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You are here : About  >  Conference Sessions  >  Tuesday

Tuesday, April 9

400s500s | 600s | 700s

 

 

Session

Title

Speakers

General Session: Never, Ever Give Up
8:30 - 9:30 AM

In the pitch-black night, stung by jellyfish, choking on salt water, singing to herself, hallucinating ... Diana Nyad just kept on swimming. And that's how she finally achieved her lifetime goal as an athlete: an extreme 100-mile swim from Cuba to Florida—at age 64. Hear her story.

DIANA NYAD, Record-breaking athlete


Break
9:30 - 9:45 AM


Breakout Sessions
9:45 - 10:45 AM


401

GDPR Update: Privacy Across the Pond

  • U.S.-based firms (including healthcare, health plans and business associates servicing healthcare) must determine if their organization is required to meet the GDPR compliance requirements
  • GDPR impact to U.S. health organizations includes controls around Consent, Privacy Notices and Breach Notification; Data Protection Officer assignment; client communication on Rights to Access; and Cross-Border Data Transfer protocols
  • An analysis of data security frameworks, such as HITRUST and Privacy Shield, are discussed; specifically, around how these certifications line up with GDPR requirements
BRIAN SELFRIDGE, Partner, Meditology Services, LLC

KEVIN HENRY
, Senior Associate, Meditology Services, LLC

 
402

HCCs and Providers: Get Paid for What You Do

  • Hierarchial Coding Conditions (HCCs) capture the complexity of patient care and ensure maximum reimbursement. Are you getting paid for what you are doing?
  • CMS Risk Adjustment shifts reimbursement risk to healthcare providers through Risk Adjustment Factors and HCC capture. As Medicare plan enrollment increases, providers must meet the challenges of provider education and documentation
  • Join us to learn how Risk Adjustment, HCCs, RAFs, and the CMS Annual Miracle Cure will impact future provider, institution, and health plan compliance and reimbursement
D. SCOTT JONES, Chief Compliance Officer, Augusta Health

 
403

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

  • A Lawyer’s Perspective: Discussion of the lawyer’s role as a business & legal counselor, the privileges that apply to the dual roles and the duties and obligations of the lawyer to protect the client’s information under ethical and legal consideration
  • A Provider’s Perspective: Discussion of what providers should look for and assurances they should seek when engaging outside counsel and the laws that apply to the relationship
  • Understanding the distinction between lawyers in compliance roles and lawyers in legal roles
DEBRA GEROUX, Shareholder, Butzel Long

JOAN PODLESKI, Chief Privacy Officer, Children’s Health System of Texas

 
404

Frankly Speaking

  • Unplugged and unvarnished observations about compliance
  • What works and what doesn’t as a compliance professional
  • How to deal those who don’t embrace compliance
FRANK SHEEDER, Partner, Alston & Bird LLP
 
405

Drip Drop: Infusion Auditing Made Simple

  • Explore fundamental rules and concepts of infusion & injection therapy reporting
  • Investigate common weaknesses causing risk when coding and reporting supplies
  • Deploy coding concepts to real-time therapy examples even non-coders can use easily!

KELLY LOYA, Associate Partner, Pinnacle Enterprise Risk Consulting Services

 
406

Compliance’s New Role in the Survey Process

  • Understand the obligations of mandated compliance programs in the context of the SNF survey process
  • Discuss creating a proactive approach within the compliance committee to address survey issues
  • Analyze and understand ramifications of the new CMS survey enforcement guidances
PAULA SANDERS, Principal and Healthcare Co-Chair, Post & Schell, P.C.

KARLA DREISBACH, VP Compliance, Friends Services for the Aging
 
407

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

  • What is a Culture of Ethics? A Culture of Compliance? Can you measure and monitor your culture? What are red flags to watch for?
  • Who is responsible for maintaining an appropriate organizational culture? What is the compliance officer’s role? How can a compliance officer and compliance staff best work to impact and/or help others understand the importance of culture
  • How do the concrete obligations of a CCO (e.g., to maintain a “seven elements” compliance program) relate to the creation and maintenance of an ethical culture? Who should the CCO partner with to best impact the culture of an organization?

