Download the 2013 Compliance Institute®. With the Compliance ... If you don't have an iPhone, iPad, or Android device,
HCCA’s 17th Annual
COMPLIANCE
INSTITUTE
®
April 21–24, 2013 Gaylord National National Harbor, MD (DC Metro Area)
FINAL
AGENDA Register now at www.compliance-institute.org www.compliance-institute.org
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HCCA would like to thank our CONFERENCE SPONSORS PLATINUM SPONSORS
Why should you attend HCCA’s Compliance Institute ? ®
You’ll learn to: 77 Describe
the various components of compliance, ethics, and corporate responsibility plans and programs within the health care arena, and know the compliance procedures and issues related to the various health care laws and regulations
77 Describe
auditing and monitoring processes in order to evaluate your own audits, and identify departmental compliance concerns
77 Have
a working knowledge of the legal issues compliance professionals face, and equip yourself with the necessary legal knowledge needed to deal with inquiries from the enforcement authorities
77 Describe
compliance issues faced in a specific segment of the health care industry
77 Describe
key tactics and compliance actions to implement and the processes to do so
77 Have
an understanding of recent laws, regulations, and enforcement actions as they pertain to a compliance program
77 Describe
GOLD SPONSORS
the compliance issues faced and the key processes to use to address them as they relate to a specific segment of the health care arena
77 Establish
a working network of compliance professionals within the compliance professional’s specific segment of health care
Who should attend? 77 Health 77 Risk
care compliance professionals
managers
77 Privacy
SILVER SPONSORS
officers and other professionals handling health care privacy issues
77 Coding 77 Health
care consultants and attorneys
77 Health
care regulators and other government personnel
77 Nurse
CONFERENCE SUPPORTERS
and billing specialists
managers and executives
77 Health 77 Staff
information management specialists
educators and trainers
77 Institutional
chief information officers
77 Health
care senior executives and leaders, including CEOs and CFOs in hospitals, medical groups and IPAs, ancillary providers, long-term care organizations and health plans
MEDIA SPONSORS
77 Members
77 Physicians 77 Health
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of the board of trustees of health care enterprises and other health professionals
care journalists, researchers and policy makers
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Don’t Let Your Learning Get Derailed at the Compliance Institute
®
Try Following a Learning Track There’s a wealth of learning options at the Compliance Institute, with tons of valuable insights to bring back to your program. But how do you choose the right sessions for you? To make the course selection easier, we’ve arranged the sessions into learning tracks. Each track is arranged around a specific area of interest, enabling you to quickly find the sessions that match your needs. You can follow one track all the way through, or hop around between them. But no matter what you choose, you’ll find our tracks a fast, easy way to help pick the right Compliance Institute sessions for you.
GENERAL COMPLIANCE/HOT TOPICS Here’s the track for everything from the basics of Compliance 101 to hot topics like health care reform. Learn what you need to know from compliance officers, regulators, outside counsel, in‑house counsel, auditors, providers and industry experts.
LONG-TERM CARE Keep abreast of the changing regulations for skilled nursing facilities, including best practices for developing an effective compliance program, and the latest information on auditing and monitoring compliance programs now regulated by the Patient Protection and Affordable Care Act.
PRIVACY & SECURITY Understand the privacy and information security compliance issues that continue to emerge. And you’ll also learn how to integrate privacy and security issues into the overall compliance program.
PHYSICIAN COMPLIANCE The sessions will cover information related to small and large physician practices, research billing for physicians, academic medical centers, hospitals and health systems.
LEGAL & REGULATORY Learn the legal basis for the compliance issues you manage. The legal track sessions will be presented by experienced and knowledgeable lawyers, from inside and outside the government. They understand the law and can make it more understandable.
AUDITING & MONITORING How do you know your compliance program is working? Auditing and monitoring is key to measuring effectiveness and improvement. Learn the practices that you need to read the vital signs of your compliance program.
HOW TO SUCCEED AS A COMPLIANCE PROFESSIONAL The more effective your leadership, the more effective your compliance program. The sessions in this track will help you develop your skills and increase your value to the compliance program and the organization for which you work.
QUALITY OF CARE Quality of Care is one of the newest compliance challenges. Hear from compliance officers, doctors, nurses and other healthcare providers as they provide you with the information, tools and processes needed to help you do quality work on Quality of Care.
ADVANCED DISCUSSION GROUP If you’re an experienced compliance and ethics professional, or looking for a more interactive program, this track is for you. Each session is designed to involve everyone in the room. There are no formal presentations, just discussion facilitated by industry experts.
www.compliance-institute.org
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Become a Mentor. Find a Mentor. Connect with Your Peers. Get Connected and Support the Development of the Profession at the Compliance Institute
®
EARN 1.5 CEUs*
Don’t just network in the halls at the 2013 Compliance Institute. Take advantage of our new, live SpeedMentoring and SpeedNetworking sessions. You can try one or both. Here’s how. Want to build out your network? Sign up for our SpeedNetworking session. It’s a fun way to connect with peers who share your challenges. Want to give back to the profession by sharing your expertise? Sign up to be a mentor. When you come to the SpeedMentoring session you’ll be connected face‑to‑face with compliance professionals looking for an experienced practitioner to guide them. Looking for a mentor? The SpeedMentoring session is the place to meet one-on-one with potential mentors.
Whichever option you choose, you are in control of the people you will connect with! Both events offer seven individual one‑on‑one meetings and provide an excellent opportunity to learn from one another and initiate long‑lasting professional relationships.
Participating in the SpeedNetworking or SpeedMentoring sessions is easy. Just sign up at www.hcca-info.org/speedmentor. You can even earn CEUs by participating.
But don’t wait to enroll. Space is limited. Sign up for the SpeedMentoring and SpeedNetworking sessions today. 4
*A maximum of 1.5 CCB credits for networking may be awarded per year
www.compliance-institute.org
Download the 2013 Compliance Institute
®
Mobile App Available March 2013 With the Compliance Institute fast approaching, we are very excited to announce the launch of our HCCAci 2013 mobile conference app. The HCCAci app takes everything you need to know about the Compliance Institute and puts it directly onto your mobile device. You can start preparing for the conference early by viewing speaker information and building your personal itinerary ahead of time. Learn about event buzz (or even generate some yourself!) and communicate with other attendees before and during the event via the live in-app Twitter feed (make sure to use the #HCCAci hashtag).
77Native app to ensure usability with or without Internet
77 PowerPoint presentation slide viewer with slide tweeting
77Full iPad support for best attendee experience
77 Note taking, speaker and session rating, and note sharing
77Real-time messages and alerts that keep you updated 77Knowledge sharing via Twitter 77Complete interactive conference program and animated floor plan maps
77 Networking with speakers 77 Exhibitor details with weblinks and animated expo hall location
If you don’t have an iPhone, iPad, or Android device, you can still use the HCCAci 2013 mobile website. Visit www.hcca-info.org/hccaci for more information. Contact Eric Newman, Esq., CCEP, with any questions about the HCCAci 2013 app: eric.newman @ hcca-info.org | 952-405-7938
www.compliance-institute.org
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Continuing Education Units HCCA is in the process of applying for additional continuing education credits, and these credit totals are subject to change. If you have questions, please call 888-580-8373 or email
[email protected]. AAPC: This program has the prior approval of the American Academy of Professional Coders (AAPC) for 19.0 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor. ACHE: The Health Care Compliance Association is authorized to award 19 hours of pre-approved Category II (non-ACHE) continuing education credit for this program toward advancement, or recertification in the America College of Healthcare Executives. Participants in this program wishing to have the continuing education hours applied toward Category II credit should indicate on their attendance when submitting application to the American College of Healthcare Executives for advancement or recertification. AHIMA: This program has been approved for 19.0 continuing education units (CEUs) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor. ASHRM: This meeting has been approved for a total of 19.75 contact hours of Continuing Education Credit toward fulfillment of the requirements of ASHRM designations of FASHRM (Fellow) and DFASHRM (Distinguished Fellow) and towards CPHRM renewal. CCMC: This program has been pre-approved by The Commission for Case Manager Certification to provide continuing education credit to CCM® board certified case managers. The course is approved for 19.25 CE contact hour(s). CLE: The Health Care Compliance Association is a State Bar of California Approved MCLE provider, a Pennsylvania Accredited Provider, a Rhode Island Accredited Provider, and a Texas Accredited Sponsor. An approximate maximum of 19.25 clock hours of CLE credit will be available to attendees
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of this conference. All CLE credits will be awarded based on individual attendance. Please see the Compliance Institute website (www.complianceinstitute.org) for individual states’ approvals. NAAC: This program has been approved by NAAC for 19.25 Continuing Education Units for use in fulfilling the continuing education requirements for the Certified Ambulance Coder (CAC) certification. NAHQ: The National Association for Healthcare Quality (NAHQ) has approved this event for 19.25 CE Hours. NAMSS: The National Association Medical Staff Services has approved this event for up to 19.0 NAMSS continuing education credits. Accreditation of this educational program in no way implies endorsement or sponsorship by NAMSS. NASBA/CPE: The Health Care Compliance Association is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE sponsors, Sponsor Identification No: 105638. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit and may not accept one-half credits. Complaints regarding registered sponsors may be addressed to the National Registry of CPE Sponsors, 150 Fourth Avenue North, Suite 700, Nashville, TN 37219-2417. Website: www.nasba. org. A recommended maximum of 23 credits based on a 50-minute hour will be granted for the entire learning activity. This program addresses topics that are of a current concern in the compliance environment. This is an update, group-live activity. For more information regarding administrative policies such as complaints or refunds, call HCCA at 888-580-8373 or 952-988-0141.
Department at ccb@compliancecertification. org with any questions you may have. Oncology Nurses who are certified by ONCC may request CA Nursing Credit (check box or indicate “Nursing” on the CEU form). RACC: Attendees seeking CRA credits through the Research Administrators Certification Council (RACC) may request a certificate of attendance from HCCA by completing an Application for Continuing Education and indicating RACC/CRA on the form. A certificate of attendance along with a complete brochure should be submitted to RACC at the end of each individual’s RACC renewal period. The Research Administrators Certification Council (RACC) promotes the concept of voluntary certification by examination for all research and sponsored programs administrators. Certification in research and sponsored programs administration is highly valued and provides formal recognition of basic knowledge in the field. SoCRA: The Society of Clinical Research Associates (SoCRA – www.SoCRA.org) accepts documentation of candidate participation in continuing education programs for recertification if the program is applicable to clinical research regulations, operations or management, or to the candidate’s clinical research therapeutic area. This program offers 19.25 hours of CE credit. SoCRA’s requirements for recertification Continuing Education credit are quite general, as they pertain to clinical research regulations, operations and management, and to the therapeutic area of the clinical research in which the candidate participates. We therefore leave it to the candidate to determine whether a course or program would be acceptable for SoCRA’s CE requirement. SoCRA does not “validate” individual training courses/ workshops.
Nursing Credit (RN): The Health Care Compliance Association is preapproved by the California Board of Registered Nursing, Provider Number CEP 12990, for an approximate maximum of 23.1 contact hour(s). The following states will not accept CA Board of Nursing contact hours: Delaware, Florida, New Jersey and Utah. Massachusetts and Mississippi nurses may submit CA Board of Nursing contact hours to their state board, but approval will depend on review by the board. Please contact the Accreditation
www.compliance-institute.org
Continuing Education Units Compliance Certification Board (CCB): Certified in Healthcare Compliance (CHC)®, Certified in Healthcare Compliance–Fellow (CHC-F), Certified in Healthcare Privacy Compliance (CHPC)®, Certified in Healthcare Research Compliance (CHRC)®, Certified Compliance & Ethics Professional (CCEP)®, Certified Compliance & Ethics Professional–Fellow (CCEP-F), Certified Compliance & Ethics Professional–International (CCEP-I): CCB has awarded a maximum of 22.8 CEUs for these accreditations. Note: CEUs are subject to change. See below for credit breakdowns based on attendance.
