Faculty Presentations
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12:00 5:00 PM
I. Long Term Care
Compliance
Chairs: Bill Altman and Eileen Coggins
HIPAA Compliance Fundamentals in Long Term Care
James Pfeiffer and Brian Zoeller, Kindred Healthcare, Inc.
HIPAA Case Study: Long Term Care (LTC)
Industry
Quality of Care as a Compliance Issue in Long Term
Care Panel:
Andrew Penn, Office of Inspector General
M.T. Connoly, Department of Justice
Irene Fleishner, Vice President of Clinical Operations, Genesis Health Ventures,
Philadelphia, PA
Moderator: Eileen Coggins, Vice President of Compliance, Genesis Health Ventures
Compliance Issues under Medicare Prospective Payment
for Nursing Facilities
Ronald Orth, RN, Director of
Utilization Compliance, Kindred Healthcare, Inc.
Patricia J. Boyer NHA, RN, BDO / Heritage
Healthcare Group
Compliance Issues under Medicare Prospective Payment for Nursing Facilities
12:00 5:00 PM
II.
Academic & Research Compliance
Judy Argon, Vice President of Research
Administration, Childrens Hospital of Philadelphia, Philadelphia,
PA
John Allen, Asst. VP for
Scientific Affairs, State Univ. of NY, Brooklyn,
NY
F. Lisa Murtha, Chief Audit & Compliance
Officer, Childrens Hospital of Philadelphia, Philadelphia,PA
HIPAA Privacy and the
Academic Medical Center
Chris Jedrey, Attorney, McDermott,
Will & Emery, Boston, MA
Academic & Research Compliance
HIPAA: Open Research Issues
12:00 5:00 PM
III.
Payors/Managed Care Compliance
Chair: Vickie McCormick
HIPAA for Payor Organizations
Michelle Huntley, UnitedHealth Group, Minnetonka, MN
Wendy Krasner, Attorney, McDermott, Will & Emery, Washington, DC
Key Issues For Health Plans Under HIPAA Privacy Regulations
Payor Relationships with the Pharmaceutical Industry
Elizabeth Moran, Attorney, Halleland, Lewis, Nilan, Sipkins & Johnson
Vickie McCormick, Halleland & Lewis, Minnetonka, MN
Payor Relationships with the Pharmaceutical Industry
Market Conduct Examination Strategies
Sharon Hayman, Newark, NJ
Mike Treash, Ernst & Young
War Stories and Deep Thoughts
Compliance Programs for Payor Organizations
Robert Freeman, BCBS of
Massachusetts, Boston, MA
Emil Moschella, BCBS of New Jersey
Compliance Programs for Payor Organizations
12:00 5:00 PM
IV. Health Care Privacy Officer Compliance
Panel Discussion on
Privacy
The Health Care Industrys New Trademark
Anthony Boswell Esq., Ethics,
Privacy, Compliance Officer and Corporate Counsel, Laidlaw, Inc.
Peter Adler, Attorney, Foley & Lardner, Washington, DC
Alyse Hutchinson, Esq., Assistant Privacy Officer,
American Medical Response, Inc.
Chuck Steen, Privacy & Data Security Officer, Catholic Healthcare
West
Mark Meaney, PhD, Executive Director,
Institute for Clinical & Corporate Ethics
The Role of the Privacy Officer
Integrating Privacy
into Organizational Culture
Corporate Privacy Official: Developing and Appropriate
Job Description & Duties
Anthony Boswell and Peter Adler
The Role of the Privacy Official in Todays Health
Care System
Chuck Steen
Privacy and Compliance: Integrating the Two Programs
The Impact of Privacy Training
Alyse Hutchinson
Ethical Implications of the Privacy Rule
Mark Meaney
Many challenges accompany the implementation of the Privacy Rule. This symposium will address a broad range of issues related to the impact of the privacy program on todays health care industry.
