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2019 Compliance Institute (CI)

2019 Compliance Institute (CI)

Managed Care Fraud: Enforcement and Compliance

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Managed Care Fraud: Enforcement and Compliance
Megan Tinker, Senior Advisor for Legal Affairs, HHS-OIG. Banjamin D. Singer, Partner, O'Melveny & Myers LLP.

April 9, 2019

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Slides

Sessions

The Risks and Benefits of Healthcare Consolidation on Innovation and Clinical Research in Health Systems and Hospitals

What Big Data Reveals about Compliance Adherence and How to Launch and Sustain a Compliance-Driven Culture

Compliance Program, Program Integrity, and Fraud, Waste, and Abuse-Where Does It All Fit?

Mergers & Acquisitions During a Time of Healthcare Transformation

You Can Lead a Horse to Water and You Can Make It Drink: The Role of the Work-Plan In Developing and Implementing POCs in Behavioral Health

You Don't Know What You Have Until It's Gone, and Then It Is Too Late: The Benefits of a Data Management Audit

Year One of a Compliance Journey: A First Year Under a CIA - Tips to Prepare for and Implement Best Practices for Your CIA

Whistleblowers: Who Are They, Why Do They Blow the Whistle, and Managing the Risk

Who's On First? Applying Learnings from Abbott and Costello to Achieve Healthcare Compliance Effectiveness

Will CMS Turn Down the Volume? Patient-Driven Payment Model (PDPM) and the Effort to Replace RUGs

What Do Carnegie Hall and Good Security Incident Response Plans Have in Common: To Get There You Have to Practice, Practice, Practice!

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

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

Women in Cybersecurity: Shattering the Career Mystique

Viewing Investigations from a Different Angle: Understanding the Varying Perspectives of Counsel, Compliance Officer and Prosecutor to Improve Your Internal Investigation Process

When Compliance Isn't the Only Hat You Wear: The Art of Allocation of Time and Resources While Maintaining an Effective Compliance Program

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

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

Working with Integrity: Taking the Right Path

Top Cyber-Risks to Include in Your Audit Plan

The Art of Conducting Effective HIPAA Privacy Intake and Investigative Interviews

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

Three CIA Provisions that Will Enhance Your Compliance Program

Teaming Together: How Compliance Can Work with the Evolving Role of Internal Audit

Telehealth Contracting for Compliance Officers: Core Concepts, Best Practices and Tips

The Fifth Element of An Effective Compliance Program: Monitoring, Auditing, and Internal Reporting Systems

Tales from the Trenches: An Inside Look at How Different Organizations Account for and Meet the Challenges of MACRA

Statistical Sampling in Healthcare Audits and Investigations

Student Documentation: The Good, Bad, and Ugly

Surviving the Compliance Storm: Beyond a Risk Assessment-Partnering with the C-Suite to Develop an Enterprise Risk Management System

Theranos Case Study: What Went Wrong?

Smooth Sailing Into Joint Venture Compliance: Best Practices for Providers, Payers and Vendors

Selling and Buying the Brooklyn Bridge: Lessons Learned from M&A Due Diligence

The State of Exclusions and OIG Enforcement Actions

Size Does Not Matter: How Any Physician Practice -Small or Large-Spots a Compliance Issue

Risk Assessment Workshop: Are You Assessing All Your Risks? Learn How to Design an All-Encompassing Risk Assessment Framework

Risk Assessments: Building Your Risk Program, Developing Partnerships, and Mitigating Risk

Risk Management & Internal Investigations

M&A Transactions in Home Health and Hospice: Compliance and Due Diligence - How Do I Get This Right?

Population Health, Quality and Compliance: A Look at the Process

The Compliance Professional's Approach to Auditing Rehabilitation Services

Beyond Auditing and Monitoring and Towards Quality Improvement

The Intersection of Clinical Quality and Regulatory Requirements in the Conditions of Participation

The #MeToo Movement: What Compliance Officers Should Know and How to Be Prepared

The Quality-Compliance Collaborative in FQHCs Illustrating the Evolving Model for American Healthcare

The Intricate Journey of Auditing and Monitoring Clinical Contractual Agreements

Telehealth or TeleHELL? Understanding the Complexities of Telehealth Beyond the Initial Set Up

Somewhere Beyond the OIG: Discussion of Exclusion Checks

The CI Is Over: Now What?