STANDARD BREAKOUT SESSIONS Pre-conference: 6.6 full-day | AM only 3.3 | PM only 3.3 Monday: 6.6 Tuesday: 5.7 Wednesday: 4.2 MAXIMUM TOTAL: 22.8
Plan now to take a CHC, CHPC, or CHRC certification exam at the Compliance Institute ®
All exams will be held Wednesday, April 24, from 2:00 – 4:00 pm The deadline for receipt of exam applications is Wednesday, April 24, 2013. To download exam applications, visit www.compliance-institute. org and click the “Certification” tab. Exam applications should be mailed or faxed separately from the conference registration as directed on the exam application. Look in the brochure for sessions marked with CHC, CHPC, or CHRC if you are interested in taking a certification exam and would like to attend potentially helpful sessions. To be eligible to sit for an exam, candidates must acquire 20 CCB continuing education units, ten of which must come from “live” events or trainings. For a full list of exam requirements, please visit www.compliancecertification.org. One clock hour of session time at the Compliance Institute counts for 1.2 CCB CEUs. CCB CEUs are calculated on a 50-minute hour. If you wish to receive credits for your attendance at this conference, you must complete and submit a Continuing Education Application (found inside your Program at a Glance, or ask HCCA staff ). If you have questions, please email ccb @ compliancecertification.org or call 888-580-8373.
www.compliance-institute.org
Certified in Healthcare Compliance Be recognized for your knowledge and experience in healthcare compliance
Certified in Healthcare Research Compliance Be recognized for your knowledge and experience in healthcare research compliance
Certified in Healthcare Privacy Compliance Be recognized for your knowledge and experience in healthcare privacy compliance
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Speakers Donna Abbondandolo [408], RHIA, CHC, CCS, CPC, Director of Compliance, Catholic Health Services of LI, Farmingdale, NY
Tamar Abell [703], MA, CCC-SLP, President, Care 2 Learn, Chicago, IL
Patricia Ariel [408], CHC, VP & Chief Compliance Officer, Westchester Medical Center, Valhalla, NY
Katie Arnholt [703], Senior Counsel, Administrative and Civil Remedies Branch, Office of Inspector General, U.S. Department of Health and Human Services, Washington, DC
Fahad Ahmed [PREPM21], CHC, CHPS, Compliance & Privacy Officer, Yale New Haven Health System, Greenwich, CT
Bruce Anderson [AD9], CHC, CCEP, FLMI, Chief Ethics Officer, Health Net, Inc, Woodland Hills, CA
Daniel Anderson [POSTAM15], Assistant Director, US Department of Justice, Washington, DC
Marti Arvin [111, POSTAM13], CHC-F, CHPC, CHRC, CCEP-F, Chief Compliance Officer, UCLA Health System, Los Angeles, CA
Betty Bibbins [PREPM15, POSTAM18],
Erika Bol [PREAM4, POSTAM4], CHC, CIPP,
Shallie Bryant [POSTAM4], CHC, CHPC,
Quality Improvement Manager, Columbia Community Mental Health, Saint Helens, OR
MD, CHC, CPEHR, CPHIT, President & Chief Med Officer, DocuComp LLC, Cape Charles, VA
CPHRM, Privacy Officer, Colorado Dept of Health Care Policy & Financing, Denver, CO
HIPAA Privacy & Security Assistant Manager/ Deputy Privacy & Security Officer, CaroMont Health, Gastonia, NC
Troy Barsky [GS], Director, Division of Technical Payment Policy, Chronic Care Policy Group, Center for Medicare, Centers for Medicare & Medicaid Services, Washington, DC
Carrie Bill [204, 308],
Carol Booth [603],
JD, Associate, Feldesman Tucker Leifer Fidell LLP, Washington, DC
RN, CHC, Compliance Specialist, NY Office of Medicaid Inspector General, New York, NY
Richard Bucher [709],
Kim Brandt [609],
David Cade [303], ESQ, Deputy General Counsel, U.S. Department of Health and Human Services, Washington, DC
Brian Beard [411, POSTAM13], CHC, JD, MPA, Director Compliance & Ethics, McKesson Specialty Health, The Woodlands, TX
Meredith S. Auten [PREAM19], Morgan, Lewis & Bockius LLP, Philadelphia, PA
Rose Marie Babbitt [209], CHC, CHRC, Vice President, Federal Contracts and Grants, American Pharmacist Association, Washington, DC
Aurae Beidler [AD1], CHC, MHA, RHIA, Compliance Certificate Program Manager, Pacific University, Hillsboro, OR
Thomas Beimers [406], Special Counsel,
MBA, CPC-I, CPC, CMRS, Director of Compliance, Arizona Community Physicians, Tucson, AZ
President, Boerner Consulting LLC, New Berlin, WI
John T. Boese [PREAM6], Of Counsel,
Deann Baker [601], CCEP, CHC, CHRC, Sutter Care at Home Compliance Officer, Sutter Health, Fairfield, CA
Jenny Bernhard [410], Privacy Officer, Regional Health, Rapid City, SD
Director, External Affairs, Office of Inspector General, Washington, DC
Compliance Manager, Intermountain Healthcare, Salt Lake City, UT
Chief Healthcare Investigative Counsel for Senate Finance Committee, US Senate Finance Comm, Min Staff, Anapolis, MD
Jacqueline Bloink [POSTAM14], CHC,
Catherine Boerner [PREAM3], Esq.,
Erin C. Bliss [710],
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Bret Bissey [401], CHC, FACHE, CMPE, Senior Vice President, Ethics & Chief Compliance Officer, UMDNJ, Newark, NJ
Faegre Baker Daniels, Minneapolis, MN
Audrey Andrews [PREPM23], Chief Compliance Officer, Tenet Healthcare Corporation, Dallas, TX
Ginger Bandeen [108], LCSW, CHC,
Fried Frank Harris Shriver & Jacobson LLP, Washington, DC
Rick Cameron [POSTAM17], Managing Director, Healthcare, Navigant, Chesterfield, MO
George Breen [PREPM24], Shareholder, Epstein Becker & Green PC, Washington, DC
Cheryl Camin Murray [302], JD, MPH, Shareholder, Winstead PC, Dallas, TX
Julene Brown [PREPM24], RN, MSN, CHC, CPC, Director of Compliance Operations/ Assistant Compliance Officer, Essentia Health, Organizational Integrity and Compliance, Fargo, ND
Robert Brown [506], MBA, CHC, Senior Compliance Specialist, UW Medicine Compliance, University of Washington, Seattle, WA
Sarah Campbell [501], CHC, CHRC, Director, Policies & Procedures Management, Tenet Healthcare Corporation, Dallas, TX
Frank C. Castronova [POSTAM7], Health Care Management Biostatistician, Blue Cross Blue Shield of Michigan
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Speakers David Childers [102], President and Chief Executive Officer, Compli, Portland, OR
Heidi Christianson [201], JD, Shareholder, Nilan Johnson Lewis, Minneapolis, MN
Andrei Costantino [507], CHC, MHA,
Shawn DeGroot [PREAM13, GS, 511],
Suzie Draper [PREAM1],
Kevin Eskew [PREAM7], Managing
Daniel Fitzgerald [306], Senior Attorney,
CFE, CPC-H, Director Organizational Integrity, Trinity Health, Farmington Hills, MI
CCEP, CHC-F, CHRC, Associate Director, Navigant, Denver, CO
Intermountain Healthcare, Vice President, Business Ethics and Compliance, Salt Lake City, UT
Director, Dentons US LLP, Chicago, IL
Regulatory Law, Litigation & Regulatory Law Department, Walgreen Co., Deerfield, IL
David Crawford [PREAM12], Compliance
Beth DeLair [PREAM3], RN, JD, DeLair Consulting, S.C., Middleton, WI
Director, Affinity Health Plan, Bronx, NY
Richard P. Church [AD5], JD, PhD, Partner, K&L Gates LLP, Research Triangle Park, NC
Yo Delmar [311], MBA, LeToia Crozier [305], BS, JD, CHC, Senior Vice President, Compliance Officer, Cogent HMG, Brentwood, TN
Timothy Cleary [211], CHC, CHPC, CHRC, SVP Compliance, Internal Audit & Privacy, Health Quest Systems, Inc., Wappingers Falls, NY
Andrew Conkovich [POSTAM1], CHC, MBA, VP Corporate Responsibility Officer, Carondelet Health Network, Tucson, AZ
Kenneth Coronel [109], Chief Legal Officer, Verisys Corporation, Alexandria, VA
CMC, CISM, CGEIT, Vice President, GRC Solutions, MetricStream Inc, Palo Alto, CA
Eric Dieterich [704], Sunera, Tampa, FL
Dawn Crump [307], MA, SSBB, SSM Health Care-St. Louis, Network Director of Audit and Compliance, St. Louis, MO
Barbara Duffy [103], Shareholder, Lane Powell, Seattle, WA
Joel Dziengielewski [PREPM21], Director, Disputes & Investigations, Navigant, New York, NY
Mark Eddy [607], BBA, CPA, VP Internal Audit, HCA, Nashville, TN
Anna Dolinsky [610], Associate, Akin Gump Strauss Hauer & Feld, LLP, Washington, DC
Gary Eiland [PREAM6], JD, Partner, King & Spalding LLP, Houston, TX
Caron Cullen [PREAM12], CHC, VP, Comp & Regulatroy Affairs, Affinity Health Plan, Bronx, NY
David M. Deaton [206], Partner,
General for Legal Affairs, Office of Counsel to the Inspector General, Washington, DC
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CHC-F, CHPC, CHRC, CIA, Chief Audit & Compliance Officer, Vidant Health, Greenville, NC
Adam Falcone [308], JD, MPH, Partner, Feldesman Tucker Leifer Fidell LLP, Washington, DC
Dennis Felty [608], President/CEO of Keystone Human Services, Harrisburg, PA Andrea M. Ferrari [POSTAM17], JD, MPH,
Denise Fletcher [606], Attorney, Brown & Fortunato, P.C., Amarillo, TX
John Ford [304], Principal, Sienna Group LLC, Oldsmar, FL
Monica R. Freedle [AD1], CHC, Kaiser Westside Medical Center, Hospital Compliance Program Manager, Portland, OR
Manager, HealthCare Appraisers Inc., Delray Beach, FL
Dr. Mike Gallagher [110], CMIO/CMO, Health Jim Donaldson [301], MPA, CHC, CISSP, CIPP/US, Director of Corporate Compliance, Privacy and Security Officer, Baptist Health Care Corp., Pensacola, FL
O’Melveny & Myers LLP, Los Angeles, CA
Robert K. DeConti [710], Assistant Inspector
John Falcetano [GS, AD7], CCEP-F,
Samuel Donio [409], President, CBIZ KA Consulting, LLC, East Windsor, NJ
Susan Emanuel [307], Director, Revenue Services, System RAC Coordinator, Dignity Health, Phoenix, AZ
John H. Fisher II, [711] CHC, CCEP, Health Care & Compliance Counsel, Ruder Ware, LLSC, Wausau, WI
Greg Endicott [POSTAM17], Managing Director, Strategic Value Group, LLC, Los Angeles, CA
Mary Fischer [GS], CEO, Southern Prairie Community Care, Marshall, MN
Revenue Assurance Associates, Plantation, FL
David Gebler [POSTAM9], JD, President, Skout Group, LLC, Boston, MA
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Speakers Susan Gillin [109],
Mike Glomb [PREAM8],
Adam Greene [604],
Deputy Branch Chief, Administrative and Civil Remedies Branch, Office of Inspector General, U.S. Department of Health and Human Services, Washington, DC
Partner, Feldesman Tucker Leifer Fidell LLP, Washington, DC
JD, Partner, Davis Wright Tremaine LLP, Washington, DC
Leon Goldman [111], Principal, Goldman Healthcare Compliance Consulting, LLC, Lexington, MA
Anna M. Grizzle [305], Esq., Partner, Bass, Berry & Sims PLC, Nashville, TN
Stephen Gillis [211], MBA, Dir, Billing Compliance, Mass General Hospital, Boston, MA
Roger Goldman [POSTAM15], Partner, Sandy Gilmore [407],
Latham & Watkins LLP, Washington, DC
Regina Gurvich [PREPM18, 611], CHC,
Vogel, Slade & Goldstein, LLP, Washington, DC