12:00 5:00 PM
V. Integrated Health Care
Systems Compliance
Moderator: Michael Hemsley, CHC, VP/Corporate Compliance & Legal Services, Catholic Health East, Newtown Square, PA
Alan Yuspeh, Senior Vice
President for Ethics, Compliance and Corporate Responsibility
Kathi Whalen, Assistant Vice President, Ethics and Compliance
Program Development
Bill Middleton, Case
Manager
Jim Finnegan, Manager, Ethics and
Compliance Program Assessment
Sara Martin-Michels, CHC, Senior Compliance Analyst
Holly Winn, Training Analyst
Exec Summary
Chicago 2002 Case Study
CPR-Corrective Action Plan
CPR-Report of Findings
EC Workplan2002
Facility Ethics and Compliance Program Review
Integrated Health Care
Systems Compliance
Revised Licensure and Certification (Divider)
Memo: Compliance Policies and Procedures
Professional Courtesy Discount Checklist
Elements of a compliance program, including setting
standards, creating awareness, measuring effectiveness, allowing for exceptions
to be reported and establishing an organizational structure to support the other elements
How we have implemented a program across an organization
comprised of hundreds of hospitals, ambulatory surgery centers and physician
practices
12:00 5:00 PM
VI. The Compliance Officer Forum Compliance Document
Workshop
Shawn DeGroot, CHC, Compliance Director, VA
Medical Center and Regional Office Center, Sioux Falls, SD
Christine Boras, CFE, CHX, MBA, CCO, United
Health Services, Inc., Binghamton, NY
Kathy
Merlo, St. Louis University, St. Louis, M
Greg Warner, Director of Compliance, Mayo Clinic, Rochester, MN
Agenda
Power Point "RISK2002"
Compliance Audit Review Plan
Audit Review Schedule
Risk Matrix
Laboratory Audit and Compliance Plans
Reporting and Responding to Allegations of Non-Compliance
Compliance Acknowledgment Receipt Form
Compliance Communications Log
Compliance Communications Report
Compliance Risk Assessment Management Interviews
Compliance & Business Integrity
Risk Assessment Tracking
Share unresolved questions and policy challenges for discussion and resolution in a facilitated small group.
Compliance professionals will meet with their colleagues
and learn from their collective experiences.
Participants will leave with greater knowledge of how to address compliance
issues and to draft, implement and evaluate policies and procedures.
All
participants will receive The HCCA Compliance Resource Collection, 300 pages of
compliance policies, procedures, educational tools, position descriptions, and
other resources vital to an effective compliance program.
3:00 5:00 PM
VII. Home Care Special Interest Group Meeting
VIII. Behavioral Health
Special Group Meeting
8:00 8:30 AM HCCA Business Meeting, Part I
8:30 9:15 AM General Session Bioterrorism and Health Care Readiness
Alice Gosfield,
Attorney, Alice Gosfield and Associates, PC, Philadelphia, PA
The Quality/
Compliance Nexus: Doing Well by Doing Right
9:30 10:30 AM General Session Health Care Fraud & Abuse Issues: The Medias Perspective
Peter Klein, Producer/60
Minutes, New York, NY
Bruce Japsen, Chicago Tribune, Chicago, IL
Mark Taylor, Modern Healthcare, Chicago, IL
Lisa Rockelli, BNA
Healthcare, Washington, DC
Craig
Webb, Editor, AHA News, American Hospital Association, Washington,
DC
Moderator: Lisa Murtha, CHOP, Philadelphia, PA
11:00 12:15 PM Concurrent Sessions I
101 Practical Tools for Auditing & Monitoring
Sheryl Vacca, CHC, Director, National Health Care Compliance
Practice, Deloitte & Touche, Los Angeles, CA
Vickie McCormick, Halleland
& Lewis, Minnetonka, MN
Complaint & Appeal Auditing
Credentialing File Review
Credentialing SAMPLE
Employer Group Files Audit
Formal Complaint Audit Tool
Generic Audit Tool
Complaint & Appeal Audit
Member Handbook Annual Review
Payor Controls Review & Testing Matrix
Practical Tools for Auditing & Monitoring
Provider Directory Annual Review
Practical application of Hands on Tools
Methodology and Sampling Techniques
Disclosure
Strategies
102 Compliance Effectiveness for 2002 and Beyond: Taking Compliance Effectiveness to the Next Level
David Orbuch, Corporate Compliance Officer, Allina
Health System, Minnetonka, MN
William Altman, Vice President of Compliance and Government Affairs,
Kindred Healthcare, Louisville, KY
Taking Compliance Effectiveness to the Next Level
Michael Hemsley, CHC, VP/Corporate Compliance & Legal Services, Catholic Health East, Newtown Square, PA
Update on latest compliance effectiveness initiatives
Innovative approaches to evaluating effectiveness
Using effectiveness measures to demonstrate value
Charting an effective approach for the
future
103 Coding for Attorneys and Compliance Professionals
Georgette Gustin, Director,
PricewaterhouseCoopers, Indianapolis, IN
Susan Postal, VP of Health Information Management Services Government Programs, HCA, Nashville, TN
