and Security: Impacts for HIE, consumer experience/outreach and vendor partners

   • Align system configuration and business rules with regulatory and operational policies

7. Millennial Mindset: Later Culture & Its Impact on the Workforce - CI0423

   HCCA 27th Annual Compliance Institute  | April 23, 2023 

   • Understand how life experiences have shaped the mindset: How Millennials compare and contrast to Gen Z

   • Discover how this combined group can be actualized to help crowdsource risk at scale sustainably

   • Learn how to activate them as human sensors to reinforce an authentic culture of integrity

8. ONC's Information Blocking Rule - Requirements, Timelines, Exceptions, and How to Make It All Work - CI0423

   HCCA 27th Annual Compliance Institute  | April 23, 2023 

   • What is information blocking?

   • Compliance requirements and timelines

   • Exceptions and overcoming obstacles

9. The Seven Habits of an Effective Compliance and Ethics Professional - CI0423

   HCCA 27th Annual Compliance Institute  | April 23, 2023 

   • Our success is driven both by others and by how we approach our work: Understanding how to be more effective at a personal level is the first step in being a more effective and respected leader in your organization

   • Understand common behaviors that promote and detract from our effectiveness, and how to mitigate our weaknesses and build on our strengths

   • Ultimately, we are responsible for our own success: Explore numerous concrete examples of how you can position yourself for success in both your current role and in future roles

10. Implementation of Risk University - CI0423

    HCCA 27th Annual Compliance Institute  | April 23, 2023 

    • Understand the value of training an entire work unit vs. classes of individuals

    • Gain an appreciation of the importance of integrating policy, tools and training

    • Develop a collaborative approach to risk management from the top down and the bottom up

11. Adapting Available Resources for Creating a Site-Specific Audit Guide - CI0423

    HCCA 27th Annual Compliance Institute  | April 23, 2023 

    • Creating a non-internal audit department guide for an effective, efficient, and ethical audit

    • Is everyone auditing the same?

    • Standardizing audit processes and procedures Creating consistent templates and tools: Do you have what you need to document?

12. Medicare, Medicaid, and Federal Exchange/Commercial Risk Areas - CI0423

    HCCA 27th Annual Compliance Institute  | April 23, 2023 

    • Identify compliance risk areas from the OIG work plan

    • Learn how CMS's Program Audit and Enforcement Report can help you identify compliance risks

    • Understand the compliance risks related to the Federal Exchange and other commercial products

13. Project Lifecyle from Launching to Landing - CI0423

    HCCA 27th Annual Compliance Institute  | April 23, 2023 

    • Project Management is more than just the nuts and bolts of "doing the work"

    • Learn steps that are involved in not only launching but landing a project successfully

    • Overview of tools that will help you manage projects in an efficient manner

14. Compliance Investigations: a 'How To' Guide For A Successful Investigation - CI0423

    HCCA 27th Annual Compliance Institute  | April 23, 2023 

    • Understanding the components of an internal investigation

    • Analyze evidence for the development of internal reports and debriefs

    • Applying attained investigative knowledge through a case study

15. Artistry in Motion, How to Mature the Program with Flair! - CI0423

    HCCA 27th Annual Compliance Institute  | April 23, 2023 

    • Master the art of delivering the news to mature the effectiveness of your compliance program

    • Position your program dashboard to meet compliance objectives, brand your message with simplicity

    • Use recent events to develop and deliver effective scenario-based education

16. 340B Drug Discount Program: Key Compliance Elements and Updates - CI0423

    HCCA 27th Annual Compliance Institute  | April 23, 2023 

    • Discuss 340B Program basics, general compliance requirements, and common risks

    • Summarize key elements of 340B contract pharmacy arrangements and emerging compliance opportunities

    • Explore developments in patient eligibility, government audits, and self-auditing best practices

17. Make Your FMV Policy Work for You (and Not the Other Way Around) - CI0423

    HCCA 27th Annual Compliance Institute  | April 23, 2023 

    • Understand the regulations that govern physician transactions and the risks associated with them

    • Learn to design simple and compliant FMV policies that work for your organization, not against it

    • Remove points of friction in the FMV process and apply strategies to lower cost and complexity

18. OIG Priorities in Managed Care Oversight - CI0423

    HCCA 27th Annual Compliance Institute  | April 23, 2023 

    • Recent OIG work in managed care

    • Using data analytics to identify risk areas

    • Upcoming OIG work and oversight trends

19. Building a Focus Arrangements Compliance Program: Facilitating Compliance with Stark & AKS for Your Referral Source Arrangements - CI0423

    HCCA 27th Annual Compliance Institute  | April 23, 2023 

    • Discuss Strategies for assuring compliance with various types of referral source arrangements

    • Review and understand the key components of a successful focus arrangements compliance program

    • Participate in exercises that will prepare you to implement a focus arrangements compliance program

20. Reshaping Your Compliance Program Post COVID - CI0423

    HCCA 27th Annual Compliance Institute  | April 23, 2023 

    • Describe compliance program elements to include in an effective compliance program

    • Differentiate compliance programs pre and post COVID-19 pandemic

    • Identify four strategies and action steps to strengthen your facility compliance program

21. Engaging Clinicians in the Compliance Effort - CI0423

    HCCA 27th Annual Compliance Institute  | April 23, 2023 

    • Explore engaging clinicians in compliance training initiatives

    • Explore engaging clinicians in relationship building to facilitate a stronger compliance culture

    • Explore how engaging clinicians can help improve accountability in reviews and corrective action plans

22. Medical Necessity: Adding Proactive Medical Necessity Monitoring to Your Compliance Program - CI0423

    HCCA 27th Annual Compliance Institute  | April 23, 2023 

    • Discuss the differences between proactive and reactive monitoring for medical necessity

    • Compare 'medical necessity' from a clinician's perspective vs. payor policy perspective

    • Highlight enforcement cases involving allegations of medically unnecessary services

23. Not Everything Is Illegal! Mitigating Risk by Clearly Distinguishing between Regulatory Requirements and Guidance - CI0423

    HCCA 27th Annual Compliance Institute  | April 23, 2023 

    • Suggestions for improving your hiring process for compliance professionals

    • Tips for explaining complicated rules and legal hierarchy to compliance and medical professionals

    • Strategies for analyzing contradictory "expert" opinions and reducing legal anxiety

24. Not Another FYRE Festival - Don't get stuck on an Island: A Primer on Understanding Compliance with Medicare Marketing Guidelines - CI0423

    HCCA 27th Annual Compliance Institute  | April 23, 2023 

    • Oversight of sales agents/brokers marketing activities

    • Provider Marketing Activities - What is permissible and what is not

    • Communication and marketing requirements (marketing at sales events, nominal gifts, promotional activities)

25. General Session: An Update on OCR's 2023 Priorities - CI0423

    HCCA 27th Annual Compliance Institute  | April 24, 2023 

    • A 2023 outlook and HHS OCR priorities

    • Status update on pending regulations and future guidance

    • Nondiscrimination in health programs and activities (including Section 1557, Language Access, Section 504)