Shawn Halcsik [403], CHC, DPT, MED, OCS, CPC, Director of Compliance, Evergreen Rehabilitation, Milwaukee, WI
Fredrikson & Byron PA, Minneapolis, MN
Daniel Gospin [602], Attorney, Epstein Becker & Green, Houston, TX
Keith Halleland [POSTAM3], CCEP, CHC, Shareholder, Halleland Habicht PA, Minneapolis, MN
& Associates, Inc., Eugene, OR
Michael Granston [PREAM6], Deputy Susan R. Glaser [GS], PhD, Glaser
Director, US Dept of Justice, Washington, DC
& Associates, Inc., Eugene, OR
Catherine Gray [210], RN, CHC, Director Corporate Compliance, Vidant Health, Greenville, NC
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Director–Clinical Trials Operations, Carondelet Health Network, Tucson, AZ
Officer, Sunrise Community Inc, Miami, FL
Nicole Harper [PREPM15, POSTAM18], Dir.Training & Dev/ Process ImprovementRevenue Cycle Operations, St. Vincents Health, Indianapolis, IN
Dan Heath [GS],
Janet Goldstein [PREAM6], Principal,
Peter A. Glaser [GS], PhD, Glaser
Marcella Henry [PREPM14], Compliance
Chief Compliance Officer, Manhattan’s Physician Group, New York, NY
CHC, HIPAA Compliance, Legacy Health, Portland, OR
David Glaser [706], Shareholder,
Greg Harlow [POSTAM1], PhD, CHRC,
Co‑author of the best‑sellers Switch and Made to Stick, and the new book Decisive
Christina Heide [PREPM17], JD, Senior Health Information Privacy Policy Specialist, U.S. Department of Health and Human Services, Office for Civil Rights, Washington, DC
Gary Herschman [AD10], Chair, Health
Strategic Design Studio, Baltimore, MD
Counsel, Manatt, Phelps & Phillips, LLP, Albany, NY
Lynda Hilliard [PREPM25],
Gabriel Imperato [706], Esq., CHC, Managing Partner, Broad and Cassel, Fort Lauderdale, FL
CCEP, CHC, Deputy Compliance Officer, University of California, Mount Shasta, CA
Jen Johnson [405], David Hoffman [PREPM23],
CFA, Partner, VMG Health, Dallas, TX
President, David Hoffman & Associates, Philadelphia, PA
D. Scott Jones [PREAM5, AD6], CHC,
RPA-C, JD, Partner, Arent Fox LLP, New York, NY
Michael Hemsley [PREAM1], Executive Vice President & General Counsel, Catholic Health East, Newton Square, PA
Senior Vice President, Claims, Risk Management, and Corporate Compliance, HPIX, Philadelphia, PA
Robyn Joppy [PREPM14], BS, MPA,
Margaret Hambleton [PREAM10], CHC, MBA, CPHRM, CHPC, Sr VP, Chief Compliance Officer, St Joseph Health System, Orange, CA
Robert Hussar [PREPM21], Esq., CHC,
Care Practice Group, Sills Cummis & Gross P.C., Newark, NJ
Rachel Hold‑Weiss [PREAM9, POSTAM6], Stephanie Heline [POSTAM4], Owner,
Kimberly Huey [505], CPC, CCS-P, PCS, President, KGG Coding & Reimbursement Consulting, Alabaster, AL
VP & Corp Compliance Officer, Keystone Human Services, Harrisburg, PA
David Holtzman [PREPM17, 104], Senior Health IT and Privacy Specialist, HHS Office for Civil Rights, Washington, DC
Al Josephs [501, POSTAM10], CHC, Sr Director Policy and Training, Tenet Healthcare Corporation, Dallas, TX
www.compliance-institute.org
Speakers John Kalb [508], JD, CCEP, CHPC, Operational Excellence Executive/ Compliance & Privacy Officer, Kootenai Health, Coeur d’Alene, ID
Dr. Kristine Koontz [708], Quality
Les Leech [608], CEO of
Kelly Loya [PREPM20],
Sunrise, Inc., Miami, FL
CHC, CPC-I, CPhT, Director, Enterprise Risk, Sinaiko Healthcare Consulting, Inc., Altegra Healthcare Company, Charlotte, NC
Management Director, Keystone Human Services, Inc.
Daniel R. Levinson, [GS], Inspector General, Rick Kam [404], President & Co-Founder, ID Experts, Portland, OR
Jared Krawczyk [605], Chief Product Architect, Fi-Med Management, Inc., Milwaukee, WI
Office of Inspector General, U.S. Department of Health and Human Services, Washington, DC
Hannah Levinson [610], JD, Candidate Geeta W. Kaveti [POSTAM15], Senior Counsel, Office of Counsel to the Inspector General, U.S. Department of Health and Human Services, Washington, DC
Vivek Krishnamurthy [102], Associate, Foley Hoag LLP, Washington, DC
Keisha Lightbourne [202], CHC, JD, MHA, Steven M. Lack [103],
Susan Kayser [603], Esq, Partner, Duane Morris LLP, New York, NY
PhD, CFE, Supervisory Special Agent (Retired), U.S. Department of Health and Human Services, Office of Inspector General, Office of Investigations, Walnut Creek, CA
Tim Kennedy [202], Director of Operations, Wolters Kluwer Law & Business, Evergreen Park, IL
Class of 2013, University of Maryland Francis King Carey School of Law, Baltimore, MD
Nathaniel Lacktman [606], Esq., BA, JD,
Steven Littlehale [203], MS, GCNSBC, Executive Vice President/Chief Clinical Officer, PointRight Inc., Lexington, MA
Ted Kobus [AD2, 404],
Partner, Patton Boggs, Washington, DC
Co-Leader, Privacy & Data Protection, BakerHostetler, New York, NY
www.compliance-institute.org
Trial Attorney, United States Department of Justice, Commercial Litigation Branch, Fraud Section, Washington DC
Chief Clinical Enterprise Compliance Officer, Assistant Vice Chancellor for Health Affairs, Office of Compliance & Corporate Integrity, Nashville, TN
Chief Compliance & Privacy Officer, Stanford University Medical Center, Palo Alto, CA
Judi McCabe [309], CHC, RN, MSHP, CPHQ, Director, Surveillance & Utilization Review, Medical Review and Medical Policy TMF Health Quality Institute, Austin, TX
CHC, Senior Director & Deputy Compliance Officer, Extendicare Health Services Inc, Milwaukee, WI
Lori McLaughlin [PREPM14], Sr VP
Ryan Meade [PREPM26, 112], CHRC, JD, Partner, Meade & Roach, LLP, Chicago, IL
CHC, CMM, ICCE, Director of Compliance Operations, SL Quality Diagnostic and Treatment Center, Brooklyn, NY
Dennis Mihale [POSTAM5], MD, MBA, President & Chief Medical Officer, Chelsea Management Group, Tampa, FL
Jacki Monson [604],
for Risk Mgmt & General Counsel, The Devereux Foundation, King of Prussia, PA
Maggie Mac [POSTAM5], CPC, CEMC, CEO, Founder, FairWarning, Inc., Clearwater, FL
Laura LaemmleWeidenfeld [109],
Susan Lynch [PREPM23],
Diane Meyer [POSTAM12], CHC,
Donna Maassen [203],
Kurt Long [304],
System Compliance Dir/ Clinics, Dignity Health, Rancho Cordova, CA
Jones Day, Columbus, OH
Senior Product Manager, Wolters Kluwer Law & Business, New York, NY
Senior Counsel, Foley & Lardner LLP, Tampa, FL
Dawnese Kindelt [510, POSTAM8], CPC, CHC,
Kevin Lyles [POSTAM12], Partner,
James S. Mathis [306], JD, CHC, CHP,
Andrea Merritt [POSTAM7], CHC, CIA, MBA, ABD, Dir, Compliance & Audit Svcs, Nova Compliance Group, Troy, MI
JD, CHC, Privacy Officer, Sutter Health, Sacramento, CA
Yolanda Whichard [210], Medical Internal Auditor, Office of Audit and Compliance, Vidant Health, Greenville, NC
Richard Moses [PREAM5, AD6], DO, JD, Physician/Attorney, Rydal, PA
F. Lisa Murtha [PREAM7, PREPM26], Partner, Dentons US LLP, Washington, DC
Mary Longe [PREPM22], Director, AHA Solutions, Inc, an American Hospital Association company
11
Speakers Kimberly New [PREPM20], Compliance Specialist, University Health System Inc, Knoxville, TN
Pat Newberry [503], Director Clinical Education, AIS Inc., Washington, DC
Carol Novak [POSTAM16], CHC, Practice Specialist, Kaiser Foundation Health Plan, Pasadena, CA
Kirk Ogrosky [PREPM19], JD, Partner, Arnold & Porter LLP, Washington, DC
Anjana Patel [506], Vice Chair, Health & Hospital Law Practice Group, Sills Cummis & Gross P.C., Newark, NJ
Michelle Pendergrass [105], CHC, Director of Compliance and Privacy Officer, Midland Memorial Hospital, Midland, TX
Corey Perman [602], JD, Compliance Officer-North Region/ Legal Counsel, Advocate Health Care, Oak Brook, IL
Rebekah Plowman [509], Partner, Jones Day, Atlanta, GA
Luanna Putney [PREPM25], CHC, CCEP, PhD, Director of Research Compliance, University of California, Oakland, CA
Greg Radinsky [101], JD, MBA, CHC, CCEP, Vice President & Chief Corporate Compliance Officer, North ShoreLIJ Health System, Great Neck, NY
CHRC, VP Chief Ethics & Compliance Officer, Sutter Health, San Francisco, CA
Connie Raffa [PREAM9, POSTAM6], JD, LLM, Partner, Arent Fox LLP, New York, NY
Robert Ossoff [AD3, 511], DMD, MD, CHC, Asst Vice Chancellor Compliance, Vanderbilt Medical Center, Nashville, TN
Frank Ruelas [PREPM17, 705],
CHC, RN, JD, Deputy Chief Compliance Officer, Sutter Health, Sacramento, CA
Valerie Rinkle [110],
Edwin Rauzi [709], Partner, Davis Wright Tremaine LLP, Seattle, WA
Julie Schwab [PREPM24], BSN,
CEO, AllMed Healthcare Mgmt Inc, Portland, OR
MSNA, MMGT, CHC, CHA, Corporate Compliance Officer, Sanford Bismarck, Bismarck, ND
Principal, HIPAA College, Casa Grande, AZ
William Segal [409],
Mark Ruppert [107],
CFE, CIA, CFSA, CICA, Corporate Compliance Officer, St. Joseph’s Healthcare System, Paterson, NJ
CHC, Director Internal Audit, Cedars-Sinai Medical Center, Los Angeles, CA
Frank Sheeder, CHC, [PREAM13, GS, POSTAM12], Partner, DLA Piper, Dallas, TX
Brian P. Ritchie [710], Assistant Inspector General for Centers for Medicare & Medicaid Audits, Office of Audit Services, Office of Inspector General, Washington, DC
Linda Sanches [504], Sr. Health Information Privacy Specialist, Office for Civil Rights, Washington, DC
James Sheehan [206],
Denise Sanders [PREPM17], Partner,
Esq., Chief Integrity Officer/Executive Deputy Commissioner, New York City Human Resources Administration, New York, NY
Daniel Roach [106], Esq., VP Compliance and Audit, Dignity Health, San Francisco, CA
Vicki L. Robinson [710], Senior Counsel for
Kern Augustine Conroy & Schoppmann, PC
Jennifer A. Shimek [PREAM12], Senior Manager, Assurance Services, Ernst & Young LLP, Iselin, NJ
Policy, Office of Inspector General, Washington, DC
Paula G. Sanders [403], Esq., Principal, William Priest [509], JD, Chief Compliance Officer, SouthernCare Inc, Irving, TX
David Pursell [402], JD, Partner, Husch Blackwell, Kansas City, MO
12
Judy Ringholz [AD4],
Marc Raspanti [POSTAM15], Paetragallo
Joan Podleski [PREPM25], Director of Institutional Ethics & Compliance, Duke University, Durham, NC
Andrew Rowe [208],
VP Revenue Informatics, Health Revenue Assurance Associates, Plantation, FL
Gordon Alfano Bosick & Raspanti, LLP, Philadelphia, PA
Steven Ortquist [112, AD4], CHC-F, CCEP,
Tim Renjilian [207], Sr Managing Director, FTI Consulting, Atlanta, GA
Mark Reagan [PREPM16], Managing Partner, San Francisco Office, Hooper, Lundy & Bookman, P.C., San Francisco, CA
Leon Rodriguez [701], Director of the Office for Civil Rights, U.S. Department of Health and Human Services, Washington, DC
Health Care Group Chair, Post & Schell, PC, Harrisburg, PA
Monique Showalter [PREPM22], Director, AHA Solutions, Inc, an American Hospital Association company
Alan Schabes [303], Partner, Benesch, Friedlander, Coplan & Aronoff LLP, Cleveland, OH
www.compliance-institute.org
Speakers Lisa Silveria [510, POSTAM8], RN,