Auditing & Monitoring for Health Insurers

The Spyware Nightmare

Responding to Government Investigations and Compliance Matters

Real-World Strategies for Identifying, Measuring, and Reporting Risk

Recent and Emerging Issues Related to Clinical Laboratory Testing and How to Prevent Them

Physician Relationships in the Academic Medical Center Context: Anti-Kickback and Stark Law Issues

Physician, Quality and Compliance Collaboration for a More Effective Compliance Program

Protecting the Bottom-line: Defending Claims with Policies & Procedures

Physician Compliance and Risk Assessment: A Two-Year, Performance Improvement Continuing Medical Education Model to Improve Quality and Compliance

Physician Engagement: How to Develop a Physician Champion Program

Physician Practice Enforcement Actions: Could You Be Next Year's News?

Only Take a Calculated Risk: Empowering Leaders to Make Risk-Informed Decisions with a Modern Enterprise Risk Management Program

Patient Incentives or Inducements? Avoiding Pitfalls and Managing Risks

Navigating the Changing Regulatory and Enforcement Landscape Relating to Opioids

Next Generation Compliance: How Metrics Should Drive Your Compliance and Ethics Program

OIG Compliance Monitoring: Practitioner and Small Business Integrity Agreements

Navigating Behavioral Health Risks and Confidentiality Tough Spots

Navigating Privacy Requirements When Integrating Mental Health, Substance Use Disorder and Primary Care Services

Leveraging Your Compliance Committee: Practical Approaches to Maximize Your Compliance Committee's Role, Overall Effectiveness, and Value to the Organization

Long-Term Care Requirements of Participation Compliance Responsibilities

Mental Health Parity: Managing Compliance Across Commercial, Medicaid, and Duals Products

Launching Ladies into Senior Leadership (2019 Compliance Institute)

OIG Developments 2019

Research Compliance for the Hospital Compliance Officer

Lessons Learned From Teaching a Provider Documentation Remediation Course

Office for Civil Rights: HIPAA Update & Enforcement

Overcoming Management Pushback to Achieve Compliance

Making Compliance Education Your First Defense

Managed Care Fraud: Enforcement and Compliance

Investigational Device Exemption (IDE) and Humanitarian Device Exemption (HDE) Device Coverage & Billing: Compliance Insights

It's Time For a Revolution: Assessing the Effectiveness of Your Code of Conduct

Internal Investigations: Refining Your Interviewing Skills

Independent Investigations: The Compliance Role

Integrating Compliance Departments in Mergers

Internal Audit's and Compliance's Role in Addressing Enterprise Risk: Behavioral Health

Incident Response: Best Practices in Breach Management

Increasing Compliance and Reducing Risk Through Information Governance Practices

How Bias and Perception Impact Compliance (2019 Compliance Institute)

How Vendor Oversight Should Lead the Charge for Contracting with a New FDR

How the Centers for Medicare and Medicaid's Target Probe and Educate (TPE) Program Can Support Your Organization's Compliance Program

Hidden Treasure or Hidden Kickback? If It Looks too Good to Be True, It Might Be an Anti-Kickback or Stark Violation

Home Health Agency: Audit Strategies and Common Red Flag Findings

Healthcare Compliance Auditing for Zones of Risk

Hidden Risk Area: Patient Grievances-Are You Prepared for a Survey?

HIPAA Privacy and Social Media: How to Create a Culture of Confidentiality

Labs, Recovery Homes, and Treatment Centers, Oh My! Follow Us Down the EKRA Brick Road

Hands On Keys Computer Lab: Computer Tips, Tricks, and Internet Hacks to Make You a More Efficient and Effective Compliance Professional

Home Health and Hospice: Enforcement Trends and Compliance

Fraud and Abuse Regulation, Compliance, and Value-Based Purchasing: The Search for Greater Alignment

From Volume to Value in Post Acute Care: Your New Compliance Data Points

GENERAL SESSION: CMS Update (2019 Compliance Institute)

Is Your Practice a Government Target?