Coding for Attorneys and Compliance Professionals
Provide an overview of common coding classifications
currently used in the inpatient, ambulatory and physician settings
Describe commonly used nomenclature and terminology
Components of successful coding/health information
Management compliance program; e.g., organizational
structure, creating awareness, setting standards, monitoring performance, identifying exceptions
104 What CCOs are Doing with Their On-line Training
Dan Roach, VP/Corporate
Compliance Officer, Catholic Healthcare West, San Francisco, CA
Suzie Draper, Compliance Administrator, Intermountain Health
Care, Salt Lake City, UT
Use of on-line training programs
Developing on-line education
Beware the unanticipated cost
On-line training resources
12:30 2:15 PM Lunch Presentation Quality and Compliance
Mindy Hatton, VP & Chief Washington Counsel,
Washington, DC
The New Proposed Changes to the Privacy
Regulations
2:15- 3:30 PM Concurrent Sessions II
201 Security and Transactions and Code Sets, the Technical Side of HIPAA Compliance
Victor Blanchard, Arthur
Andersen, Baltimore, MD
Ed Shay, Attorney, Post & Schell, Philadelphia, PA
HIPAA Update: Everything But Privacy
HHS Proposes Changes That Protect Privacy, Access to Care
Standards for Privacy of Individually Identifiable Health Information Proposed Rule Modification
Most health care enterprises have moved beyond initial awareness of compliance with the transaction/code set and security requirements of HIPAA. This session will build from that knowledge base and describe current developments in transactions, code sets and security. It will cover current implementation challenges such as testing/certification requirements for extensions under the recently enacted compliance date extension legislation strategies for submitting a credible application. The session will examine new challenges posed by soon-to-be issued final security rules for those who have already done their gap assessments based on the proposed rules.
202 Business Associates What Should You be Doing Now?
Jody Ann Noon, Partner, Deloitte & Touche, Portland, OR
Linda Malek, Attorney, Moses & Singer, New York, NY
Business Associates: What Should You Be Doing?
Overview of the HIPAA Business Associate Requirements
Practical approaches to identify business associates
A Step-by-Step Guide to implement the HIPAA Business
Associate Requirements
Identifying who your business associates are
Required elements of a business associate agreement
Considerations for drafting a
business associate agreement
203 Compliance Officer Personal Liability and Insurance Coverage Issues
Elizabeth Carder, Attorney, Reed Smith, Washington, DC
Compliance Officer Personal Liability Issues
Does D&O coverage really protect the compliance professional?
Does the compliance professional have personal exposure?
What should the compliance professional do
to mitigate potential exposures?
Review of HCCA
Compliance Professional Ethical Obligations Statement for guidance.
204 Updates on the False Claims Act
Margaret Hutchinson, Assistant US Attorney, US Attorneys Office, Philadelphia, PA
2002 focus areas of the Department of Justice
Understand what to do to avoid False Claims Act exposure
Proactive compliance measures every
healthcare organization should consider
Handouts provided in
Hard Copy only
3:45 5:00 PM Concurrent Sessions III
301 Advanced Investigations, Privileges and Disclosure
Doug Lankler, Pfizer, New York, NY
Mike Kendall, Attorney, McDermott Will & Emery,
Boston, MA
Advanced Investigations, Privileges and Disclosures
Responding to Enforcement Initiatives
Audit Results
How to conduct an Effective and Ethical Internal Investigation in Defense of the Government Investigation
How to conduct a
vigorous defense without running a follow-up of ethical rules (of the government)
How to understand/anticipate government strategies
Strategic and Tactical concerns where
defending a provider undergoing Government Scrutiny
302 Stark 2002: A Detailed Overview of the Law
Gadi Weinreich, Attorney, Shaw Pittman, Washington, DC
Application and scope of the Stark law and its
exceptions: reality vs myth
Principal regulatory developments
Current government enforcement
initiatives and compliance solutions
Handouts provided in Hard
Copy only
303 Research Compliance and Human Subject Research
Lisa Murtha, CHOP, Philadelphia, PA
Kendra Dimond, Attorney, Epstein Becker &
Green, Washington, DC
Conflicts of Interest - Individual and Organizational
Conflict Of Interest Issues Resource Material For Additional Information
Overview of Federal Enforcement Initiatives in Research
Overview of Key Laws and Regulations affecting research
Overview of Administrative and
Human Subject Protection Requirements
Compliance
Recommendations for Clinical Research and Trends
