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You are here : About  >  Conference Sessions  >  Tuesday

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Tuesday, April 17




General Sessions
8:40 AM - 9:00 AM


Update from CMS

Kimberly Brandt, Principal Deputy Administrator for Operations, CMS

9:00 AM - 9:50 AM


Compliance as a Strategic Business Partner: A CEO’s Perspective

Lloyd Dean, President and CEO, Dignity Health

9:50 am - 10:30 am

Ethical Vigilance Creates a WellNow Culture

Rashmi Airan, Ethics Speaker and Consultant

Break Out Sessions
11:00 AM - 12:00 PM

Escobar and the New Compliance Cartel

  • An overview of Universal Health Services, Inc. v. United States ex rel. Escobar and the new world of False Claims Act compliance
  • We Are Living in a Material World: understanding the important nuance of materiality
  • What Are You Implying: the practical solutions for explicit and implicit compliance
Jeffrey Jeter, Special Counsel, Jones Walker, LLP


Operationalizing Compliance with the New Nondiscrimination Requirements of Section 1557 of the Affordable Care Act

  • Section 1557 of the ACA is the first civil rights law for the healthcare field and prohibits discrimination against patients, visitors, human subjects, and in employee health benefits, on the basis of sex, race, color, national origin, disability, & age
  • Section 1557’s regulation imposes several requirements and adopts several interpretations of the law that present new and significant compliance challenges to the industry. Providers must also take immediate action for compliance
  • This presentation will summarize Section 1557 and its regulatory requirements, address potential risks for litigation, and detail practical steps that healthcare providers must take to achieve compliance and minimize exposure to discrimination claims
Drew Stevens, Attorney, Arnall Golden Gregory LLP

Toby K. Morgan, Director of Compliance-Section 1557, Emory Healthcare, Inc.

Lions, Tigers, and Bears… Oh My! Walking through the Dark Forest of the Compliance Knowns and Unknowns in Mergers, Acquisitions, and Divestitures in Post-Acute Care

  • Best practices
  • Issues to avoid
  • Once the deal is done...
David C. Beck, Chief Ethics and Compliance Officer, Sava Senior Care Administrative Services, LLC

Sarah Finnegan, VP of Compliance, Kindred Health Care

BAM! A Sound You Want to Hear When Working with Your Business Associates

  • Understand how effective Business Associate Management (BAM) is a vital function that both Covered Entities and Business Associates should perform continuously and effectively
  • Correlate the HIPAA requirements related to Business Associates with sound business practices that enable Covered Entities and Business Associates to work as a team in their shared commitments and expectations in the safeguarding of PHI
  • Learn from case studies of Covered Entities that were successful BAM practitioners as well as from those that were not so as to identify the best strategies to design and effectively implement BAM within your organization
Frank Ruelas, Facility Compliance Professional, St. Joseph’s Hospital and Medical Center/Dignity Health

Shawn Y. DeGroot, President, Compliance Vitals

A Roadmap for Medical Staff Corrective Action: How to Avoid the Many Pitfalls

  • Physicians and hospitals often find themselves in a quandary when clinical or behavioral concerns result in a request for corrective action: this session will map out the essential aspects from both the hospital and the physician standpoint
  • The Health Care Quality Improvement Act provides immunity to those involved in peer review if certain parameters are followed: this session will explain those parameters in the context of real life and offer practical insight
  • The nuances of when and how to report (or not) to the National Practitioner Databank as well as state licensing boards will be explained in a way that actually makes sense!

Sarah Coyne, Partner, Quarles

Jon Kammerzelt, Quarles & Brady LLP


Telemedicine and Digital Health: Compliance Hot Topics for 2018 and Beyond

  • This course, focusing on a 2018 hot topics update, is a practical discussion of hot topics in telehealth law and compliance, and what lawyers and compliance professionals can do to stay abreast in this rapidly changing area
  • Attendees will learn about new telehealth billing rules, multi-state provider enrollment, international arrangements, ABNs and charging beneficiaries, interstate licensing, e-prescribing, e-health commerce, and key telemedicine fraud & abuse rules
  • Attendees will receive a 2018 toolkit with charts, checklists, and resources. Session will also discuss texting patients, e-consults, and new non-face-to-face services
Thomas Ferrante, Attorney, Foley & Lardner