Juliann Tenney [PREPM26], JD, CHRC,
BSN, System Compliance Director, Dignity Health, Stockton, CA
Inst Research & Comp Officer, UNC-Chapel Hill, Chapel Hill, NC
Curtis Udell [605],
Nancy Vogt [702], CHC,
CPAR, CPC, CMPA, Director, Corporate Compliance, Center for Vein Restoration, Greenbelt, MD
RHIT, CHP, Director of Compliance, Aurora Health Care, Milwaukee, WI
Howard Tepper [PREPM18], Darren Skyles [105], JD, CHC, Attorney, Cotton Bledsoe Tighe & Dawson, PC, Midland, TX
Earl E. Smith III [309], MD, FACEP, Chief Medical Officer, TMF Health Quality Institute, Austin, TX
Vice President, Physician Practice and Ambulatory Service, St. Joseph’s Healthcare System, Paterson, NJ
David Thompson [402], CPA, Director, CBIZ, Leawood, KS
Bill Ulrich [503], CHC, President, Consolidated Billing Srvcs Inc, Spokane, WA
Sheryl Vacca [PREAM2, 502], CCEP,
Tammy Stewart [410], Director of Research Integrity, Regional Health, Rapid City, SD
CHC-FCCEP-F, CHRC, CHPC, CCEP-I, Managing Director, Aegis Compliance & Ethics Center, Chicago, IL
Physician, Kaiser Permanente, Denver, CO
Charge, Investigations Branch, Office of Investigations, Office of Inspector General, Washington, DC
www.compliance-institute.org
VP Clinical Practice Performance, Henry Ford Health Syst, Detroit, MI
Sara Kay Wheeler [207], Esq., CHC,
Christopher Young [PREAM11], CHC,
Partner, King & Spalding, Atlanta, GA
Laboratory Management Support Services (LMSS), Phoenix, AZ
Ryan Whitehill [POSTAM10], Mgr
Howard Young [PREPM19], JD,
Ethics & Compliance Training, Tenet Healthcare Corporation, Dallas, TX
Partner, Morgan Lewis, Washington, DC
Jeff Wiggins [AD3],
Cheryl Wagonhurst [PREAM1, PREPM14],
JD, MHA, CHC, CICA, Vice President, Audit and Compliance, Vidant Health, Greenville, NC
Philip Yuson [POSTAM16], Esq., Practice Specialist, Rehabilitative Services, Kaiser-Permanente, Southern California Region, Pasadena, CA
CCEP, Owner, Law Office of Cheryl Wagonhurst, Santa Barbara, CA
Kelly Willenberg [PREAM7, 310], CHC,
Lawrence W. Vernaglia [POSTAM17],
Jennifer A. Trussell [710], Special Agent in James Taylor [AD8],
Director of Compliance, Sun Healthcare Group, Inc, Albuquerque, NM
Associate Professor, George Washington University, Washington, DC
Debbie Troklus [PREAM2, 610],
Assoc VP & Director, Emory University, Office of Research Compliance, Atlanta, GA
Robert Wade [106], Esq, Partner, Krieg Devault LLP, Mishawaka, IN Janine Valdez [PREAM3], Senior
Jane Hyatt Thorpe [PREAM8, 204], JD, Esq., CHC, Chief Compliance Officer, Cancer Treatment Centers of America, Schaumburg, IL
Esq., Owner/Principal, Wachler & Associates, P.C., Royal Oak, MI
CCEP-I, CHC-F, CHPC, CHRC, SVP/Chief Comp & Audit Officer, University of CA, Oakland, CA
CHC, CHPC, President, MTA, Inc, Westport, MA
President, Touchstone Valuation, LLC, Allen, TX
John Steiner [PREAM1],
CEO, DV & Associates Inc, Salt Lake City, UT
Kathleen Yaremchuk [AD3], MD, CHC,
Andrew Wachler [307],
Mary Thornton [205], Timothy Smith [POSTAM2], CPA/ABV,
Diana Voorhees [PREAM11], Principal/
Kristin West [PREPM25], CHRC,
JD, MPH, Partner & Chair of the Health Care Industry Team, Foley and Lardner LLP, Boston, MA
Catherine Wakefield [PREPM22], CHC, VP Corp Compliance & IA, MultiCare Health System, Tacoma, WA
Monica Zachary [PREAM12], MS, CHC, CHE, Commercial Compliance Officer, Corporate Compliance and Ethics, Coventry Health Care, Champaign, IL
Ralph Wuebker [406, POSTAM11],
Donnessa Vessakosol [302], Manager, Strategic Value Group, Dallas, TX
CHRC, BSN, Owner, Kelly Willenberg, LLC, Chesnee, SC
Debi Weatherford [707], Executive Director
MD, MBA, Chief Medical Officer, Executive Health Resources, Newton Square, PA
Kenneth Zeko [411], Director, KPMG, Dallas, TX
Internal Audit, Piedmont Healthcare, Atlanta, GA
13
Program at a Glance Saturday, April 20 7:30 am – 12:00 pm
7 th Annual Volunteer Project
11:00 am – 8:00 pm
Conference Registration
Sunday, April 21 7:30 am – 6:00 pm (includes 15-minute break)
PRE-CONFERENCE MORNING BREAKOUT SESSIONS
9:00 am – 12:00 pm
7:30 – 8:30 am
(includes 15-minute break)
PRE-CONFERENCE AFTERNOON BREAKOUT SESSIONS
1:30 pm – 4:30 pm
12:00 – 1:30 pm
14
TRACKS
3:30 – 4:30 pm 4:30 – 6:00 pm
Conference Registration SpeedNetworking PREAM1 Large Hospital Systems – Suzie Draper, Intermountain Healthcare, Vice President, Business Ethics and Compliance; Michael Hemsley, Executive Vice President & General Counsel, Catholic Health East; John Steiner, Chief Compliance Officer, Cancer Treatment Centers of America; Cheryl Wagonhurst, Owner, Law Office of Cheryl Wagonhurst PREAM2 Compliance 101 – Sheryl Vacca, SVP/Chief Comp & Audit Officer, University of CA; Debbie Troklus, Managing Director, Aegis Compliance & Ethics Center CHC CHPC CHRC PREAM3 Compliance Programs: The Next Generation – Catherine Boerner, President, Boerner Consulting LLC; Beth DeLair, DeLair Consulting, S.C.; Janine Valdez, Senior Director of Compliance, Sun Healthcare Group, Inc PREAM4 HIPAA Privacy & Security 101 – Erika Bol, Privacy Officer, Colorado Dept of Health Care Policy & Financing CHC CHPC PREAM5 Can Compliance Teach Physicians to Comply? Adapting Different Healthcare Models to Teach Physicians Compliance – D. Scott Jones, Senior Vice President, Claims, Risk Management, and Corporate Compliance, HPIX; Richard Moses, Physician/Attorney CHC PREAM6 False Claims Act Development – John Boese, Of Counsel, Fried Frank Harris Shriver & Jacobson LLP; Gary Eiland, Partner, King & Spalding LLP; Michael Granston, Deputy Director, US Dept of Justice; Janet Goldstein, Principal, Vogel, Slade & Goldstein, LLP PREAM7 Implementing a Research Auditing Program – Kevin Eskew, Managing Director, Dentons US LLP; F. Lisa Murtha, Partner, Dentons US LLP; Kelly Willenberg, Owner, Kelly Willenberg, LLC CHRC PREAM8 Effective Training: Teach Compliance to Clinicians – Mike Glomb, Partner, Feldesman Tucker Leifer Fidell LLP; Jane Hyatt Thorpe, Associate Professor, George Washington University PREAM9 Hot Topics in Medicare, RAC, ZPIC & MIC Appeals – Rachel Hold-Weiss, Partner, Arent Fox LLP; Connie Raffa, Partner, Arent Fox LLP PREAM10 Effective ACO Compliance – Margaret Hambleton, Sr VP, Chief Compliance Officer, St Joseph Health System PREAM11 Labs – Diana Voorhees, Principal/CEO, DV & Associates Inc; Christopher Young, Laboratory Management Support Services (LMSS) PREAM12 How Is Your Fraud, Waste, and Abuse Program Incorporated into Your Compliance Plan for Your Health Plan? – Monica Zachary, Commercial Compliance Officer, Corporate Compliance and Ethics, Coventry Health Care; David Crawford, Compliance Director, Affinity Health Plan; Caron Cullen, VP, Comp & Regulatory Affairs, Affinity Health Plan; Jennifer A. Shimek, Senior Manager, Assurance Services, Ernst & Young LLP PREAM13 Compliance Implications of Health Care Reform – Shawn DeGroot, Associate Director, Navigant; Frank Sheeder, Partner, DLA Piper Lunch (on your own) PREPM14 Behavioral Health Compliance and Quality: Opportunities and Challenges for Integration and Implementation – Marcella Henry, Compliance Officer, Sunrise Community Inc; Robyn Joppy, VP & Corp Compliance Officer, Keystone Human Services; Lori McLaughlin, Sr VP for Risk Mgmt & General Counsel, The Devereux Foundation; Cheryl Wagonhurst, Owner, Law Office of Cheryl Wagonhurst PREPM15 Preparing for ICD-10 While Living in ICD-9 – Betty Bibbins, President & Chief Med Officer, DocuComp LLC; Nicole Harper, Dir.Training & Dev/Process Improvement-Revenue Cycle Operations, St. Vincents Health PREPM16 ZPICs, RAC, HIPAA Audits in LTC: Are You Ready? – Mark Reagan, Managing Partner, Hooper, Lundy & Bookman, P.C. PREPM17 HHS/OCR Reports on the New HIPAA Rules – Christina Heide, Senior Health Information Privacy Policy Specialist, U.S. Department of Health and Human Services, Office for Civil Rights; David Holtzman, Senior Health IT and Privacy Specialist, HHS Office for Civil Rights; Frank Ruelas, Principal, HIPAA College; Denise Sanders, Partner, Kern Augustine Conroy & Schoppmann, PC CHPC PREPM18 How to De-Stress the Politics of Physician Coding – Regina Gurvich, Chief Compliance Officer, Manhattan’s Physician Group; Howard Tepper, Vice President, Physician Practice and Ambulatory Service, St. Joseph’s Healthcare System PREPM19 Handling a Health Care Fraud Investigation – Kirk Ogrosky, Partner, Arnold & Porter LLP; Howard Young, Partner, Morgan Lewis; Meredith Auten, Morgan, Lewis & Bockius LLP CHC CHPC CHRC PREPM20 Health Facility Drug Diversion: Essential Auditing and Compliance Measures – Kelly Loya, Director, Enterprise Risk, Sinaiko Healthcare Consulting, Inc., Altegra Healthcare Company; Kimberly New, Compliance Specialist, University Health System Inc PREPM21 Bipartisan Compliance Programs Know No Term Limits – Fahad Ahmed, Compliance & Privacy Officer, Yale New Haven Health System; Joel Dziengielewski, Director, Disputes & Investigations, Navigant; Robert Hussar, Counsel, Manatt, Phelps & Phillips, LLP PREPM22 Delving into the Comprehensive Care Enterprise Delivery Model: Uncovering and Resolving Ever‑Increasing Compliance Challenges – Mary Longe, Director, AHA Solutions, Inc, an American Hospital Association company; Monique Showalter, Director, AHA Solutions, Inc, an American Hospital Association company; Catherine Wakefield, CHC, VP Corp Compliance & IA, MultiCare Health System PREPM23 The Drive To Quality: Are You On The Bus or Under It? – Audrey Andrews, Chief Compliance Officer, Tenet Healthcare Corporation; David Hoffman, President, David Hoffman & Associates; Susan Lynch, Trial Attorney, United States Department of Justice, Commercial Litigation Branch, Fraud Section PREPM24 Compliance Essentials for DME – George Breen, Shareholder, Epstein Becker & Green PC; Julene Brown, Director of Compliance Operations/Assistant Compliance Officer, Essentia Health, Organizational Integrity and Compliance; Julie Schwab, Corporate Compliance Officer, Sanford Bismarck PREPM25 And the Question Is: What Are the Key AMC Compliance Focus Areas in the Current Regulatory Environment – Lynda Hilliard, Deputy Compliance Officer, University of California; Joan Podleski, Director of Institutional Ethics & Compliance, Duke University; Luanna Putney, Director of Research Compliance, University of California; Kristin West, Assoc VP & Director, Emory University, Office of Research Compliance PREPM26 Research Compliance: Hot Topics and Practical Tips from the Trenches – Ryan Meade, Partner, Meade & Roach, LLP; F. Lisa Murtha, Partner, SNR Denton US LLP; Juliann Tenney, Inst Research & Comp Officer, UNC-Chapel Hill CHRC SpeedMentoring Networking Reception in Exhibit Hall GENERAL COMPLIANCE/HOT TOPICS