304 Governance: The Balance of Power
Marti Arvin, CHC, Compliance
Officer, University of Pittsburgh Physicians, Pittsburgh, PA
Dr. Thomas Clay, Compliance Officer, East Carolina University
School of Medicine, Greenville, NC
How does your organizational chart effect
decision making and access to resources
Your leverage for management and physician buy-in
7:00 Enron and Andersen:
Heed the Questions and Warnings They Raise for Your Own
Company
Joseph Murphy,President, Compliance Systems Legal
Group, Haddonfield, NJ
Howard Young,
Arent Fox, Washington, DC
Greg Warner,
Dir. of Complaicne, Mayo Clinic, Rochester, MN
Sheryl Vacca, CHC, Dir., National Health Care Complaicne
Practice, Deliotte & Touche, Los Angeles, CA
Moderator: Brent Saunders, Partner, PricewaterhouseCoopers,
Washington, DC
Heed the Questions and Warnings
Report 1
Report 2
Report 3
Report 4
8:00 - 8:30 AM HCCA Business Meeting, Part II
8:30 9:15 AM General Session Bioterrorisms
Impact on Health Care Operations
Bob Arnot, MD, NBC News, New York, NY
9:15 10:15 AM Regulatory Panel Hot Topics and Current Events
Lewis Morris, Asst. Inspector General for Legal Affairs, Office of the Inspector General in the US Dept. of
HHS, Washington, DC
James Sheehan, Asst. US Attorney and Chief, Civil Division, United States Attorneys Office,
Philadelphia, PA
Phil Dunne, Chief Executive Officer, Texas Medical Foundation, Austin, Texas
Payment Error Prevention Program
Comparison of Sixth Scope of Work to Seventh Scope of Work
Moderator: Brent Saunders, Partner, PricewaterhouseCoopers, Washington, DC
10:45 12:00 PM Concurrent Sessions IV
401 Privacy Assessments: Beginning the Process
Chuck Self, Baptist Health Systems, Birmingham, AL
Debbie Troklus, CHC, Manager, PricewaterhouseCoopers, Louisville, KY
Privacy Assessment: Beginning the Process
Common Privacy Projects
Amendment of PHI 164.526 Checklist for compliance with regulation
Seven steps to beginning the process
Gap analysis vs. project approach
Common privacy projects
Structuring project teams
402 Sampling Techniques for Auditing and Monitoring
Sandy Piersol, Senior Manager, Deloitte & Touche, Philadelphia, PA
Sampling Techniques for Auditing and Monitoring
Darrell Contreras, Manager, Ernst & Young, Phoenix, AZ
Sampling Techniques for Auditing and Monitoring
Learn about probe samples-the value, the risk
What is extrapolation-how does it hurt and how does it help
Random sampling and degrees of precision
Do you need to test every provider?
What is the 80/20 rule and how does it work?
403 Ethics and the Compliance Professional
Jeffrey Oak, Compliance &
Business Integrity, Veterans Administration, Washington, DC
Mark Meaney, Executive Director, Bioethicist, Institute for Clinical
and Corporate Ethics, Liberty, MO
Thinking Like a Compliance Professional
Case Study: A Duty to Resist?
Conflicts of Interest for Compliance Professionals
Responsibilities to Diverse Stockholders
Political Capital: Spending It, Saving It and Sharing It
404 Current Events and Hot Topics in HIPAA
Moderator: Ryan Meade, Attorney, Katten Muchin Zavis, Chicago, IL
Leslie Berkeyheiser, The Clayton
Group, Glen Mills, PA
Ted Sanford, MD, University
of MI Health Systems, Ann Arbor, MI
Sue Prophet, CHC, RHIA, CCS, Director of Coding, Policy & Compliance, AHIMA, Chicago, IL
Recent legislation
State law preemption & state privacy initiatives
Trends in implementation in light of regulatory ambiguities
12:00 1:30 PM Lunch Presentation
Moderator: L. Stephan Vincze, CHC, Ethics & Compliance Officer, TAP Pharmaceutical Products, Inc., Lake Forrest, IL
12:30 1:30 PM Update on HCCA Coalition to Study Compliance Program Effectiveness
L. Stephan Vincze, CHC, Ethics & Compliance Officer, TAP Pharmaceutical Products, Inc., Lake Forrest, IL
1:45 3:00 PM Concurrent Sessions V
501 Physician Compliance Training
Phoebe Moore, BA, CPC, CPC-H, Relationship Manager, HP3 Healthcare Concepts, Bethlehem,
PA
Physician Compliance Training
Joette Derricks, CHC, CEO, Healthcare Management Solution Inc., Camp Hill, PA
Physician Compliance Training
What should a physician practice compliance program
look like?
Styles of training including web-based
options, videos, live training, using sample records to train
How often should training take place and what areas
should be covered?
Use of external experts for training
502 Managed Care Compliance Risks
V. Jones, Attorney, Foley & Lardner, San Francisco, CA
Vickie McCormick, Halleland & Lewis, Minnetonka, MN
Managed Care Compliance Risks
Managed care regulatory compliance issues
Monitoring and auditing in managed care
Coordinating compliance with providers
503 Privacy Primer The Overview You Have Been Waiting For!
Amanda Yoh, Compliance Manager, Laidlaw, Inc., Arlington, TX
HIPAA: The Overview You Have Been Waiting For!