Monica Chmielewski, Attorney, Foley & Lardner, LLP

MYSSION: Monitoring Your Short Stays and Observation Nights

  • Overview of regulatory changes and impact of the Two-Midnight Rule. Contractor and QIO reviews of short stays
  • Claims submission requirements and reimbursement impact examples of Condition Codes 44 and W2 for stays that do not meet inpatient requirements
  • Comprehensive demonstration of trended metrics to analyze and assist in determining if your Case Management, Utilization Review and Post discharge self-audit program is working effectively. Recommendations for process improvement

Amy M. Gendron, Dir Clinical & Regulatory Compliance, Trinity Health

Patricia J. Hamon, OI Specialist, Trinity Health


Leveraging Internal Audit & Forensics in Your Compliance Program

  • Learn how the Internal Audit program can be used to support compliance activities
  • Gain insight on forensic activities that can benefit your compliance program
  • Learn how Cleveland Clinic structured its Integrity Office to leverage Internal Audit and Corporate Compliance resources

Donald A. Sinko, Chief Integrity Officer, Cleveland Clinic

Vicki R. Bokar, Senior Director, Corporate Compliance, Cleveland Clinic


Preparing for a Job Search

  • How to Build a Better Resume
  • Preparing for Your Interview
  • Interview Tips

Beth DeLair, President, Health Care Compliance Recruiting


MACRA: Not Just for Providers

  • Understand providers will look to payers and health systems to support and collaborate to achieve MACRA’s objectives
  • How payers can offer clinical decisionsupport tools, access to data, better integrated care teams, additional CM / DM services, and share knowledge from past experience predicting risk to show value-add services and maintain / grow market position
  • Why this is important? This helps validate value based contracts and provides differentiation in the market with better providers in their network

Todd M. Gower, Advisory Sr Mgr Healthcare & Risk, Ernst & Young

Lisa Alfieri, Manager- Risk and Compliance, Ernst and Young


Compliance Design in a World of New Models

  • Consider compliance risks presented by new models of payment and delivery, including the role of data and quality; as well as how human resources can drive a compliance culture
  • Explore new regulatory flexibility for increasing access to care and reducing costs
  • Educate start-ups and non-traditional players on program integrity principles

Kristen M. Lilly, Healthcare Consultant, PYA

Fatema Zanzi, Partner, Drinker Biddle Reath

Vicki Robinson, Senior Counsel for Policy, Office of the Inspector General


Out of the Shadows: Behavioral Health Compliance and Legal Issues for Every Provider

  • With the opioid crisis reaching unprecedented levels, integrated treatment is more important that ever. But what treatment records can providers exchange, and under what circumstances?
  • Revisions to 42 CFR part 2 expand the scope of who is accountable for protecting treatment information. Are you in compliance?
  • You have come into possession of addictionrelated treatment records. What do you need to know that you didn’t learn under HIPAA?

Gerald Fornwald, Attorney, Winthrop & Weinstine, P.A.

Jennifer Lohse, General Counsel, Hazelden Betty Ford Foundation



Let’s Talk Shop

  • Compliance projects/activities (investigations, measuring program effectiveness, etc.)
  • How you solved it or how can your peers in this discussion group help
  • Lessons learned

*Advanced Discussion Groups open on a first come, first-served basis, and are limited to the first 50 attendees. Pre-registration is not available for these sessions.

Al Josephs, Compliance Consultant


Compliance Officer Ethics Scenarios

  • Discuss 5 ethics scenarios that the compliance officer may encounter
  • Review the role of ethics in compliance programs
  • Identify ethics frameworks to use in decision-making

*Advanced Discussion Groups open on a first come, first-served basis, and are limited to the first 50 attendees. Pre-registration is not available for these sessions.

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


The Intersection of Compliance and Quality Management

  • Discuss ways to effectively and positively collaborate with quality management on mitigating risks to improve organization outcomes
  • List the key role differences between quality and compliance
  • Discuss methods to bridge any “turf” gaps with quality or other operational units when implementing compliance program

*Advanced Discussion Groups open on a first come, first-served basis, and are limited to the first 50 attendees. Pre-registration is not available for these sessions.

