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You are here : About  >  Conference Sessions  >  Sunday

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 Pre Conference AM                                  Pre Conference PM


Sunday, April 15





Pre Conference Morning Breakout Sessions

9:00 AM - 12:00 PM 


Large Hospital Systems

  • Learn how to benchmark your program against other large hospitals and health systems through use of polling software
  • Understand challenges relevant to large hospitals and large health systems
  • Engage in dialogue with your colleagues regarding operational solutions and best practices for large hospitals and health systems
Suzie Draper, VP Business Ethics & Compliance, Intermountain Healthcare

Margaret Hambleton, VP Corporate Compliance, Dignity Healthcare

Kimberly Otte, Chief Compliance
Officer, Mayo Clinic


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

  • Describe the fundamental elements of a compliance program
  • Identify ways to leverage current resources
  • Provide tips on getting organization buy in
Debbie Troklus, Senior Managing Director, Ankura Consulting

Sheryl Vacca, Chief Risk Officer, Providence St Joseph Health

Hey, Therapy Provider! The Government and Private Insurers Have Therapy in Focus—Do You?

  • Therapy focus explained: JIMMO, Probes, Targeted Medical Reviews, Supplemental Reviews, OIG reports and findings, Investigations, Therapy Related Civil Monetary Penalties
  • Understand and implement the who, what, how and why of auditing therapy Conditions for Coverage, Conditions of Participation, and Conditions of Payment
  • Take away an audit tool to ensure your focus on compliance with therapy technical and medical necessity requirements for restorative and maintenance therapy (JIMMO)
Shawn Halcsik, Corporate Compliance Officer, Encore Rehabilitation

Nancy Beckley, President, Nancy Beckley & Associates LLC


Designing an Effective Privacy Program

  • Understand the latest industry trends/ developments and potential for a government audit
  • Using the 7 elements as a framework and the HIPAA Audit protocol as a guide to create a foundation for HIPAA compliance
  • Learn about OCR’s focus and continued scrutiny on risk analysis efforts while understanding techniques taken by leading organizations to minimize risk exposure in conjunction with these efforts
Christopher T. Terrell, Deputy Chief Compliance Officer & Privacy Officer, Encompass Health

Adam Greene, Partner, Davis Wright Tremaine, LLP

David Behinfar, Chief Privacy Officer, University of North Carolina Health

Katherine Georger, Associate Compliance Officer, Duke University Health System

Physician and APP Coding Workshop

  • Coding basics for compliance professionals—knowing where to find the code information, defining the sources for definitive guidance—how to educate your providers and audit-proof your coding and billing
  • Understanding the gray areas of evaluation and management coding, appropriately applying modifiers, and documenting to support the medical necessity of all services
  • Defining and maximizing the role of advanced practice providers, aka non‑physician practitioners, in the practice and compliantly billing for their services
Kimberly G. Huey, President, KGG Coding & Reimbursement Consulting

Sandra K. Giangreco Brown, Coding Compliance Audit Sr Manager, CHAN Healthcare



False Claims Act Developments

  • Understand the fundamentals of liability, damages and procedure under the FCA
  • Review critical recent court interpretations of the Supreme Court’s Escobar decision
  • Discuss recent decisions on determining “falsity” in medical necessity cases

John T. Boese, Counsel, Fried Frank Harris Shriver & Jacobson LLP

Michael D. Granston, Director, Commercial Litigation Branch, Fraud Section, Civil Division, US Department of Justice

Gary W. Eiland, Partner, King & Spalding LLP

Michael Morse, Partner, Pietragallo Gordon Alfano Bosick & Raspanti, LLP


The Great Internal Audit‑Compliance Mystery

  • Guests will observe and identify, or even become party to, the ultimate compliance mystery/conspiracy
  • Attendees will assist in identifying acts of noncompliance and network with the cast and other guests to determine what wrongdoing occurred, why and define an appropriate response to the wrongdoing
  • Attendees will utilize strategies to help define compliance program weaknesses and what safeguards may have prevented an identified behavior

Kristen R. Taylor, Managing Director, Pinnacle Enterprise Risk Consulting Services 