STEVEN ORTQUIST, Senior Managing Director, Ankura Consulting Group

MARIANNE JENNINGS, W.P. Carey School of Accountancy

 
408

Effective Risk Management in Medicare Compliance: How to Detect, Prevent, and Correct Issues Without Becoming the Compliance Officer Who Cried Wolf

  • Implement a “Detect, Correct & Prevent” approach to Risk Management; adopt a risk-aware mindset & use critical thinking to make sound recommendations; cure problems vs. treat symptoms, look through a risk lens to discover opportunities for improve z Message clearly without inducing defensiveness; discuss risks with senior leadership, advocate for your plan, encourage others to take ownership; be a team player but retain autonomy; share accountability without getting thrown under the bus z Establish credibility through transparency and consistency; build a “tri-folio” of 1) documented successes, 2) risks that were avoided (and the attendant savings) 3) opportunities & improvements based on detecting, correcting & preventing risks

LAURA FORSTER, Plan Compliance Officer, Aetna

 
 409

Top Cyber-Risks to Include in Your Audit Plan-Update

  • The use and deployment of information technology (IT) is a critical success factor for healthcare organizations. The speed of change, complexity and new requirements in the technology arena impact the ability to manage risk and ensure compliance
  • In this session, participants will learn about the latest IT and cyber threats that can challenge their ability to deliver quality outcomes. They will learn how to best protect their data, ensure compliance and effectively monitor IT & cyber risks
  • We will discuss best practices in IT Governance and help participants become better prepared for the latest IT audit challenges. This will include references to excepted industry standards

JOHAN LIDROS, President, Eminere Group


 
410

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

  • Present case scenarios and discuss compliance and risk exposures related to EMTALA (e.g. defining an EMC for psychiatric patients, complications when transferring psychiatric patients, patient acceptance and risk benefit analysis, etc.)
  • Discuss obligations for treating medical, psychiatric and substance abuse conditions in connection with EMTALA and who is qualified to perform a psychiatric medical screening exam
  • Provide examples of EMTALA documentation and audit tools (e.g. documenting capability and capacity, recipient hospital obligations workflow, EMTALA compliance self-audit tool, etc.)

REBEKAH STEWART, Chief Ethics and Compliance Officer, Diamond Healthcare Corporation

KATHERINE BORNSTEIN, JD, Entity Compliance Officer, MedStar Health

ALLISON LUKE, Principal, AK LUKE, LLC Healthcare Compliance Consulting

  
 411

The Spyware Nightmare

  • A spyware incident revealed itself when the FBI notified us of suspicious criminal activity. How would you respond if one of your providers was accessing your health system, unaware of the presence of malware?
  • We will inform attendees on the activation of data breach response procedures, the investigation and forensic review, analysis of patient data at risk, public breach notification and communications, and corrective actions taken. 
  • At end we will discuss steps a healthcare organization should take once a malware breach is suspected or has been determined, and how to protect your organization from these types of attacks. We will also reveal our most beneficial lessons learned.

REGINA VERDE, Chief Corporate Compliance & Privacy Officer, University of Virginia Health System

ERIN TROST, Information Security Manager, University of Virginia Health System

 
 412

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

  • Build your brand: assertive and approachable
  • Get and keep compliance at the table
  • Engage the workforce by moving beyond the regulations

KYM CREEKMORE, Chief Compliance Officer, National Service Center-Eurofins

SCOTT INTNER, Chief Compliance Officer, GW Medical Faculty Associates

 
 

413

Drug Diversion: A Multidisciplinary Approach

  • Creating a Drug Diversion Task Force, implementing a quick response system, tracking and trending drug diversions throughout a hospital system
  • Ensuring Best Practices-Establishing the requirements of each key stakeholder and maintaining accountability
  • Closing the Loop-Cultivating an environment that deters drug diversion while also providing resources for employees that require treatment for substance abuse
GREGORY FERRELL, Compliance Officer, University Hospitals

EDWARD SOYKA
, Manager - Hospital Compliance, University Hospitals
 

414

Working with Integrity: Taking the Right Path

  • Ethics, Integrity, & Compliance: Is there a difference?
  • Case studies that lead to taking the wrong path
  • Steps to consider for making the right choices