Lynda Hilliard, Healthcare Compliance Professional, Hilliard Compliance Consulting
Break Out Sessions
1:00 PM - 2:00 PM

Dealing with Legalized Medical Marijuana: The Dilemma Created by Conflicting Federal and State Laws

  • This presentation will address the current conflict between state laws permitting the use of medical marijuana and the federal prohibition
  • Discuss issues that healthcare providers need to consider when determining how to deal with emplolyees for whom medical marijuana has been prescribed
  • How to deal with patients for whom medical marijuana has been prescribed
Stephen H. Siegel, Of Counsel, Broad and Cassel

Medicare Managed Care Compliance Standards for FDRs: Is Your Organization’s Compliance Program Adequate?

  • Develop an understanding of FDR compliance program requirements;
  • Learn about audit tools and protocols used by CMS and how Medicare Advantage Organizations use these to assess the compliance programs of their FDRs; and
  • Explore different strategies for achieving compliance with the requirements and responding to Medicare Advantage Organizations compliance program inquiries, attestation requests, and audits

Heather L. Fields, Shareholder, Chair- Hospital/Health Systems Practice, Reinhart Boerner Van Deuren s.c.

Catherine M. Boerner, President, Boerner Consulting LLC

Stacy Chalupsky, Director, UnitedHealthcare


Compliance and Risk Management: A Marriage Made in LTC Regulatory Heaven

  • This session provides tips on developing compliance and risk management programs with limited resources. We will compare and contrast the requirements of compliance programs and enterprise risk management programs, in the LTC community
  • Who should be involved? Who is best to coordinate the efforts and can be "drafted" to assist? Presenters will touch a number of ways this can be approached by evaluating current activities through a compliance and risk lens
  • Is it possible to marry current activities with a compliance program? We will describe the activities, functions, and programs which can be leveraged to meet the regulatory challenges of a compliance program and an enterprise risk management program

Dawn Michelle Kinneer, Sr. Risk and Patient Safety Consultant, MMIC

Sharon L. Taylor, Dir Risk Management/ AccreditationSvcs, Burgess Health Center


Unforeseen Vulnerabilities in Healthcare Mergers and Acquisitions

  • Mergers, integrations, and acquisitions are rapidly on the rise. While such healthcare integrations may be profitable, they introduce many challenges from an IT security and compliance standpoint
  • This session will cover specific steps organizations can take before and after an acquisition. Timing considerations and integration of toolsets is also a focus
  • Learning objectives include identifying and addressing security and compliance risks after a merger, formulating action plans for security plan implementation, and establishing a framework for pre-merger due diligence steps
Ryan Freeman-Jones, IT Risk Management Manager, Meditology Services


The Dx on HCC: How Medicare Advantage Plans and ACOs Create New Compliance Risk for Physicians

  • Let’s delve into the CMS Hierarchical Condition Categories (HCC) Risk Adjustment system which is a primary driver of Medicare Advantage and Accountable Care Organization payments
  • Explore how HCC coding can expose physicians to financial and regulatory requirements, as well as have an impact on their professional fee billing
  • Learn how HCCs have impacted physician documentation and work flow, and the compliance risks that must be managed under this system

Kevin McPoyle, Director of Compliance, Jefferson Community Physicians-Northern Division


Real World Repayment Dilemmas: DRG Validation v. Clinical Validation v. Quality Measures v. Government Audit Findings

  • Background: Understanding Metrics for DRG Validation compared to Clinical Validation, Quality Metrics, Government Audits and how conflicting interpretations arise
  • Practical Considerations when faced with reported discrepancies including paradigms for conducting internal reviews and addressing potential repayment issues
  • Case reviews and examples
Tracy M. Field, Partner, Parker Hudson Rainer & Dobbs LLP

Nancy Hirschl, VP HIM Services, Streamline Health Inc.