Kelly C. Loya, Managing Director, Pinnacle Enterprise Risk Consulting Services


Top IT and Cyber Risks to Include in Your Audit Plan

  • Learn about key IT and Cyber risks
  • Learn trending IT governance best practices
  • Discuss IT audit challenges in an evolving IT risk environment
Johan Lidros, President, Eminere Group


Try Your Luck: Solve a Complex Compliance Case Study

  • Walk through a complex compliance case study in this interactive session and try your luck on making complex decisions to solve the case
  • Learn tips on how to investigate and document complex matters, spot coding and billing issues, interview witnesses, develop a corrective action/mitigation plan, and communicate sensitive matters to senior leadership and your board
  • Understand considerations for self‑disclosure, attorney-client privilege and when to use it, and the Yates memo

Melissa J. McCarthy, AVP, Deputy Chief Corporate Compliance Officer, Northwell Health

Greg Radinsky, SVP, Chief Corporate Compliance Officer, Northwell Health


Why In The World Is the Compliance Officer Asking about Quality?

  • Attendees will define compliance and quality, explore CMS’ value-based reimbursement model, evaluate the alignment of quality care with reimbursement, and examine work models requiring synergy between compliance and quality to meet CMS requirements
  • Attendees will be introduced to key programs related to value-based reimbursement, examine the implications for the receipt of quality-based reimbursement, and discuss the compliance professionals’ role in monitoring compliance with CMS regulations
  • Attendees will learn effective techniques to monitor and share data, and study effective tools to aide collaboration between senior leadership and the medical staff regarding operations, finances, and clinical outcomes for value-based reimbursement
Eugena A. White, Compliance Officer, Medical West, an affiliate of the UAB Health System

Deborah F. Grimes, Chief Diversity Officer, UAB Hospital


Due Diligence for Acquisition and Partnerships

  • Outline and discuss the strategy, analyis and due diligence necessary for determining fit, aligning appropriate resources and implementing a successful transition for acquisition or partnership with another practice
  • Discuss common goals, areas of compromise and deliverables in order to navigate logistical hurdles and contractual negotiations
  • Share lessons learned and provide practical tips to ensure thorough due diligence from beginning to go-live and thereafter
Catherine I. Masoud, Compliance and Privacy Manager for External Affairs, University of Kentucky, UK HealthCare

John Allen
, Chief Administrative Officer, University of Kentucky, UK HealthCare


Navigating Therapy Compliance Requirements Across the Continuum of Care

  • “Medical Necessity” is the key concept to justify Medicare payment for services, but how is medical necessity evaluated in the outpatient, inpatient rehab, home health and SNF settings?
  • Documentation requirements for Medicare payment vary significantly between the OP/IRF/HH and SNF settings. You will learn the documentation commonalities but also the key differences between the settings to better audit and monitor compliance
  • What are the challenges and best practices for compliance training and monitoring for therapists who provide services in multiple settings?
Catherine Gill, Director of Quality, Compliance Officer, Franciscan VNS

Kay Hashagen, Senior Consultant, LW Consulting, Inc.



Laboratory Compliance: Maintaining Compliance in an Uncertain and Changing Environment

  • Compliance issues facing today’s laboratories include medical necessity, marketing arrangements, network participation issues, toxicology testing, pathology date of service issues, legal actions initiated by insurers, actions under Medicare enrollment authorities, and repayments
  • What you should know about CLIA and the avoidance of commonly identified citations. Presenters will look at proficiency testing requirements, proficiency testing referral safeguards, the overlap between CLIA regulations and billing considerations, and other current certification and accreditation topics
  • Practices that can result in imposition of sanctions, and use of general laboratory auditing plans and other steps to minimize legal and regulatory risk


Tim Murray, National Director Laboratory Compliance, Corporate Responsibility, Catholic Health Initiatives

Barbara Senters, Chief Compliance & Ethics Officer, Ameritox

Kathleen A. Fitzgerald, Chief Counsel, COLA, Inc.

Robert E. Mazer, Shareholder, Baker Donelson



Managed Care Organizations and Measuring Compliance Program Effectiveness: Review the Tools Used by Hospitals, Health Plans and Providers to Measure Effectiveness and See How They Work!