RUTH KRUEGER, MS, Owner, Compliance Coach Co. LLC


 
415 

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

  • Healthcare stakeholders are developing new care delivery and payment models using financial incentives to encourage healthcare stakeholders to work together to integrate care between and among providers and other healthcare organizations
  • The current legal framework was designed for fee-for-service payments where financial arrangements between and among healthcare stakeholders could encourage the overutilization of resources and inappropriately influence provider decision-making
  • This session will address potential changes to the framework that would support new care delivery and payment models while still protecting against fraud and abuse and guidance for compliance professionals navigating this new terrain
JANE HYATT THORPE, Associate Professor, George Washington University

ELIZABETH GRAY
, Research Scientist, The George Washington University Milken Institute School of Public Health

 

Last Chance to Visit with Exhibitors
10:45 - 11:15 AM


 

Breakout Sessions
11:15 AM - 12:15 PM


501

Data, Monitoring and the Culture of Privacy

  • Learn how a leading health system adopted a strong privacy monitoring approach by implementing a clinically-aware and AI-enabled platform that brings together data from many disparate sources to identify possible threats to patient privacy
  • Understand how this transition improved the organization’s ability to strengthen the culture of privacy sensitivity. 
  • Learn about the key metrics the organization tracks to determine the effectiveness of its privacy operation and how it uses this data to improve the strength of its program
LAUREN STEINFELD, Chief Privacy Officer, Penn Medicine

ANDREA THOMAS-LLOYD
, Director, Information Assurance, Penn Medicine
 
502

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

  • Here comes trouble! Request for medical record documentation! Who’s requesting? Insight on the regulatory landscape surrounding audits, and tools for a proactive response to a request for records
  • Medicare audits: proper response is essential. To appeal or not to appeal—the recipe for a collaborative approach to audit response by the healthcare attorney and coding and compliance expert
  • Best practices! Tools and strategy for healthcare attorney and coding & compliance expert to minimize risk for future audits

MAGGIE MAC, President, Maggie Mac-MPC Inc.

MICHAEL IGEL, Esquire, Johnson Pope Bokor Ruppel & Burns LLP

 
 503

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

  • Discuss application of kickback and physician self-referral (Stark) laws to academic medical centers in the clinical care context and beyond, including with respect to engagement in medical education and research
  • Review recent developments in kickback and Stark laws and apply evolving legal standards to various hypotheticals
  • Identify practical strategies to mitigate risk, including tips for preparing physician agreements, monitoring and auditing compliance with agreements and applicable policies, and addressing fair market value and commercial reasonableness

AMY JOSEPH, Senior Counsel, Hooper, Lundy & Bookman, PC

 
504

Internal Investigations: Refining Your Interviewing Skills

  • Interviewing questions, skills, and processes
  • Investigation documentation
  • Mock interviews
MELISSA EDSON, Standards & Compliance Specialist, Hazelden Betty Ford Foundation

JACKIE STEMWEDEL, Sr. Manager, Standards & Compliance, Hazelden Betty Ford Foundation

JACKI WALTMAN, Mgr Health Information/ Corporate Privacy Officer, Hazelden Betty Ford Foundation
 
505

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

  • Learn the compliance-oriented work flow processes, risks, and monitoring requirements that drive health system charge data (often referred to as Charge Management, Charge Master, Charge Description Master, or CDM)
  • Eliminate the mystique of Charge Master Management, and learn why charge data auditing and monitoring should be a concern for healthcare organizations of all sizes
  • Learn how properly-performed Charge Master audits (whether internally or externally-performed) can identify unforeseen compliance risk
  • Discuss the various types of audits and how to determine the best audit focus for your organization

ROSEMARY HOLLIDAY, Managing Partner, Holliday & Associates

 
506

Compliance for Hospice and Home Care

  • Understanding the key compliance and fraud, waste, and abuse risk areas in hospice and home care
  • Developing a robust compliance program to prevent and detect non-compliance and fraud, waste, and abuse in hospice and home care
  • Ensuring that senior management and boards of directors remain well-informed of compliance risk areas facing a hospice or home care organization
RANDI SEIGEL, Partner, Manatt, Phelps & Phillips, LLP