HCCAS and Providers: Get Paid for What You Do

Fraud and Abuse Laws 101 & OIG's Role

GDPR Update: Privacy Across the Pond

HHS Cybersecurity Top Threats and Best Practices

Health IT Risk Roundtable

HIPAA Privacy Officer 101

False Claims Act Developments Part 1

Experimental Drugs, Marijuana, and Complementary Medication Use in Long-Term Care Settings: Risks and Best Practices

EMTALA and Behavioral Health: Myths, Mired Down, and Making Sense of It All

Effective Risk Management in Medicare Compliance: How to Detect, Prevent, and Correct Issues

Drug Diversion: A Multidisciplinary Approach

Effectively Managing Risk: The Intersection of Compliance, Enterprise Risk Management and Internal Audit

Due Diligence for Acquisition and Partnerships: What to Consider When Bringing a Small Private Practice Into a Large Health System or Academic Medical Center

EHR Documentation Risks and Internal and External Reviews

Developing Your Hospice Compliance Risk Assessment

Disaster Planning in Senior Living: HIPAA Still Matters

Developing Compliant Physician Compensation Arrangements in the Current Enforcement Environment

Data, Monitoring and the Culture of Privacy

Five Strategies to Create Compliance Allies

Data Analytics and Risk-Based Methodologies in Refreshing Revenue Compliance Auditing & Monitoring

Examining the Foundational Features of a Patient Protection-Driven Compliance Program

Data Protection, Privacy, and Security in the Healthcare Industry Year in Review: State Enforcement Focus Areas in 2018 and Outlook for 2019

Cyberbattle: A Practical Demonstration of Hacking and Defending Your Organization

Facing an Extrapolation? Steps for Checking the Statistical Approach

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

False Claims Act Developments Part 2

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

Criminal and Civil Liability for Overpayments

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

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

Conducting a Behavioral Health Risk Assessment

Creating a Compliance Plan in the New Post-Acute World

Compliant Physician Documentation in an Electronic World

Everything Under The Sun(shine)

Frankly Speaking

Drip Drop: Infusion Auditing Made Simple

Compliance at the Point of Sale

Compliance Program Operations vs. Conducting a Complex Investigation

Compliance Program Start Up: What Are the Basics Needed for Your Infrastructure?

Compliant Billing for Inpatient Rehab: How to Avoid Documentation Perils

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

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

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

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

Communicating with Your Audit and Compliance Committee from Both a Compliance Officer's and Board Member's Perspective

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

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

Capture the Big Picture! Design a Risk Assessment Framework that Accurately Depicts Your Risk Landscape

Blockchain Technology: Move Fast and Break Things Reconsidered

An Effective Privacy Program Built Through Strategic Vision and Leadership Support

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

A System-wide Approach to 340B Compliance in a Multi-state Integrated Health System

A Compliance Case Study from the Trenches with Current and Former DOJ Prosecutors

ACO Compliance Program Implementation When You Are Not All In the Same Family

Compliance for Hospice and Home Care

Compliance's New Role in the Survey Process

Compliance Challenges for Advanced Practice Providers

Compliance Culture Case Studies

Beyond the Elements: Operationalizing Compliance

Anatomy of an Attack: Key Security Trends

Ask the Stark Law Professionals

Auditing Clinical Trial Billing: A Real-World Approach

Actively Assess and Audit Your Post-Acute Service Lines

About SCCE

The Society of Corporate Compliance and Ethics (SCCE) is a non-profit, member-based professional association. SCCE supports our members' work with education, news, and discussion forums. We are a community of leaders, defining and shaping the corporate compliance environment across a wide range of industries and geographic regions. In developing and maintaining effective ethics and compliance programs, our members strengthen and protect their companies.

952.933.4977

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About HCCA

The Health Care Compliance Association (HCCA), is a 501(c)6 non-profit, member-based professional association. HCCA was established in 1996 and is headquartered in Minneapolis, MN. We provide training, certification, and other resources to over 10,000 members. Our members include compliance officers and staff from a wide range of organizations, including hospitals, research facilities, clinics and technology service providers.

952.988.0141

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