PHYSICIAN COMPLIANCE
HOW TO SUCCEED AS A COMPLIANCE PROFESSIONAL
LONG-TERM CARE
LEGAL & REGULATORY
QUALITY OF CARE
PRIVACY & SECURITY
AUDITING & MONITORING
ADVANCED DISCUSSION GROUP
www.compliance-institute.org
Program at a Glance Monday, April 22 7:00 am – 6:00 pm
Conference Registration
7:30 – 8:30 am
Continental Breakfast
8:30 – 8:45 am
Opening Remarks
8:45 – 9:15 am
General Session: OIG Update – Daniel R. Levinson, Inspector General, Office of Inspector General, U.S. Department of Health and Human Services
9:15 – 10:15 am
BREAKOUT SESSIONS
11:00 am – 12:00 pm
10:15 – 11:00 am
BREAKOUT SESSIONS
1:30 pm – 2:30 pm
12:00 – 1:00 pm 1:00 – 1:30 pm
General Session: Be Quiet, Be Heard: The Paradox of Persuasion – Peter A. Glaser, PhD, Glaser & Associates, Inc.; Susan R. Glaser, PhD, Glaser & Associates, Inc. Networking Break in Exhibit Hall 101 Inside the Beltway: Compliance Effectiveness Tips – Greg Radinsky, Vice President & Chief Corporate Compliance Officer, North Shore-LIJ Health System 102 Cyber Compliance: What Every Compliance Professional Needs to Know about Cyber Risks and Cyber Vigilance – David Childers, President and Chief Executive Officer, Compli; Vivek Krishnamurthy, Associate, Foley Hoag LLP 103 What You Say Can and Will Be Used Against You – Barbara Duffy, Shareholder, Lane Powell; Steven Lack, Supervisory Special Agent (Retired), U.S. Department of Health and Human Services, Office of Inspector General, Office of Investigations CHC CHPC CHRC 104 OCR Reports on Enforcement of the HIPAA Rules – David Holtzman, Senior Health IT and Privacy Specialist, HHS Office for Civil Rights CHPC 105 Managing Physician Financial Relationships – Michelle Pendergrass, Director of Compliance and Privacy Officer, Midland Memorial Hospital; Darren Skyles, Attorney, Cotton Bledsoe Tighe & Dawson, PC CHC 106 Practical Strategies for Minimizing Stark Risk – Dan Roach, VP Compliance and Audit, Dignity Health; Robert Wade, Partner, Krieg Devault LLP CHC 107 Patient Identity Theft: Risk, Controls, and Audit – Mark Ruppert, Director Internal Audit, Cedars-Sinai Medical Center CHPC 108 One Day at a Time: Compliance and Ethics in the Aftermath of a Tragedy – Ginger Bandeen, Quality Improvement Manager, Columbia Community Mental Health 109 Navigating the OIG s Self-Disclosure Protocol – Kenneth Coronel, Chief Legal Officer, Verisys Corporation; Susan Gillin, Deputy Branch Chief, Administrative and Civil Remedies Branch, Office of Inspector General, U.S. Department of Health and Human Services; Laura Laemmle-Weidenfeld, Partner, Patton Boggs CHC 110 Compliance Reporting Post ICD-10: Avoiding the Chasm – Dr. Mike Gallagher, CMIO/CMO, Health Revenue Assurance Associates; Valerie Rinkle, VP Revenue Informatics, Health Revenue Assurance Associates 111 Conflicts of Interest: What Happens When What Is Reported to You Does Not Match What Is Reported by or to Others? – Marti Arvin, Chief Compliance Officer, UCLA Health System; Leon Goldman, Principal, Goldman Healthcare Compliance Consulting, LLC CHC 112 Building a Compliance Program from the Ground Up – Ryan Meade, Partner, Meade & Roach, LLP; Steven Ortquist, VP Chief Ethics & Compliance Officer, Sutter Health CHC AD1 Fighting the Good Fight: Expanding Best Practices Beyond the RAC – Aurae Beidler, Compliance Certificate Program Manager, Pacific University; Monica R. Freedle, Kaiser Westside Medical Center, Hospital Compliance Program Manager AD2 The Latest Trends in Data Breach Threats – Ted Kobus, Co-Leader, Privacy & Data Protection, BakerHostetler CHPC Networking Luncheon Networking Break in Exhibit Hall 201 Non-Profit Governance: What Every Compliance Officer Should Know – Heidi Christianson, Shareholder, Nilan Johnson Lewis 202 An Integrated Approach to Compliance & Risk – Tim Kennedy, Director of Operations, Wolters Kluwer Law & Business; Keisha Lightbourne, Senior Product Manager, Wolters Kluwer Law & Business CHC 203 MDS 3.0: A Compliance Officer s Nightmare or Nirvana? – Steven Littlehale, Executive Vice President/Chief Clinical Officer, PointRight Inc.; Donna Maassen, Senior Director & Deputy Compliance Officer, Extendicare Health Services Inc 204 Patient Privacy Requirements Beyond HIPAA – Carrie Bill, Associate, Feldesman Tucker Leifer Fidell LLP; Jane Hyatt Thorpe, Associate Professor, George Washington University CHPC 205 Managing Risk in Psychiatric Medication Management – Mary Thornton, President, MTA, Inc 206 Compliance Issues in Managed Care – David Deaton, Partner, O’Melveny & Myers LLP; James Sheehan, Chief Integrity Officer/Executive Deputy Commissioner, New York City Human Resources Administration 207 Understanding Audit Error Rates: How Are We Doing? – Tim Renjilian, Sr Managing Director, FTI Consulting; Sara Kay Wheeler, Partner, King & Spalding 208 Why Compliance Officers Should Care About Improving Quality of Care – Andrew Rowe, CEO, AllMed Healthcare Mgmt Inc 209 340B Drug Discount Program: Understanding the Audit Process and Preparing your Pharmacy– Rose Marie Babbitt, Vice President, Federal Contracts and Grants, American Pharmacist Association 210 Hidden Liabilities in the EMR – Catherine Gray, Director Corporate Compliance, Vidant Health; Yolanda Whichard, Medical Internal Auditor, Office of Audit and Compliance, Vidant Health 211 The Role of Compliance in Effectively Managing External Audits – Timothy Cleary, SVP Compliance, Internal Audit & Privacy, Health Quest Systems, Inc; Stephen Gillis, Dir, Billing Compliance, Mass General Hospital CHC CHPC CHRC AD3 Integrating Quality Into Your Compliance Program – Robert Ossoff, Asst Vice Chancellor Compliance, Vanderbilt Medical Center; Jeff Wiggins, Vice President, Audit and Compliance, Vidant Health; Kathleen Yaremchuk, VP Clinical Practice Performance, Henry Ford Health System CHC AD4 What Makes a Compliance Committee Effective? – Steven Ortquist, VP Chief Ethics & Compliance Officer, Sutter Health; Judy Ringholz, Deputy Chief Compliance Officer, Sutter Health CHC AD5 Stark Compliance Practices – Richard Church, Partner, K&L Gates LLP CHC Networking Break in Exhibit Hall
www.compliance-institute.org
TRACKS
2:30 – 3:00 pm
GENERAL COMPLIANCE/HOT TOPICS
PHYSICIAN COMPLIANCE
HOW TO SUCCEED AS A COMPLIANCE PROFESSIONAL
LONG-TERM CARE
LEGAL & REGULATORY
QUALITY OF CARE
PRIVACY & SECURITY
AUDITING & MONITORING
ADVANCED DISCUSSION GROUP
15
Program at a Glance 301 Social Networking: Managing the Risks and Realizing the Benefits – Jim Donaldson, Director of Corporate Compliance, Privacy and Security Officer, Baptist Health Care Corp. 302 Physician Alignment: Legal and Fair Market Value Compliance – Cheryl Camin Murray, Shareholder, Winstead PC; Donnessa Vessakosol, Manager, Strategic Value Group 303 2013 OIG Work Plan for Post Acute Providers – David Cade, Deputy General Counsel, U.S. Department of Health and Human Services; Alan Schabes, Partner, Benesch, Friedlander, Coplan & Aronoff LLP 304 The Defining Moments of a Data Breach – John Ford, Principal, Sienna Group LLC; Kurt Long, CEO, Founder, FairWarning, Inc. CHPC 305 Anatomy of a Guilty Referral Relationship: Dissecting the Risk Areas and Ensuring Compliance – LeToia Crozier, Senior Vice President, Compliance Officer, Cogent HMG; Anna Grizzle, Partner, Bass, Berry & Sims PLC 306 What Is Happening in the Pharmacy? – Daniel Fitzgerald, Senior Attorney, Regulatory Law, Litigation & Regulatory Law Department, Walgreen Co.; James S. Mathis, Chief Clinical Enterprise Compliance Officer, Assistant Vice Chancellor for Health Affairs, Office of Compliance & Corporate Integrity 307 Audit Appeals and Preparing for the Future – Dawn Crump, Network Director of Audit and Compliance, SSM Healthcare; Susan Emanuel, Director, Revenue Services, System RAC Coordinator, Dignity Health; Andrew Wachler, Owner/Principal, Wachler & Associates, P.C. 308 Compliance as a Quality of Care Metric – Carrie Bill, Associate, Feldesman Tucker Leifer Fidell LLP; Adam Falcone, Partner, Feldesman Tucker Leifer Fidell LLP 309 Utilizing Data to Identify Fraud, Waste, and Abuse – Judi McCabe, Director, Surveillance & Utilization Review, Medical Review and Medical Policy TMF Health Quality Institute; Earl Smith III, Chief Medical Officer, TMF Health Quality Institute CHC 310 Fair Market Value and Clinical Trial Budgets – Kelly Willenberg, Owner, Kelly Willenberg, LLC CHRC 311 Monitoring, Measuring, and Mitigating Social Media Risk – Yo Delmar, Vice President, GRC Solutions, MetricStream Inc CHPC AD6 Lessons From the Field: Analysis and Solutions of Audience Submitted Case Studies – D. Scott Jones, Senior Vice President, Claims, Risk Management, and Corporate Compliance, HPIX; Richard Moses, Physician/Attorney AD7 Compliance Program Self Assessment – John Falcetano, Chief Audit & Compliance Officer, Vidant Health CHC CHPC CHRC AD8 EMR: Use the Tool to Enhance Rather Than Hinder Compliance – James Taylor, Physician, Kaiser Permanente
BREAKOUT SESSIONS
3:00 pm – 4:00 pm
Monday, April 22
Networking Break in Exhibit Hall 401 UMDNJ: Compliance after Deferred Prosecution – Bret Bissey, Senior Vice President, Ethics & Chief Compliance Officer, UMDNJ 402 Analyzing Risk in Hospital/Physician Transactions – David Pursell, Partner, Husch Blackwell; David Thompson, Director, CBIZ 403 Provider Predictive Modeling: Utilizing SNF Data to Mitigate Risk – Shawn Halcsik, Director of Compliance, Evergreen Rehabilitation; Paula Sanders, Principal, Health Care Group Chair, Post & Schell, PC 404 Mobile Threats and How Healthcare Can Reduce Risks – Rick Kam, President & Co-Founder, ID Experts; Ted Kobus, Co-Leader, Privacy & Data Protection, BakerHostetler 405 Trends in Physician Compensation Arrangements – Jen Johnson, Partner, VMG Health 406 Private Contractor Actions: RACs, ZPICs, etc. – Thomas Beimers, Special Counsel, Faegre Baker Daniels; Ralph Wuebker, Chief Medical Officer, Executive Health Resources 407 Who Is Looking at Your Electronic Medical Record? A Practical Guide to Building an Audit Plan – Sandy Gilmore, HIPAA Compliance, Legacy Health CHC 408 Not a Quality Expert? How to Integrate Quality into Your Compliance Program – Donna Abbondandolo, Director of Compliance, Catholic Health Services of LI; Patricia Ariel, VP & Chief Compliance Officer, Westchester Medical Center 409 Using RAC Data Mining to Improve Compliance – Samuel Donio, President, CBIZ KA Consulting, LLC; William Segal, Corporate Compliance Officer, St. Joseph’s Healthcare System 410 Research Participants Rights and Privacy – Tammy Stewart, Director of Research Integrity, Regional Health; Jenny Bernhard, Privacy Officer, Regional Health CHRC 411 Failing and/or Thriving as a Compliance Officer – Brian Beard, Director Compliance & Ethics, McKesson Specialty Health; Kenneth Zeko, Director, KPMG CHC AD9 Tools for Business Ethics Leaders – Bruce Anderson, Chief Ethics Officer, Health Net, Inc AD10 Preparing Compliance Program Effectiveness Reports – Gary Herschman, Chair, Health Care Practice Group, Sills Cummis & Gross P.C. CHC AD1b/repeat Fighting the Good Fight: Expanding Best Practices Beyond the RAC – Aurae Beidler, Compliance Certificate Program Manager, Pacific University; Monica R. Freedle, Kaiser Westside Medical Center, Hospital Compliance Program Manager