ANNIE MIYAZAKI, Chief Compliance and Privacy Officer, Visiting Nurse Service of New York
 
507

Everything Under The Sun(shine)

  • Best practices, tools, and getting the most out of Open Payments data for your organization
  • Developing, monitoring, and auditing conflict of interest management plans to optimize compliance for your organization
  • Tracking current legislation and potential impact on the Sunshine Act: How your institution can prepare for what lies ahead

REBECCA SCOTT, Compliance/Privacy Manager, University of Kentucky

ANDREW HILL, Compliance Analyst/ Auditor, UK HealthCare Office of Corporate Compliance

C. J. WOLF, Senior Compliance Executive, Healthicity

 
508

Identifying, Assessing and Auditing IT Risks in Health

  • Risk and claim management evolve through claims identification, investigation, discovery, mediation, and resolution. Learn how to achieve excellence by establishing standard policies, protocols, and procedures to guide your claims management process
  • Discover how modernizing your policy and procedure management platform enables the ability to verify staff have reviewed the most current policies, helps you easily and effectively defend claims and aids accreditation with easy access to approved policies
  • Learn how to eliminate liabilities by streamlining your healthcare claims management activities and reducing operational spending with digital policies and procedures easily accessible to all staff and dynamic workflows enable easy policy maintenance
RENEE BLOMME, Manager Patient Experience, North York General Hospital
 
 509

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

  • Understand the different roles each function plays in enterprise risk management and corporate strategy
  • Learn how collaboration between Compliance, Enterprise Risk, and Internal Audit improves the overall effectiveness of risk management
  • Obtain takeaways on the Cleveland Clinic approach to integrate the three risk assessment processes
DONALD SINKO, Chief Integrity Officer, Cleveland Clinic

VICKI BOKAR
, Senior Director, Corporate Compliance, Cleveland Clinic
 
510

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

  • ERM Risk Identification: explanation of the process for identification and ownership of enterprise risk (includes risk assessment tools and heat maps)
  • Key Areas of Focus and Process Improvement: collaboration with clinical, executive and front-line leadership to implement identified improvements—restraint/seclusion, face-to-face assessments, ligature risks, status individual observation, and safety
  • Governance, Execution and Sustainability: engagement of the board in risk identification, monitoring and sustainability, redundant leadership, metrics, continuous monitoring (includes LEAN tools such as A3)
KIMBERLY JORDAN, Chief Compliance Officer, Fairview Health Services

LORRIE GHOSE, System Director, Fairview Health Services

  
 511

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

  • Review a real-life case study on the discovery of fraud in the workplace and the six significant risk factors that rendered the control environment ineffective
  • Learn the limitations and barriers to reporting wrongdoing that exist in current whistleblower and anti-retaliation organizational policies
  • Discuss three important steps to take Before, During, and After the reporting of wrongdoing to stop retaliation before it become a second form of misconduct

AMY JOY, Faculty/Specialist Emeritus, University of California, Davis


 
 512

Next Generation Compliance Program: Moving from Mitigation to Strategy!

  • Discussion of key elements of what a next Generation Compliance Program should strive to accomplish
  • Practical tips and discussion for developing your compliance program as an asset to the organization
  • Moving your Compliance Program beyond risk mitigation

DISCUSSION GROUPS are filled first‑come, first‑served. Attendance is limited to the first 50 attendees. Session selection is not available for these sessions.

JENNIE HENRIQUES, Chief Compliance & Audit Officer, South Shore Health System

DONNA SCHNEIDER, Vice President, Corporate Compliance and Internal Audit, Lifespan


 
513

The State of Exclusions and OIG Enforcement Actions

  • We will review the latest statistics and breakdown of exclusions at the OIG and discuss trends and traps
  • Hear from a former Senior Counsel to HHS-OIG who advised OIG on exclusions and gain a better understanding OIG’s enforcement approach and how to avoid/ mitigate enforcement
  • We will review relevant cases of enforcement and learn tips for Effective Exclusion Monitoring