  • Discuss what tools may best fit your organization for measuring compliance effectiveness regardless of whether you are a Hospital, Health Plan, or Provider
  • Review actual examples of these tools from various organizations and see their effectiveness by examining associated results
  • Share ideas regarding the CMS 2017 three new audit elements of Prevention, Detection, and Correction and consider the similarities and differences (if any) from using the seven elements of an Effective Compliance Program
Pamela Jackson, Compliance Officer, Inland Empire Health Plan

Caron Cullen, President, Positive Compliance Outcomes, Inc.

Kelsey C. Brodsho, Chief Compliance Officer, North Memorial Health Care


Pre Conference Afternoon Breakout Sessions

 1:30 PM - 4:30 PM


Tactics for Maintaining Expected Levels of Performance in an Increasingly Complex Regulatory Environment

  • Application of proven Quality Management methods to systematically identify, measure, and monitor key performance metrics and generate targeted, informed responses when deviations occur
  • Orchestrate the efforts of operations, compliance, and specialized teams across the enterprise to make, manage, and sustain change
  • Strategies for effective and sustainable quality improvement: project selection, team engagement, and building a culture of continuous improvement

Kristine Koontz, VP of Quality and Corporate Integrity, Keystone Human Services Inc

Amy Short, Administrative Director, Center for Improvement Science
Victoria Hoshower, Quality and Performance Manager


Conflict of Interest 2.0: Beyond Data Collection

  • Join us while we review the intricacies of COI policy evolution
  • We’ll discuss updates and advancements in CMS’ Open Payments Database
  • We’ll provide useful skills and tools to help you conduct investigations and implement conflict management plans
Rebecca M. Scott, Compliance/Privacy Manager, University of Kentucky

C.J. Wolf, Senior Compliance Executive, Healthicity

Andrew H. Hill, Compliance Analyst/Auditor, UK HealthCare Office of Corporate Compliance



Post-Acute Compliance Officers: How Do You Prepare for Constant Change and the Unknown of the Regulatory Environment

  • Join our Compliance Officer Roundtable
  • Does your company invest in compliance without a CIA?
  • Is there a best practice for structuring an effective program and have you tested it?
  • Do you have a seat at the decision maker table?
  • Can you afford to be proactive or just reactive?
Karla Dreisbach, VP Ccompliance, Friends Services for the Aging

Betsy Wade, Corporate Compliance Officer, Signature HealthCARE

Jeramy Kuhn, Corporate Compliance Officer, Care Initiatives



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

  • Discussion of the purpose of and process around table top exercises
  • Discussion of the goals of the exercise and pre-table top exercises to dos
  • Performance of a mock table top exercise with audience participation and role assignments and identification of terms used
Marti Arvin, Vice President, Audit Strategy, CynergisTek, Inc.

Joseph Dickinson, Partner, Smith Anderson

Benchmarking and Coding Outlier Workshop

Jared Krawczyk, Mathematician, Nektar Analytics

Andrei M. Costantino, VP of Integrity & Compliance, Trinity Health


Anatomy of a False Claims Act Case: Investigation, Litigation, Negotiation, Resolution

  • The Investigation Phase: subpoenas, witness interviews and more
  • The Litigation Phase: Discovery and Motions Practice
  • The Resolution Phase: Settlements, CIAs and Relator issues
Rick Robinson (Moderator), Global Co-Head of Life Sciences and Healthcare, Norton Rose Fulbright US LLP

Lisa Re, Assistant Inspector General for Legal Affairs, OIG HHS

Daniel C. Gerhan, Director and Senior Litigation Counsel, Boston Scientific Corp.

Robert Vogel, Partner, Vogel, Slade & Goldstein, LLP



340B Compliance Monitoring Utilizing Data Analytics

  • Utilizing data analytics to monitor the 340B Drug Discount Program allows healthcare systems to ensure compliance with the 340B Program and maximizes cost-saving opportunities afforded by the 340B Program
  • KPIs allow for granular analysis of high risk area related to diversion, duplicate discounts, the GPO prohibition, and provide insights into missed cost-saving opportunities where split-billing software limitations and/or poor master data come into play
  • Reduce risk of fines and sanctions by regulators and protection against reputational damage; Improve risk management from automated continuous monitoring for 100% of transactions; Reduce number of FTEs used to maintain compliance with 340B program
Tim Krzeminski, Healthcare Compliance Director, PwC