BREAKOUT SESSIONS
4:30 pm – 5:30 pm
4:00 – 4:30 pm
5:30 – 7:00 pm
Networking Reception in Exhibit Hall
Tuesday, April 23 7:30 am – 4:00 pm 7:30 – 8:30 am
Continental Breakfast
8:30 – 8:40 am
Opening Remarks
8:40 – 9:40 am
General Session: ACO/Healthcare Reform – Moderator: John Falcetano, Chief Audit & Compliance Officer, Vidant Health; Panelists: Shawn DeGroot, Associate Director, Navigant; Frank Sheeder, Partner, DLA Piper; Troy Barsky, Director, Division of Technical Payment Policy, Chronic Care Policy Group, Center for Medicare, Centers for Medicare & Medicaid Services; Mary Fischer, CEO, Southern Prairie Community Care
9:40 – 10:25 am
TRACKS
10:25 – 11:00 am
16
Conference Registration
General Session: Decisive: How to Make Better Choices in Life and Work – Dan Heath, co-author of the best-sellers Switch and Made to Stick, and the new book Decisive Networking Break in Exhibit Hall
GENERAL COMPLIANCE/HOT TOPICS
PHYSICIAN COMPLIANCE
HOW TO SUCCEED AS A COMPLIANCE PROFESSIONAL
LONG-TERM CARE
LEGAL & REGULATORY
QUALITY OF CARE
PRIVACY & SECURITY
AUDITING & MONITORING
ADVANCED DISCUSSION GROUP
www.compliance-institute.org
Program at a Glance BREAKOUT SESSIONS
11:00 am – 12:00 pm
Tuesday, April 23
Networking Luncheon Networking Break 601 The Road to a Compliant Culture though the Bridge of Communication and the Vehicle of Education – Deann Baker, Sutter Care at Home Compliance Officer, Sutter Health 602 Keeping Up, Moving Ahead: Practical Guidance for Success and Survival in the Modern World of Government Audits – Daniel Gospin, Attorney, Epstein Becker & Green; Corey Perman, Compliance Officer-North Region/Legal Counsel, Advocate Health Care 603 A View From New York: Compliance Mandates You May See in Your State – Carol Booth, Compliance Specialist, NY Office of Medicaid Inspector General; Susan Kayser, Partner, Duane Morris LLP 604 Managing Privacy & Security of Patient EHR Portals – Adam Greene, Partner, Davis Wright Tremaine LLP; Jacki Monson, Privacy Officer, Sutter Health CHPC 605 Proof Positive: Identify Your Statistically-Hot Providers (Before the Feds Do) – Jared Krawczyk, Chief Product Architect, Fi-Med Management, Inc.; Curtis Udell, Director, Corporate Compliance, Center for Vein Restoration 606 DMEPOS Compliance Issues – Denise Fletcher, Attorney, Brown & Fortunato, P.C.; Nathaniel Lacktman, Senior Counsel, Foley & Lardner LLP 607 Auditing the Physician Credentialing Process – Mark Eddy, VP Internal Audit, HCA 608 CEOs Perspectives: Operational Viability & Compliance: Challenges & Opportunities – Les Leech, CEO, Sunrise, Inc.; Dennis Felty, President/CEO, Keystone Human Services 609 Congressional Priorities for 2013: What Every Healthcare Provider Needs to Know – Kim Brandt, Chief Healthcare Investigative Counsel for Senate Finance Committee, US Senate Finance Comm, Min Staff 610 The Future of Compliance: Where Law Students and New Attorneys Fit In – Anna Dolinsky, Associate, Akin Gump Strauss Hauer & Feld, LLP, Washington, DC; Hannah Levinson, Candidate Class of 2013, University of Maryland Francis King Carey School of Law; Debbie Troklus, Managing Director, Aegis Compliance & Ethics Center 611 Know Thy Customer: Credentialing & Compliance – Regina Gurvich, Chief Compliance Officer, Manhattan’s Physician Group AD5b/repeat Stark Compliance Practices – Richard Church, Partner, K&L Gates LLP CHC AD6b/repeat Lessons From the Field: Analysis and Solutions of Audience Submitted Case Studies – D. Scott Jones, Senior Vice President, Claims, Risk Management, and Corporate Compliance, HPIX; Richard Moses, Physician/Attorney AD7b/repeat Compliance Program Self Assessment – John Falcetano, Chief Audit & Compliance Officer, Vidant Health CHC CHPC CHRC
2:30 – 3:00 pm
Networking Break
www.compliance-institute.org
TRACKS
BREAKOUT SESSIONS
1:00 – 1:30 pm
1:30 pm – 2:30 pm
12:00 – 1:00 pm
501 Annual Reporting: Documenting Compliance Programs –Sarah Campbell, Director, Policies & Procedures Management, Tenet Healthcare Corporation; Al Josephs, Sr Director Policy and Training, Tenet Healthcare Corporation CHC 502 Conflicts of Interest: The Compliance Officer’s Role in Assuring the Process of Disclosure Is Effective – Sheryl Vacca, SVP/Chief Comp & Audit Officer, University of CA CHC 503 100 Ways to Prevent an Overpayment – Pat Newberry, Director Clinical Education, AIS Inc.; Bill Ulrich, President, Consolidated Billing Srvcs Inc 504 HHS/OCR & HIPAA/HITECH Audits: Report and Findings – Linda Sanches, Sr. Health Information Privacy Specialist, Office for Civil Rights CHPC 505 Compliance Risks with Non-Physician Practitioners – Kimberly Huey, President, KGG Coding & Reimbursement Consulting 506 Anti-Kickback Statute 101 – Robert Brown, Senior Compliance Specialist, UW Medicine Compliance, University of Washington; Anjana Patel, Vice Chair, Health & Hospital Law Practice Group, Sills Cummis & Gross P.C. CHC 507 Don’t Take Those Old Records Off the Shelf: Change Your Tune Using Real-Time Monitors to Focus on Risks Identified by OIG, CMS and Other Regulators – Andrei Costantino, Director Organizational Integrity, Trinity Health 508 Enhancing Patient Quality & Safety with Compliance – John Kalb, Operational Excellence Executive/Compliance & Privacy Officer, Kootenai Health 509 Settlement Is Not Always the Final Chapter – Rebekah Plowman, Partner, Jones Day; William Priest, Chief Compliance Officer, SouthernCare Inc 510 Advanced Principles of Compliance Program: Bringing It All Together – Dawnese Kindelt, System Compliance Dir/Clinics, Dignity Health; Lisa Silveria, System Compliance Director, Dignity Health CHC 511 Avoiding Career Burnout In Healthcare Compliance – Shawn DeGroot, Associate Director, Navigant; Robert Ossoff, Asst Vice Chancellor Compliance, Vanderbilt Medical Center AD2b/repeat The Latest Trends in Data Breach Threats – Ted Kobus, Co-Leader, Privacy & Data Protection, BakerHostetler CHPC AD3b/repeat Integrating Quality Into Your Compliance Program – Jeff Wiggins, Vice President, Audit and Compliance, Vidant Health; Kathleen Yaremchuk, VP Clinical Practice Performance, Henry Ford Health Syst CHC AD4b/repeat What Makes a Compliance Committee Effective? – Steven Ortquist, VP Chief Ethics & Compliance Officer, Sutter Health; Judy Ringholz, Deputy Chief Compliance Officer, Sutter Health CHC
GENERAL COMPLIANCE/HOT TOPICS
PHYSICIAN COMPLIANCE
HOW TO SUCCEED AS A COMPLIANCE PROFESSIONAL
LONG-TERM CARE
LEGAL & REGULATORY
QUALITY OF CARE
PRIVACY & SECURITY
AUDITING & MONITORING
ADVANCED DISCUSSION GROUP
17
Program at a Glance 701 A Dialogue on HIPAA/HITECH Compliance: Considerations Now that the HITECH Rules Are Here – Leon Rodriguez, Director of the Office for Civil Rights, U.S. Department of Health and Human Services 702 Programming Your Program – Nancy Vogt, Director of Compliance, Aurora Health Care 703 The Making of a Successful Quality of Care CIA – Tamar Abell, President, Care 2 Learn; Katie Arnholt, Senior Counsel, Administrative and Civil Remedies Branch, Office of Inspector General, U.S. Department of Health and Human Services 704 Conducting a Privacy Risk Assessment – Eric Dieterich, Sunera CHPC 705 ACA: From a Practical, Practice Perspective – Frank Ruelas, Principal, HIPAA College CHPC 706 Creative Arguments to Avoid/Defend Overpayments – David Glaser, Shareholder, Fredrikson & Byron PA; Gabriel Imperato, Managing Partner, Broad and Cassel 707 Auditing Considerations Related to Implantable Devices Replaced Under Recall or Warranty – Debi Weatherford, Executive Director Internal Audit, Piedmont Healthcare 708 The Role of Quality and Performance Management in Compliance – Dr. Kristine Koontz, Quality Management Director, Keystone Human Services, Inc. 709 Developments in the 340B Program – Richard Bucher, Compliance Manager/Regulatory Counsel, Intermountain Healthcare; Edwin Rauzi, Partner, Davis Wright Tremaine LLP 710 One OIG, Many Tools: Strategic Approaches to Protecting Integrity in an Evolving Health Care Landscape – Brian P. Ritchie, Assistant Inspector General for Centers for Medicare & Medicaid Audits, Office of Audit Services, Office of Inspector General; Jennifer A. Trussell, Special Agent in Charge, Investigations Branch, Office of Investigations, Office of Inspector General; Robert K. DeConti, Assistant Inspector General for Legal Affairs, Office of Counsel to the Inspector General; Vicki L. Robinson, Senior Counsel for Policy, Office of Inspector General; Erin C. Bliss, Director, External Affairs, Office of Inspector General 711 Compliance Issues in Mergers and Acquisitions – John Fisher II, Health Care & Compliance Counsel, Ruder Ware, LLSC AD8b/repeat EMR: Use the Tool to Enhance Rather Than Hinder Compliance – James Taylor, Physician, Kaiser Permanente AD9b/repeat Tools for Business Ethics Leaders – Bruce Anderson, Chief Ethics Officer, Health Net, Inc AD10b/repeat Preparing Compliance Program Effectiveness Reports – Gary Herschman, Chair, Health Care Practice Group, Sills Cummis & Gross P.C. CHC
BREAKOUT SESSIONS
3:00 pm – 4:00 pm
Tuesday, April 23
Wednesday, April 24 8:00 am – 9:45 am
POST-CONFERENCE BREAKOUT SESSIONS
7:30 am – 12:00 pm
POST-CONFERENCE BREAKOUT SESSIONS
10:00 am – 11:45 am
9:45 – 10:00 am
18
TRACKS
2:00 – 4:00 pm