MICHAEL ROSEN, Co-Founder, ProviderTrust, Inc

DAVID BLANK, Partner, Quarles & Brady LLP

GEOFFREY HYMANS, Senior Counsel, Office of Inspector General

 
514

TBA


 

515

TBA


Lunch
12:15 - 1:30 PM


Breakout Sessions
1:30 - 2:30 PM


601

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

  • Attendees will hear how the explosion of social media (and smart phones) has led to increased HIPAA Privacy Risks. Presenters will share real world examples of breaches at other organizations originating from social media posts by employees
  • Presenters will share tactics used to create cultures of confidentiality within their respective organizations
  • Presenters will share how proactive monitoring of social media accounts has led to mitigation of potential privacy breaches and educational opportunities
CARLOS CRUZ, SVP, Chief Compliance Officer, Tri-City Healthcare District

MELISSA MITCHELL
, Chief Compliance Officer, Sinai Health System
 
602

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

  • Physician arrangements are a highly regulated business. Compliance can feel big brother to physicians if not presented as part of the culture
  • When time studies are needed, physicians often don’t understand the significance of compliance for the organization and for themselves. Strategies and best practices to manage arrangements that align priorities
  • Capital Health System Case Study. Physician leader and CMO of system will present their path in engaging physicians. Jefferson Health Case Study. SVP legal will present how they dialog with physicians about work performed to drive clinical agenda

GAIL PEACE, President, Ludi

KELLY WALENDA, Sr VP Legal Services and Chief Privacy Officer, Jefferson Health

EUGENE MCMAHON, Senior VP and Chief Medical Officer, Capital Health System

 
 603

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

  • Legal gymnastics of the deal, including structuring within Corporate Practice of Medicine, regulatory compliance, and due diligence across multi-specialty/ multi-state acquisitions
  • Translating due diligence findings into an action plan for an effective, centralized compliance program and a scalable framework for future acquisitions
  • Lessons learned from successes and fiascos, actionable pointers, and a few tools to make it all work

REGINA GURVICH, VP, CCO, OMNI Ophthalmic Management Consultants

DANIEL MEIER, Healthcare Regulatory and Transactional Attorney, Benesch Friedlander Coplan & Aronoff

 
604

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

  • How to unlock some of the unused potential of your computer using functions and tools that you may not be aware of and how these functions can increase your effectiveness in your time management efforts
  • Learn how to identify daily processes and workflows so as to identify if they may present opportunities for you to automate various tasks while also increasing the overall accuracy of your work product
  • Participate in hands on exercises during the session to make your use of the internet more productive while also learning how to maximize the use of Internet based resources
FRANK RUELAS, Principal, HIPAA College

RACHEL BUCHANAN, Compliance Manager, Oregon Urology Institute

 
605

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

  • Strategies and ideas on how to ensure auditing and monitoring are fully integrated into your Compliance Program
  • Guidance and strategies on how to tailor the 5th Element of auditing and monitoring for your specific organization. Once Size does not fit all!
  • Discussion on how and when to move from the 5th Element (Auditing & Monitoring) to the 7th Element of Investigations and Remedial Measures when significant concerns are identified

VICKI DWYER, Chief Compliance & Risk Officer, Valley View Hospital Association

NANCY KENNEDY, Compliance Auditor, Oklahoma Heart Hospital Physicians

 
606

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

  • Identify and address issues around who can administer experimental and complementary medications as well as marijuana and CBD/Hemp oil
  • Discussion of storage and access to marijuana, experimental, and complementary medications
  • Identify and address the legal risks associated with patient use of marijuana, experimental, and complementary medications in long-term care facilities
ALEAH SCHUTZE, Of Counsel, Steptoe & Johnson PLLC

SARAH POTTER, Associate General Counsel, BrightSpring Health Services
 
607

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

  • Patients who refuse care based on providers’ race, language or other personal traits present complex challenges for organizations; patient bias can impact the safety, quality and equity of care, affect employee well-being and increase compliance risks
  • Hear how one organization used principles of collaboration, organizational culture, diversity and inclusion, compliance and a patient- and staff-centered approach to effectively address patient bias in ambulatory and inpatient settings
  • Learn how to evaluate and navigate patient bias in a variety of care settings and to manage organizational risk around this growing issue; improve workforce awareness; and develop tools that will support your organization’s ability to address patient bias