An Ounce of Prevention: Adding Cybersecurity Tabletop Exercises to Your Compliance Toolkit

  • Attendees will get a brief history of the evolution of tabletop exercises and their emergence as a valuable tool in testing cybersecurity preparedness and compliance with the HIPAA Security Rule and other regulatory requirements
  • A tabletop exercise overview will be presented and compared with other types of testing such as drills, functional exercises, and full-scale exercises. Attendees will then participate in a live tabletop exercise and hotwash wrap-up of the exercise
  • The session will conclude with questions and answers on the exercise. Attendees will leave with a broad understanding of tabletop exercises and an insight into the effectiveness of this tool that can only be gained through active participation

Allyson J. Labban, Partner, Smith Moore Leatherwood LLP

Steve Snyder, Smith Moore Leatherwood LLP


Identifying, Assessing and Auditing IT Risks in Health

  • Understand the implication of IT risks to key business strategies, objectives and processes
  • How to identify, assess and report IT risks to executives and integrate with enterprise risk management (ERM) and compliance
  • Review a sample of key IT risks (Cyber, IT provider and payer implementation etc.), controls and considerations for auditing them
Vishal Suchdev, Senior Manager, Ernst & Young

How to Change the Perception of Compliance from Obstacle to Business Partner

  • Learn strategies to gain respect and buy-in for the compliance program in the organization
  • Learn how to build stronger relationships with leaders and overcome the defensive ones
  • Learn strategies for creating solutions that are compliant and business friendly
Jay P. Anstine, President, Bluebird Healthlaw Partners

Managing Ethical Issues in FCA and Other Enforcement Actions

  • This panel will discuss best practices for conducting effective, efficient and costappropriate internal investigations as well as address ethical dilemmas that often arise in litigation
  • Panelists will review 2017 healthcare enforcement trends and offer an early outlook for 2018
  • This presentation will examine parallel investigations and negoation of global resolutions, including requests for cooperation credit
Precious Gittens, Partner, Hooper, Lundy & Bookman PC

Catherine Dick, Trial Attorney, Criminal Division, United States Department of Justice


Are You Ready to Weather the Storm: Aftermath of Hurricanes Harvey and Irma

  • How governmental agencies have historically changed their regulations in emergency situations
  • Real life examples of working with governmental agencies during disaster situations
  • What provisions a compliance program should include to weather a disaster situation

Brian Beard, Senior Director Compliance, McKesson Specialty Health

Judy Ringholz, Vice President of Compliance and Ethics & Chief Compliance Officer, Jackson Health System


Key Issues an AMC Privacy Officer Should Know

  • Key monitoring that a privacy officer should consider
  • Considerations of access to EHR by nonclinicians and external parties
  • Approaching breach analysis when multiple covered entities are involved

Mildred L. Johnson, Compliance Director, Baylor College of Medicine

Colleen Shannon, Chief Compliance & Privacy Officer, Duke University Health System


Stark: Mitigating the Battle Scars

  • Discuss who are the enemies and what are we doing to make them allies
  • Discuss and share mitigating processes
  • Discuss and share tools used to ease the battle scars

*Advanced Discussion Groups open on a first come, first-served basis, and are limited to the first 50 attendees. Pre-registration is not available for these sessions.

Dwight Claustre, Managing Director, Ankura Consulting


Providers Expanding into Managed Care

  • Create a forum of discussion with participants regarding the key strategies that help drive a compliant and ethical culture
  • Provide sample documents, methods and resources that can be used to leverage change and impact organizational results
  • Discuss best practices that participants are utilizing to foster networking and an opportunity to learn from one another

*Advanced Discussion Groups open on a first come, first-served basis, and are limited to the first 50 attendees. Pre-registration is not available for these sessions.

Deann Baker, Sutter Care at Home Compliance Officer, Sutter Health



Privacy Officer & Researcher: The Reluctant Partnership

  • What are the differences in HIPAA requirements in the research world?
  • What are the HIPAA requirements that are the same as in the clinical world, but still a challenge for Researchers and their Covered Entities?
  • How does a Privacy Officer become their Researchers’ best friend?

*Advanced Discussion Groups open on a first come, first-served basis, and are limited to the first 50 attendees. Pre-registration is not available for these sessions.