Conference Registration POSTAM1 NCD-LCD Education: A Proactive Approach to Denials – Andrew Conkovich, VP Corporate Responsibility Officer, Carondelet Health Network; Greg Harlow, Director Clinical Trials Operations, Carondelet Health Network POSTAM2 The Effective Use of Valuations for FMV Compliance – Timothy Smith, President, Touchstone Valuation, LLC POSTAM3 State Development of Medicaid ACO – Keith Halleland, Shareholder, Halleland Habicht PA POSTAM4 Your Personalized Road Trip to HIPAA/HITECH Compliance Land – Erika Bol, Privacy Officer, Colorado Dept of Health Care Policy & Financing; Shallie Bryant, HIPAA Privacy & Security Assistant Manager/ Deputy Privacy & Security Officer, CaroMont Health; Stephanie Heline, Owner, Strategic Design Studio CHPC POSTAM5 E/M Documentation: Deal or No Deal? – Maggie Mac, Director of Compliance Operations, SL Quality Diagnostic and Treatment Center; Dennis Mihale, President & Chief Medical Officer, Chelsea Management Group CHC POSTAM6 Hospice/Nursing Home Partnership: Do it Right! – Rachel Hold-Weiss, Partner, Arent Fox LLP; Connie Raffa, Partner, Arent Fox LLP POSTAM7 Painless Statistics for Compliance Professionals – Frank Castronova, Health Care Management Biostatistician, Blue Cross Blue Shield of Michigan; Andrea Merritt, Dir, Compliance & Audit Svcs, Nova Compliance Group POSTAM8 Keeping It All Straight: Compliance Resources at Your Fingertips – Dawnese Kindelt, System Compliance Dir/Clinics, Dignity Health; Lisa Silveria, System Compliance Director, Dignity Health POSTAM9 Make Culture Matter! How to Show Leadership that Culture is the Key to Performance – David Gebler, President, Skout Group, LLC CHC CHPC CHRC Networking Break POSTAM10 Importance of Compliance Training – Al Josephs, Sr Director Policy and Training, Tenet Healthcare Corporation; Ryan Whitehill, Mgr Ethics & Compliance Training, Tenet Healthcare Corporation CHC CHPC CHRC POSTAM11 Best Practices for Denials Management – Ralph Wuebker, Chief Medical Officer, Executive Health Resources POSTAM12 Healthcare Reform: The Road Ahead – Kevin Lyles, Partner, Jones Day; Diane Meyer, Chief Compliance & Privacy Officer, Stanford University Medical Center; Frank Sheeder, Partner, DLA Piper POSTAM13 Privacy Officer Roundtable: OCR Enforcement—Are You Ready? – Marti Arvin, Chief Compliance Officer, UCLA Health System; Brian Beard, Director Compliance & Ethics, McKesson Specialty Health CHPC POSTAM14 Design a Useable Compliance Policy – Jacqueline Bloink, Director of Compliance, Arizona Community Physicians CHC CHPC CHRC POSTAM15 Negotiating False Claims Act Settlements and Corporate Integrity Agreements – Daniel Anderson, Assistant Director, US Department of Justice; Roger Goldman, Partner, Latham & Watkins LLP; Geeta W. Kaveti, Senior Counsel, Office of Counsel to the Inspector General, U.S. Department of Health and Human Services; Marc Raspanti, Paetragallo Gordon Alfano Bosick & Raspanti, LLP POSTAM16 Tips for Auditing/Monitoring of Medicare Documentation for PT, OT, and Speech – Carol Novak, Practice Specialist, Kaiser Foundation Health Plan; Philip Yuson, Practice Specialist, Rehabilitative Services, Kaiser-Permanente, Southern California Region POSTAM17 A Compliance Officer’s Approach to Fair Market Value Analyses: Practical Advice and Dilemmas – Rick Cameron, Managing Director, Healthcare, Navigant; Greg Endicott, Managing Director, Strategic Value Group, LLC; Lawrence W. Vernaglia, Partner & Chair of the Health Care Industry Team, Foley and Lardner LLP; Andrea M. Ferrari, Manager, HealthCare Appraisers Inc. POSTAM18 ICD-10 for the (Non Coder) Compliance Officer – Betty Bibbins, President & Chief Med Officer, DocuComp LLC; Nicole Harper, Dir Training & Dev/ Process Improvement-Revenue Cycle Operations, St. Vincents Health CHC, CHPC, and CHRC Certification Exams GENERAL COMPLIANCE/HOT TOPICS
PHYSICIAN COMPLIANCE
HOW TO SUCCEED AS A COMPLIANCE PROFESSIONAL
LONG-TERM CARE
LEGAL & REGULATORY
QUALITY OF CARE
PRIVACY & SECURITY
AUDITING & MONITORING
ADVANCED DISCUSSION GROUP
www.compliance-institute.org
Agenda SATURDAY, APRIL 20 7:30 am – 12:00 pm
7th Annual Volunteer Project 11:00 am – 8:00 pm
Conference Registration
SUNDAY, APRIL 21 7:30 am – 6:00 pm
Conference Registration 7:30 – 8:30 am
SpeedNetworking 9:00 am – 12:00 pm (includes 15-minute break)
GENERAL COMPLIANCE/HOT TOPICS
PREAM2 Compliance 101 CHC CHPC CHRC SUNDAY, 9:00 am – 12:00 pm Sheryl Vacca, SVP/Chief Comp & Audit Officer, University of CA Debbie Troklus, Managing Director, Aegis Compliance & Ethics Center 77 Identify the basic framework for compliance
programs in healthcare
77 Apply the compliance principles to your
LONG-TERM CARE
PREAM3 Compliance Programs: The Next Generation SUNDAY, 9:00 am – 12:00 pm
PREAM1 Large Hospital Systems
77 Compliance Metrics in 2013
Cheryl Wagonhurst, Owner, Law Office of Cheryl Wagonhurst 77 How do you compare? Learn how to benchmark
your program against other large hospitals and health systems through use of polling software
77 Understand challenges relevant to large hospitals
and large health systems
77 Engage in dialogue with your colleagues
regarding operational solutions and best practices for large hospitals and health systems
Richard Moses, Physician/Attorney
organization
INDUSTRY IMMERSION
John Steiner, Chief Compliance Officer, Cancer Treatment Centers of America
D. Scott Jones, Senior Vice President, Claims, Risk Management, and Corporate Compliance, HPIX
77 Develop a compliance education program for
77 Identify three tools you could use in your
Janine Valdez, Senior Director of Compliance, Sun Healthcare Group, Inc
Michael Hemsley, Executive Vice President & General Counsel, Catholic Health East
SUNDAY, 9:00 am – 12:00 pm
77 Learn how to educate physicians on compliance
Beth DeLair, DeLair Consulting, S.C.
Suzie Draper, Intermountain Healthcare, Vice President, Business Ethics and Compliance
PREAM5 Can Compliance Teach Physicians to Comply? Adapting Different Healthcare Models to Teach Physicians Compliance CHC
organization
PRE-CONFERENCE MORNING BREAKOUT SESSIONS
SUNDAY, 9:00 am – 12:00 pm
PHYSICIAN COMPLIANCE
Catherine Boerner, President, Boerner Consulting LLC
77 What does “effective” mean? 77 Do you know how to audit? PRIVACY & SECURITY
PREAM4 HIPAA Privacy & Security 101 CHC CHPC SUNDAY, 9:00 am – 12:00 pm Erika Bol, Privacy Officer, Colorado Dept of Health Care Policy & Financing 77 An overview of the HIPAA Privacy Rule
77 HITECH’s Breach Notification Requirements 77 An overview of the HIPAA Security Rule
concepts
healthcare providers
77 Analyze and discuss compliance teaching problems
with a practicing physician-attorney educator LEGAL & REGULATORY
PREAM6 False Claims Act Development SUNDAY, 9:00 am – 12:00 pm John Boese, Of Counsel, Fried Frank Harris Shriver & Jacobson LLP Gary Eiland, Partner, King & Spalding LLP Michael Granston, Deputy Director, US Dept of Justice Janet Goldstein, Principal, Vogel, Slade & Goldstein, LLP 77 Review of recent amendments and case law
developments interpreting the False Claims Act
77 Review of latest False Claims Act settlements and
the implications for organizational compliance
77 Discussion of whistleblower, government and
defense perspectives in False Claims Act matters AUDITING & MONITORING
PREAM7 Implementing a Research Auditing Program CHRC SUNDAY, 9:00 am – 12:00 pm Kevin Eskew, Managing Director, Dentons US LLP F. Lisa Murtha, Partner, Dentons US LLP Kelly Willenberg, Owner, Kelly Willenberg, LLC 77 Development strategies of a research auditing
and monitoring program
77 Tips for reviewing risks for an action plan 77 Implementation process and structure
www.compliance-institute.org
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Agenda HOW TO SUCCEED AS A COMPLIANCE PROFESSIONAL
INDUSTRY IMMERSION
PREAM8 Effective Training: Teach Compliance to Clinicians
PREAM11 Labs
SUNDAY, 9:00 am – 12:00 pm
Diana Voorhees, Principal/CEO, DV & Associates Inc
Mike Glomb, Partner, Feldesman Tucker Leifer Fidell LLP
Christopher Young, Laboratory Management Support Services (LMSS)
Jane Hyatt Thorpe, Associate Professor, George Washington University 77 Discuss challenges associated with educating
clinicians about compliance
77 Describe effective methods for teaching clinicians 77 Identify strategies for achieving change in
clinician compliance behavior
GENERAL COMPLIANCE/HOT TOPICS
PREAM9 Hot Topics in Medicare, RAC, ZPIC & MIC Appeals SUNDAY, 9:00 am – 12:00 pm Rachel Hold-Weiss, Partner, Arent Fox LLP Connie Raffa, Partner, Arent Fox LLP 77 Describe the appeals process and tips for winning
Medicare, RAC, ZPIC & MIC Appeals
77 Identify common issues that are the subject of
hospice and home health appeals and how to respond
77 Employ compliance strategies to challenge a
denial at any level of appeal and prevent denials in the future QUALITY OF CARE
PREAM10 Effective ACO Compliance SUNDAY, 9:00 am – 12:00 pm Margaret Hambleton, Sr VP, Chief Compliance Officer, St Joseph Health System 77 Understand Accountable Care Organizations
(ACOs), including Medicare Shared Savings Programs (MSSPs), within the framework of the “Triple Aim”: costs, quality, and patient experience
77 Learn the quality and compliance obligations of
ACOs
77 Discuss practical solutions to implementing
and maintaining an effective ACO compliance program
SUNDAY, 9:00 am – 12:00 pm
77 Obtain the latest information on laboratory CPT
coding compliance including current status of molecular and genetic CPT codes and policies
12:00 – 1:30 pm
Lunch (on your own) 1:30 pm–4:30 pm (includes 15-minute break)
PRE-CONFERENCE AFTERNOON BREAKOUT SESSIONS INDUSTRY IMMERSION
refunds of laboratory overpayments and learn the ins and outs, and risks, of voluntary refunds and the appeals process as they pertain to laboratory claims
PREPM14 Behavioral Health Compliance and Quality: Opportunities and Challenges for Integration and Implementation
compliance issues and best practices for laboratory compliance officers
SUNDAY, 1:30 pm – 4:30 pm
77 Learn how to respond to government demands for
77 Discuss current and near future laboratory
INDUSTRY IMMERSION
PREAM12 How Is Your Fraud, Waste, and Abuse Program Incorporated into Your Compliance Plan for Your Health Plan? SUNDAY, 9:00 am – 12:00 pm David Crawford, Compliance Director, Affinity Health Plan Caron Cullen, VP, Comp & Regulatory Affairs, Affinity Health Plan Monica Zachary, Commercial Compliance Officer, Corporate Compliance and Ethics, Coventry Health Care
Marcella Henry, Compliance Officer, Sunrise Community Inc Robyn Joppy, VP & Corp Compliance Officer, Keystone Human Services Lori McLaughlin, Sr VP for Risk Mgmt & General Counsel, The Devereux Foundation Cheryl Wagonhurst, Owner, Law Office of Cheryl Wagonhurst 77 Clinical issues/concerns
77 Reimbursement issues/concerns 77 Enforcement
GENERAL COMPLIANCE/HOT TOPICS
Jennifer A. Shimek, Senior Manager, Assurance Services, Ernst & Young LLP
PREPM15 Preparing for ICD-10 While Living in ICD-9
77 Learn how other Health Plan Compliance
SUNDAY, 1:30 pm – 4:30 pm
Officers are overseeing or implementing the Fraud, Waste, and Abuse Program as an additional element of the Compliance Plan
77 Discuss the differences among Health Plan based
upon the size and structure of the organization— what works and what does not work?