TOBI TANZER, Vice President, Integrity and Compliance, Chief Compliance Officer, HealthPartners, Inc

SHAMAYNE BRAMAN, Director, Diversity and Inclusion, HealthPartners, Inc

 
608

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

  • Learn how to refine your risk management process so it not only involves the right people, information, and implementation, but also conveys the importance and impact to your business decision makers
  • Discuss how to quantify business risk exposure and think like your CEO so you can get buy-in from your leadership team
  • Understand common barriers to success and how to overcome them
NIKOLA TODEV, Head of Information Security, OnRamp
 
 609

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

  • Discuss the changing role of internal audit in healthcare and how that impacts the compliance function
  • Share leading practices on how compliance and Internal Audit can collaborative and team successfully
  • Provide illustrative examples of successful teaming activities
MICHAEL CRONIN, Managing Director, Deloitte & Touche LLP
 
610

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

  • Successfully providing co-located and integrated services depends on timely sharing of patient information—but there is no “one size fits all” approach
  • Understanding state and federal privacy laws is key when developing an integration program for mental health, substance use, and primary care services
  • The presenters will highlight key privacy issues and share practical lessons learned from their first-hand experience with integrated services
ELIZABETH WINCHELL, Attorney, Health Care Practice Group, Nilan Johnson Lewis PA

KRISTINE PRESTON, Corp Compliance Director, Wilder Foundation

  
 611

Theranos Case Study: What Went Wrong?

  • Join us for this interactive session to discuss how a young college dropout hoodwinked major venture capitalists
  • Discover the 8 signs of trouble that were overlooked and resulted in a $9 Billion fraud scheme
  • Explore these key questions: Would an effective compliance program cause the startup to fail or succeed? What is the role of the compliance professional when faced with signs of fraud? Is an industry that affects people’s lives held to a higher standard?

CINDY HART, Associate Consultant, Acevedo Consulting, Inc

TOMI HAGAN, Chief Compliance Officer, Great River Health System


 
 612

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

  • Discussion of behaviors that define a good culture in healthcare companies and what initiatives compliance can lead to inspire those behaviors
  • Mood in the middle—how to get middle management to buy into demonstrating a culture of compliance and integrity
  • Examples of what other companies just like yours are doing to build and establish a strong culture

DISCUSSION GROUPS are filled first‑come, first‑served. Attendance is limited to the first 50 attendees. Session selection is not available for these sessions.

MARY SHIRLEY, Senior Director, Ethics and Compliance, Fresenius Medical Care North America


 
613

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

  • We know what the basic rules are. Now what?? Understanding the complexities of consents, record sharing and more!
  • State Lines: Dare I cross them? Understanding more about how Telehealth is impacted by state borders
  • Is it okay if we... A comprehensive look at some of the strangest questions and answers for Telehealth operations!

TONJA WISE, Director of Revenue Cycle Compliance, Kaiser Permanente National Compliance, Ethics and Integrity Office

 
614

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

  • Overview of the #MeToo movement as it relates to the healthcare environment
  • Legal and compliance impact of allegations and investigations
  • How to educate and change organization’s culture
KIM DANEHOWER, Corporate Compliance Officer, Baptist Memorial Health Care Corporation

 

615

Patient Incentives or Inducements? Avoiding Pitfalls and Managing Risks

  • Overview of regulatory guidance particularly in the accountable care organization / provider and managed care setting
  • Discuss operational objectives and practical considerations in administering beneficiary incentives
  • Provide examples of how to design beneficiary incentives and avoid design flaws
CATIE HEINDEL, Managing Senior Consultant, Strategic Management Services, LLC