Joan Podleski, Senior Director & Chief Privacy Officer, Children’s Health


Break Out Sessions
2:30 PM - 3:30 PM


340B: Current State, HRSA Audit Enhancements and What the Future Holds

  • Leveraging experiences from the 340B auditor/consultant and 340B attorney perspectives, discuss recent enhancements to the HRSA audit process, including areas of increased focus, and best practices to adequately prepare
  • Present the most frequently identified audit issues, root causes, and potential corrective actions to mitigate the risks moving forward
  • Provide an overview of the proposed regulation changes that may impact 340B programs and outline potential next steps covered entities should consider performing
Chris Wasik, National 340B Solution Leader

Kyle Vasquez, Shareholder, Polsinelli PC


Creating Effective Compliance Program at Your Community Health Center

  • Compliance Program Effectiveness for FQHCs and similar community health centers
  • This focus will geared towards preparing for and passing a HRSA FQHC site visit
  • Each of the 7 elements will be included in the 19 program requirements for an all encompassing community health presentation that will be a nice primer for new compliance officers at community health centers

Trent Stechschulte, Compliance Officer & Legal Counsel, Equitas Health


How to Conduct a Compliance Risk Assessment

  • Compliance baseline audits and annual risk assessments will soon be mandatory for nursing home chains, and are a best practice for all nursing homes. Yet many homes have not completed the process, due to resources issues or not knowing where to start
  • In this session, we will take the mystery out of the compliance risk assessment process and walk through approaches you can take to conduct your own assessment - or oversee an assessment performed by a contractor
  • Special emphasis will be placed on strategies for evaluating compliance culture, board and Compliance Committee engagement, audit integrity, quality of reporting, and the program's ability to spot and address new compliance issues
Margaret Scavotto, President, Management Performance Associates

Scott Gima, COO & Executive Vice President of Compliance & Management, Management Performance Associates


Encryption Is Not Enough

  • What Privacy Officers need to know about encryption: review of how encryption protects data-at-rest and data-in-motion
  • Beyond encryption: explore ways a breach can occur even though data is encrypted
  • Questions to ask: review questions Privacy Officers can ask Security Officers and vendors to assess the protection of data
Andrew Rodriguez, Corporate Privacy and Security Officer, Shriners Hospitals for Children


When Physicians Work with Non-Physician Practitioners: Compliance Risks of Collaborative Practices

  • Increase in use of PAs and NPs is leading to more collaboration between physicians and non-physician practitioners. Review of some of the more common collaborative practice models
  • Overview of the regulations and guidelines governing how services should be documented and billed when physicians see patients collaboratively with non-physician practitioners
  • Review of common risk areas of collaborative practices and strategies for identifying and resolving these concerns in your organization
Brenden O’Neal, Regional Compliance Officer, Intermountain Healthcare


Ask Stark Law Professionals: Q&A Session

  • General overview of the Stark Law
  • Bring your Stark Law questions and the panel will analyze and discuss "real time" potential Stark Law risks
  • "Live" answers to your Stark Law operational questions
Robert A. Wade, Partner, Barnes & Thornburg LLP

Lester J. Perling, Partner, Broad and Cassel LLP

Daniel Melvin, Partner, McDermott Will & Emery, LLP


Physician Arrangement Auditing 101

  • Conduct a mock audit of a physician arrangement by reviewing key areas of focus as defined by the Stark law
  • Define and interpret audit findings
  • Discuss the role distinctions between the compliance officer and legal counsel when issues are identified

Anne E. Brummell, Compliance Program Manager, Honor Health

Juliette Stancil, Regional Compliance Officer, Presence Health


Intersection of Internal Audit and Compliance

  • Identify opportunities to more efficiently and effectively monitor current and emerging areas of risk using the Lines of Defense as reference
  • Align Compliance and Internal Audit behind a common language for risk; promote strategic auditing of internal and external threats and harmonize monitoring activities
  • Promote Compliance and Internal Audit as trusted resources to help Operations keep pace with the evolving risk landscape and regulatory requirements