Lisa Clark, Attorney, Duane Morris & Hecksher, Philadelphia, PA
HIPAA Privacy Primer:Covered Entities, Business Associates and other HIPAA Designations
A brief overview of the HIPAA privacy regulations
Most recent HHS guidance on how to interpret complex and confusing areas under the regulations
Focus on "hot"
issues, including how to draft business associates agreements, consents and
notices, how to identify business associates, hospital/medical staff disclosure
issues, and implementation best practices
504 Conflicts of Interest Individual and Organizational
Monte Dube, Attorney, McDermott
Will & Emery, Chicago, IL
Implementing a Clinical Research Compliance Program.
How to manage and implement a conflicts program
Designing a conflicts policy
Understanding research and clinical conflicts of interest
Monitoring conflicts of interest
3:15 4:30 PM Concurrent Sessions VI
601 Quality Issues and Compliance
Sheryl Vacca, CHC, Director, National Health Care Compliance Practice, Deloitte & Touche, Los Angeles,
CA
Kristin Jenkins, Compliance & Quality Officer, JPS Health Network, Fort Worth, TX
The Governments Interest in Quality from a Compliance
Perspective
The Ethical Framework for the
Compliance Effort in VHA
Overlaps in Compliance and Quality Reviews
and Functions The OIG, JCAHO and Beyond
Selling the
Idea of Combining the Compliance and Quality Functions to your CEO
602 To De-Identify or Not to De-Identify. That is the Question?
Kent Giles, PricewaterhouseCoopers, Atlanta, GA
To Identify or Not to Identify, that is the
Question
What are identifiers and what does HIPAA require you
to do about them?
Understanding what institutions
should be doing about Identifiers today
Policies and procedures necessary for HIPAA compliance
603 Integrating HIPAA Into Your Compliance Program
Carole Klove, Partner, Deloitte
& Touche, Los Angeles, CA
Implementing HIPAA into a Compliance Program
Ken Fody, Esq., Independence Blue Cross, Philadelphia, PA
Combining HIPAA Readiness Into Compliance Audits
Integrating HIPAA Issues into Compliance Training
604 HIPAA Readiness Survey/Tools for Self Assessment
John Steiner, Director of
Corporate Compliance, Cleveland Clinic Foundation, Cleveland, OH
Kristin Johnson, KPMG, New York, NY
State of HIPAA Compliance
Findings of the HCCA HIPAA Benchmarking Study
HCCA HIPAA Readiness Survey
Survey Results
Implementation, Process: Where is Your Program?
I. Compliance 101
Debbie Troklus, CHC, Manager,
PricewaterhouseCoopers, Louisville, KY
John Knapp, Partner, Cozen & O'Connor,
Philadelphia, PA
Compliance 101 Handout
New or aspiring health care compliance professionals face many challenges as they make their way into a new position or career. This popular session has been offered a round the country and has provided instruction on the basics of health care compliance to compliance professionals from all healthcare settings. Topics include: Defining compliance, compliance necessity, the seven essential elements of a compliance program and compliance program start-up.
II. Graduate Level - Compliance 202
Sheryl Vacca, CHC, Director, National Health Care Compliance Practice, Deloitte & Touche, Los Angeles,
CA
Allison Maney, CHC, CPA, Compliance Officer, Lovelace Health System, Albuquerque, NM
Compliance Program Management: Operations and Effectiveness
The duties of a compliance professional do not end when the compliance program is up and running. Auditing, monitoring and constant follow-up are a must and how do you know if your program is actually effective? How does a program adjust to shifting trends in enforcement and new regulations? This session answers these questions and provides the opportunity for experienced compliance professionals to learn from each others shared challenges and concerns.
III. HIPAA Document Workshop
Kristin Jenkins, District Compliance Officer, JPS Health Network, Fort Worth, TX
Lisa L. Dahm, Attorney, MedSafe, Houston, TX
Robert Lower, Partner, Alston & Bird, Atlanta, GA
Brian Gradle, Partner, Epstein Becker &
Green, Washington, DC
Notice of Privacy Practices Template
Security Assessment Template
Review and discuss project and workgroup documentation,
board and executive reporting formats and model consents, authorizations and
other documents and changes necessary to your systems policies and procedures
for adherence to HIPAA regulations.
NOTE: Review will not be comprehensive
(due to time constraints), but information can be used to develop comprehensive plans for your organization.