RITA ISNAR
, Managing Sr. Consultant, Strategic Management Services, LLC

Break

2:30 - 3:00 PM


Breakout Sessions

3:00 - 4:00 PM


701 

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

  • Look beneath the surface of your vendor’s security incident report to identify if there is a reportable breach and the roles your privacy, compliance, and security professionals, in-house counsel, and outside consultants and advisers should play
  • Explore the questions that need to be asked to identify the root cause of the incident. How to determine the extent of information needed to assess the risk of data compromise. How to view the vendor’s own assessment critically
  • Answer these questions through scenarios applying not only a HIPAA lens but also the patchwork of state health information privacy rules, for a complete picture on what is a reportable breach, who must be notified by whom, and when it must be reported
DAVID HOLTZMAN, VP Compliance Strategies, CynergisTek, Inc

THORA JOHNSON, Partner, Venable LLP


SHARI LEWISON, Chief Information Security Officer, University of Iowa Hospitals and Clinics

 
702 

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

  • Lessons learned from a twelve-month summary of published enforcement actions against providers and physician practices
  • Simplified approach to a risk assessment for your practice, large or small
  • Practical compliance plan development based on your risk assessment

SARAH COUTURE, Senior Associate, Ankura Consulting Group

GLENA JARBOE, Compliance Manager, University of Kentucky


 
 703

Criminal and Civil Liability for Overpayments

  • The statutory obligation to return a “known overpayment” and its application in criminal and civil enforcement proceedings
  • The basis for liability for “retention of a known overpayment” under the United States False Claims Act
  • The “identification” of a “known overpayment” and the time requirements for disclosure and return of overpayment
GABRIEL IMPERATO, Managing Partner, Nelson Mullins Broad and Cassel

DAVID FUCHS, Senior Counsel, Office of the Inspector General

 
 704

Five Strategies to Create Compliance Allies

  • Identify five strategies for compliance and ethics professionals to create allies within their organization
  • Discuss easy to implement tactics that can be used to put the strategies into practice and why each tactic can make a difference
  • Recognize that having allies is a win-win for both compliance and operations and learn how it positively influences the effectiveness of a compliance program
CINDY MATSON, Executive Director, Compliance, Sanford Health

 
705

The Compliance Professional’s Approach to Auditing Rehabilitation Services

  • Describe regulations guiding therapy practice, documentation, and billing
  • Review the required elements of therapy documentation
  • Identify key elements of an effective auditing and monitoring program for rehabilitation services
YOLUNDA DOCKETT, CHC, MOT, OTD, Corporate Compliance Officer, Lorien Health Services

HOLLY HESTER
, SVP, Compliance and Quality, Casamba

 
706

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

  • Compliance and due diligence challenges in home health and hospice transactions
  • Successful strategies for dealing with DOJ, OIG and state MFCU concerns
  • Maximizing the role of the compliance officer in home health and hospice M&A transactions
ALAN SCHABES, Partner, Benesch, Friedlander, Coplan & Aronoff LLP

SHANNON DRAKE, General Counsel, Aveanna Healthcare

 
707

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

  • Learn how you can: implement a new EMR system AND be a new or repeat MACRA participant, identify workflow-friendly measures, regardless of specialty; and apply/receive an exception approval, to achieve maximum scores, using ONLY minimal resources
  • Navigate the minefields of MACRA by educating/receiving buy-in from all roles at all levels; from C-Suite to staff that is ultimately responsible for documenting the details; and receive proven examples on how to overcome technical/ performance barriers
  • Understand how to create processes and templates to give real-time provider feedback; and identify low-tech methods to capture missing data; ALL to propel you from “this sounds great in theory” to potentially earning maximum positive payment adjustment

JACKIE ROBERTSON-GUTSHALL, Compliance Officer, Advanced Regional Center for Ankle and Foot Care

SHELLEY TIMKO, Regulatory Compliance Manager and Privacy Officer, Laser Spine Institute


 
708

Risk Management & Internal Investigations

  • Risk management: Leveraging effective internal coordination
  • Internal investigations: Customizing your investigations program to strategically remediate and mitigate risk
  • To privilege or not to privilege: Risk assessments, reviews, audits, and investigations

KIMYATTA MCCLARY, Compliance Investigations Counsel, McKesson Corporation


 
709

Home Health Agency: Audit Strategies and Common Red Flag Findings

  • Understand types of HHA internal audits
  • Define methodology for conducting the internal audit
  • Discuss common findings
SHAWN STEVISON, Associate Director, Healthcare Consulting, Dean Dorton