Maria Toribio, Director, PricewaterhouseCoopers

Jack Flaherty, Director, PricewaterhouseCoopers


David & Goliath: Compliance Investigations in the Era of Social Media

  • Building on Investigative Skills: intake, planning, online tools, and developing a final investigative report
  • Emerging Forensic Resources: tools, social media tips and tricks, consulting and legal support, efficiency, opportunities, and effective coordination with other key stakeholders (such as HR, Internal Audit, Legal, and IT) and their tools
  • Legal & Compliance: Effective Partnership & Coordination: attorney client privileges, privacy, policy and procedure development, competing legal issues (employment law, privacy, compliance, and associated case law discussion
Regina F. Gurvich, Director, Contract Assurance & Monitoring, NYC H+H

Christie A. Moon, Legal Counsel, Sutter Health

Brian Callihan, Director of Special Projects, Sutter Health


Coding & Documentation Compliance Risks: Hints & Tips for the Compliance Professional

  • This presentation will provide an in-depth walk through the different healthcare settings that carry greatest and most frequent risks. The attendee will receive tips and hints to assist in their compliance work towards accuracy and data integrity
  • Accurate clinical documentation to support a true picture of patient illness is important to the revenue cycle, data analytics, and overall compliance. Absence of accuracy carries great risk for any practice, facility or organization
  • Compliance professionals need to be on top of the many risk areas. Areas to be reviewed in this presentation are documentation and coding in the inpatient, outpatient, emergency and clinic. Additionally, CDI and chargemaster will also be reviewed
Dana L. Brown, President, Reimbursement Management Consultants, Inc.

Gloryanne H. Bryant, HIM Coding Specialist


CIA Success Story: Settlement, Implementation, Effectiveness

  • Hear the former Amerigroup Chief Compliance Officer, IRO representative, and OIG attorney-monitor discuss how, after challenging settlement negotiations, Amerigroup embraced its CIA, worked with OIG, and improved the effectiveness of its Compliance Program.
Laura E. Ellis, Senior Counsel, Office of Counsel to the Inspector General, U.S. Department of Health and Human Services

Georgia Dodds Foley, Former Chief Compliance Officer, Amerigroup

Rita Isnar, Senior Vice President, Strategic Management, Strategic Management Services, LLC


Barriers to Sharing Health Information in Behavioral Health

  • An overview of barriers to information sharing in behavioral health
  • Approaches to compliance with HIPAA and 42 CFR Part 2 in substance abuse treatment, particularly in an integrated care environment
  • Addressing operational challenges encountered in sharing PHI among health care providers and managed care organizations

Tim Timmons, Privacy and Security Officer, Greater Oregon Behavioral Health

Kelly T. Hagan, Attorney, Schwabe Williamson & Wyatt PC


Risk Assessments: The Critical Role of Assessing and Managing Risk in Today’s Enforcement and Compliance Environment

  • Explore developments emphasizing the role of an active and effective enterprise wide risk management program and discuss wide ranging authority and other best practices for enhancing an organization’s ability to effectively assess and manage risk
  • Examine the role of various stakeholders in the risk management process (including compliance, legal, internal audit, senior leadership and governing bodies)
  • Identify challenges commonly experienced by organizations attempting to enhance risk management programs and consider potential solutions

*Advanced Discussion Groups open on a first come, first-served basis, and are limited to the first 50 attendees. Pre-registration is not available for these sessions.

Sara Kay Wheeler, Partner, King & Spalding


Navigating the Gray Zones of the Anti‑Kickback Statute

  • Review the boundaries of the Anti‑Kickback Statute, Special Fraud Alerts and Advisory Opinions
  • Identify techniques for applying the Anti‑Kickback Statute to situations that fall outside of the specific guidance
  • Discussion to analyze and apply the techniques to specific case scenarios

*Advanced Discussion Groups open on a first come, first-served basis, and are limited to the first 50 attendees. Pre-registration is not available for these sessions.

Darrell Contreras, Chief Compliance Officer, Millennium Health


Engaging your Executive Team and Board in a Strategic Vision for Your Compliance Program

  • Compliance program strategies? Is that an oxymoron?
  • Soup Nazi, Servpro or Smoky Bear? Creating and changing perceptions
  • What Drucker really said: the balancing act. Establishing objectives/measuring outcomes and building/nurturing relationships

*Advanced Discussion Groups open on a first come, first-served basis, and are limited to the first 50 attendees. Pre-registration is not available for these sessions.

Steve Ortquist, Senior Managing Director, Ankura Consulting Group, LLP