Ryan Hayden, Partner, PricewaterhouseCoopers

Three Keys to Rock Your Auditing and Monitoring Plan

  • Review the importance of pre-audit preparation and decisions—including what to audit and what to monitor
  • Cover tips on the value of collaboration, clarity of accountability, what to do with incidental findings and more
  • Provide sample tools and the three key concepts that will help you get the job done
Ruth Krueger, Lead Compliance Program Administrator, Sanford Health

Cindy J. Matson, Sr Executive Director, Compliance, Sanford Health

Mary Jo Henne, Director of Compliance, Sanford Health

Collaboration between Compliance, Internal Audit and Coding Operations

  • Effective Collaboration between Compliance, Internal Audit and Coding Operations can have a positive impact on the bottom line of your organization
  • Policy and Procedure of the organization impacts all levels and areas, how to help ensure policies and procedures are value-add
  • Insights on collaborative efforts within our organizations with focus on the positives and negatives

Kenneth M. Jenkins, Hospital Compliance Officer, Vanderbilt University Medical Center

Colleen A. King-Dennis, Associate Vice President of Compliance Billing & Education, University of Louisville-Physicians


Three Blind Mice: Achieve a Shared Vision for Compliance, Risk, and Quality

  • Obstacles to creating a unified approach to healthcare compliance, risk, and quality initiatives
  • Achieving integration through the development of shared goals
  • Leveraging technology and data to break down communication silos
Jessica L. Smith, Vice President, Compliance Partners, LLC

Jonathan Brouk, Director, Compliance & Privacy Officer, Children’s Hospital New Orleans

Sandra A. Keller, VP Compliance & Regulatory, Lafayette General Medical Center


Whistle While You Work: How to Prevent Activity Leading to Whistleblower Actions and Protect Health Organizations and Medical Practices from Whistleblower Threat

  • Significant Regulatory Changes and OMHA Initiatives Impacting the Medicare Appeals Process
  • Key OMHA initiatives taking place at the ALJ appeal level, including the new Statistical Sampling Initiative, implementation of attorney adjudicators, and expansions to the Settlement Conference Facilitation program
  • Understand the impact these reforms and OMHA initiatives will have on providers, and learn strategic approaches and practical tips to consider and implement when appealing overpayment demands and claim denials through the Medicare appeals process
Andrew B. Wachler, Partner, Wachler & Associates, P.C.

Nancy Griswold, Chief Administrative Law Judge, Department of Health and Human Services, Office of Medicare Hearings and Appeals

The Ups and Downs of DME

  • Identify industry trends and current legislative activity related to audits, appeals, and compliance for DME suppliers, including some positive news for suppliers
  • Identify common legal issues related to providing DME in current regulatory environment
  • Identify current products being targeted for audits and common denial reasons
Wayne H. van Halem, CFE, AHFI, President The van Halem Group – A Division of VGM Group, Inc.

Joshua Skora, Attorney, K & L Gates, LLP

Kelly Grahovac, Sr. Consultant The van Halem Group


Issues in Academic Medical Compliance: Bridging the Great Divide

  • Working with FDA Surveyors, Clinical Research Billing, and Audits: Using the process and results to improve and augment your compliance program
  • Conflicts of Interest across the medical center, campus, and community environments: Managing and mitigating
  • Physician Hospital Contracting and Reimbursement Challenges in Academic Medical Centers: The compliance role in negotiations, review, and advisement for new and ongoing arrangements
Valerie Dixon, Deputy Compliance Officer, University of California-Irvine

Kim Bixenstine, Chief Compliance Officer, University Hospitals

David Lane, Chief Compliance Officer, Providence St. Joseph Health


What’s New and Exciting in Research Compliance: Exploring New Laws, Regulations and Government Guidance

  • Overview of new laws, regulations, and government guidance from NIH, OHRP, ORI, FDA, WHO and more
  • Review of recent enforcement initiatives related to the life sciences and research from DOJ, OIG, CMS
  • Best practices for oversight of research programs and ongoing compliance
F. Lisa Murtha, Senior Managing Director, Ankura Consulting, Inc

Ryan Meade, Dir Regulatory Compliance Studies, Loyola University Chicago School of Law