 
 710

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

  • Learn about Mental Health Parity requirements, including the most recent guidance from federal regulators, and how the rules differ for commercial, Medicaid and duals products
  • Gain insight into federal and state parity enforcement initiatives and oversight efforts
  • Discuss key issues in assessing parity, such as: who is responsible for the parity assessment, how to address behavioral health carve outs and correctly identifying non-quantitative treatment limits
HELAINE FINGOLD, Senior Counsel, Epstein Becker Green

 
 711

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

  • A panel of legal, privacy and compliance professionals from University Medical Center of Southern Nevada (UMC) will describe their experiences, the impact, and the aftermath of the largest mass shooting in U.S. history through their unique perspectives.
  • Explore the challenges experienced and lessons learned.
  • Investigate key questions: Can you be prepared for such an event? How are compliance boundaries pushed in an emergency of this magnitude? How long afterwards are the impacts of mass casualty events felt?
SUSAN M. PITZ, General Counsel, University Medical Center of Southern Nevada

KEITH SLADE, Privacy Officer, University Medical Center of Southern Nevada

RANI GILL, Compliance Officer, University Medical Center of Southern Nevada

  
 712

Health IT Risk Roundtable

  • Experience a forum for interaction with experts in healthcare IT risk, audit and compliance. This talented group will discuss the most relevant topics in the field and address questions raised by their peers
  • The panel and participants will discuss current best practices in healthcare IT risk management, IT auditing, Health IT and provide useful recommendations to manage key related IT risk related to cyber, patient safety, resilience, information governance
  • Everyone will benefit from hearing the challenges faced by others in the community—and the creative solutions they are adopting

DISCUSSION GROUPS are filled first‑come, first‑served. Attendance is limited to the first 50 attendees. Session selection is not available for these sessions.

JOHAN LIDROS, President, Eminere Group

STEPHANIE CRABB


KATE MULLIN, 


 
713

EHR Documentation Risks and Internal and External Reviews

  • Electronic Health Record (EHR) documentation risks (templates, copy & paste, etc.)
  • Malpractice and other risks with EHR documentation
  • Internal compliance reviews; Targeted Probe and Educate (TPE); RAC and other risks with EHR documentation
KENNETH JENKINS, Hospital Compliance Officer, Vanderbilt University Medical Center

SHELLY DENHAM, University of Louisville Physicians, University of Louisville Hospital and James Graham Brown Cancer Center

COLLEEN KING-DENNIS, AVP, Compliance Coding Education, University of Louisville-Physicians

 
 714

Statistical Sampling in Healthcare Audits and Investigations

  • Discuss increasing use of statistical sampling and extrapolation of overpayment liabilities by federal and state audit contractors, regulators, and commercial payers
  • Discuss the fundamentals of proper statistical sampling, how to draw reliable conclusions from a sample to the underlying universe of claims, and statistical sampling of healthcare claims by regulators and thirdparty auditors
  • Discuss experiences in defending healthcare providers against the use of flawed statistical sampling and extrapolation models, including experience in pursuing available administrative appeals

MICHAEL HOLPER, SVP Compliance and Audit Services, Trinity Health

STEFAN BOEDEKER, Managing Director, Berkley Research Group, LLC


 
 715

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

  • This panel will look at compliance initiatives involving AI/AN communities
  • It will address both healthcare (including P.L. 638 programs) and human services (including LiHeap, HeadStart, TANF, and other programs)
  • It will include tips for maximizing the services available for your communities while minimizing vulnerabilities to fraud, waste, and abuse

ANDREA TREESE BERLIN

DALE ROBINSON, JR., Lead Compliance Officer, Eastern Band of Cherokee Indians

CASEY MOORE, Healthcare Compliance Manager, Colville Confederated Tribes


Break

4:00 - 4:15 PM


General Session: How I started as a federal prosecutor, became a compliance officer, ran a hospital and became an international business leader

4:15 - 5:15 PM

DAVID ORBUCH, Executive Vice President, UK Managing Director, Optum

Closing Remarks
5:15 PM