77 Share pros and cons for the integration or
separation of the Fraud, Waste, and Abuse component of your Health Plan’s Compliance Plan GENERAL COMPLIANCE/HOT TOPICS
Betty Bibbins, President & Chief Med Officer, DocuComp LLC Nicole Harper, Dir.Training & Dev/Process ImprovementRevenue Cycle Operations, St. Vincents Health 77 Discuss how Compliance Officers can champion
physician documentation & coding
77 Identify methods to improve ICD-9
documentation that will reduce transition chaos into ICD-10
77 Increase awareness of the ICD-10 compliance
impact
PREAM13 Compliance Implications of Health Care Reform SUNDAY, 9:00 am – 12:00 pm Shawn DeGroot, Associate Director, Navigant Frank Sheeder, Partner, DLA Piper 77 What compliance officers need to be doing now 77 Recent regulations that merit attention
20
77 Points to address with senior leaders
www.compliance-institute.org
Agenda LONG-TERM CARE
LEGAL & REGULATORY
PREPM16 ZPICs, RAC, HIPAA Audits in LTC: Are You Ready?
PREPM19 Handling a Health Care Fraud Investigation CHC CHPC CHRC
SUNDAY, 1:30 pm – 4:30 pm
SUNDAY, 1:30 pm – 4:30 pm
Mark Reagan, Managing Partner, San Francisco Office, Hooper, Lundy & Bookman, P.C.
Kirk Ogrosky, Partner, Arnold & Porter LLP
77 Lessons learned in ZPIC and RAC Audits
77 What to expect in the initial HIPAA Audits 77 What can SNFs do to prepare? PRIVACY & SECURITY
PREPM17 HHS/OCR Reports on the New HIPAA Rules CHPC SUNDAY, 1:30 pm – 4:30 pm Christina Heide, Senior Health Information Privacy Policy Specialist, U.S. Department of Health and Human Services, Office for Civil Rights David Holtzman, Senior Health IT and Privacy Specialist, HHS Office for Civil Rights Frank Ruelas, Principal, HIPAA College Denise Sanders, Partner, Kern Augustine Conroy & Schoppmann, PC 77 The Final Rules…before and now
77 A common data breach scenario and its
organizational impact, including what to do when a breach occurs
77 Considerations in developing a breach response
plan in advance of a crisis PHYSICIAN COMPLIANCE
PREPM18 How to De-Stress the Politics of Physician Coding SUNDAY, 1:30 pm – 4:30 pm Regina Gurvich, Chief Compliance Officer, Manhattan’s Physician Group Howard Tepper, Vice President, Physician Practice and Ambulatory Service, St. Joseph’s Healthcare System 77 Learn how to properly structure a physician audit
program
77 Helpful tips to resolve opposing coding opinions 77 Case studies on hot physician coding topics
Howard Young, Partner, Morgan Lewis Meredith Auten, Morgan, Lewis & Bockius LLP 77 Responding to and handling an external health
GENERAL COMPLIANCE/HOT TOPICS
PREPM22 Delving into the Comprehensive Care Enterprise Delivery Model: Uncovering and Resolving Ever‑Increasing Compliance Challenges Mary Longe, Director, AHA Solutions, Inc, an American Hospital Association company
care fraud investigation
Monique Showalter, Director, AHA Solutions, Inc, an American Hospital Association company
an internal investigation in a timely and costeffective manner
Catherine Wakefield, CHC, VP Corp Compliance & IA, MultiCare Health System
77 Discussion of issues and aspects of completing
77 Discussion of attorney/client privilege and
voluntary disclosure and the resolution of a health care fraud matter AUDITING & MONITORING
PREPM20 Health Facility Drug Diversion: Essential Auditing and Compliance Measures SUNDAY, 1:30 pm – 4:30 pm Kelly Loya, Director, Enterprise Risk, Sinaiko Healthcare Consulting, Inc., Altegra Healthcare Company
77 Learn about the new health care model that
embraces new community relationships, builds bridges with physicians, breaks down silos of care and requires data connectivity and transparency
77 Participate in identifying new and residual
compliance challenges for health care organizations, large and small
77 Hear directly from fellow Compliance execs
how their organizations have resolved those compliance challenges GENERAL COMPLIANCE/HOT TOPICS
Kimberly New, Compliance Specialist, University Health System Inc
PREPM23 The Drive To Quality: Are You On The Bus or Under It?
77 Civil and regulatory implications of drug diversion
SUNDAY, 1:30 pm – 4:30 pm
77 Conducting a comprehensive diversion
investigation from detection to reporting
77 Implementation of preventive policies and measures HOW TO SUCCEED AS A COMPLIANCE PROFESSIONAL
PREPM21 Bipartisan Compliance Programs Know No Term Limits SUNDAY, 1:30 pm – 4:30 pm Fahad Ahmed, Compliance & Privacy Officer, Yale New Haven Health System
Audrey Andrews, Chief Compliance Officer, Tenet Healthcare Corporation David Hoffman, President, David Hoffman & Associates Susan Lynch, Trial Attorney, United States Department of Justice, Commercial Litigation Branch, Fraud Section 77 Review of state and federal quality initiatives in
hospitals and long-term care
77 Enforcement activities
77 Strategies for ensuring quality care and regulatory
compliance
Joel Dziengielewski, Director, Disputes & Investigations, Navigant Robert Hussar, Counsel, Manatt, Phelps & Phillips, LLP 77 Tips for navigating in a politically charged
environment
77 Developing diplomatic relations among
constituents across both sides of the aisle
77 Avoiding filibusters and vetoes to achieving
compliance effectiveness
www.compliance-institute.org
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Agenda INDUSTRY IMMERSION
PREPM24 Compliance Essentials for DME
GENERAL COMPLIANCE/HOT TOPICS
9:15 am – 10:15 am
General Session: Be Quiet, Be Heard: The Paradox of Persuasion
SUNDAY, 1:30 pm – 4:30 pm
PREPM26 Research Compliance: Hot Topics and Practical Tips from the Trenches CHRC
George Breen, Shareholder, Epstein Becker & Green PC
SUNDAY, 1:30 pm – 4:30 pm
Susan R. Glaser, PhD, Glaser & Associates, Inc.
Julene Brown, Director of Compliance Operations/ Assistant Compliance Officer, Essentia Health, Organizational Integrity and Compliance
Ryan Meade, Partner, Meade & Roach, LLP
77 DECODE the hidden world of non-verbal
Julie Schwab, Corporate Compliance Officer, Sanford Bismarck 77 The auditors are coming: preparing for, living
through, and defending against a DME audit
77 Anticipating the audit: The key compliance
policies and practices your business must have in order to survive
77 Overpayments and the DME industry: What the
compliance officer needs to know—and should do now to be ready for the onslaught
INDUSTRY IMMERSION
PREPM25 And the Question Is: What Are the Key AMC Compliance Focus Areas in the Current Regulatory Environment SUNDAY, 1:30 pm – 4:30 pm Lynda Hilliard, Deputy Compliance Officer, University of California Joan Podleski, Director of Institutional Ethics & Compliance, Duke University Luanna Putney, Director of Research Compliance, University of California Kristin West, Assoc VP & Director, Emory University, Office of Research Compliance 77 This interactive session will provide perspectives
from three major academic medical centers compliance professionals on current regulatory questions or areas of concern
22
F. Lisa Murtha, Partner, Dentons US LLP Juliann Tenney, Inst Research & Comp Officer, UNC‑Chapel Hill 77 Learn about the latest research-related laws,
regulations and government guidance issued in 2012 and 2013
77 Understand government enforcement around
conflicts of interest, IRB, grants, off label uses, and related topics
77 Examine the intersection between research and
fraud and abuse
Peter A. Glaser, PhD, Glaser & Associates, Inc.
communication to understand what people are really saying
77 TEACH people how their behavior is a problem
without making them feel defensive
77 CONVERT criticism from defensiveness and
blame to insight and agreement
77 RAISE difficult issues that simultaneously solve
problems and strengthen relationships
77 TRANSFORM the organization’s culture from
avoidance to positive engagement
77 CREATE trust through conflict
4:30 – 6:00 pm
10:15 – 11:00 am
Networking Reception in Exhibit Hall
Networking Break in Exhibit Hall
MONDAY, APRIL 22
11:00 am – 12:00 pm
7:00 am – 6:00 pm
Conference Registration
BREAKOUT SESSIONS GENERAL COMPLIANCE/HOT TOPICS
7:30 – 8:30 pm
101 Inside the Beltway: Compliance Effectiveness Tips
Continental Breakfast
MONDAY, 11:00 am – 12:00 pm
8:30 – 8:45 am
Greg Radinsky, Vice President & Chief Corporate Compliance Officer, North Shore-LIJ Health System
Opening Remarks
77 Understand the latest government guidance on
8:45 am – 9:15 am
77 Helpful tips to demonstrate compliance
General Session: OIG Update Daniel R. Levinson, Inspector General, Office of Inspector General, U.S. Department of Health and Human Services
compliance effectiveness effectiveness
77 Learn how to leverage internal and external
compliance data
www.compliance-institute.org
Agenda GENERAL COMPLIANCE/HOT TOPICS
102 Cyber Compliance: What Every Compliance Professional Needs to Know about Cyber Risks and Cyber Vigilance MONDAY, 11:00 am – 12:00 pm David Childers, President and Chief Executive Officer, Compli Vivek Krishnamurthy, Associate, Foley Hoag LLP 77 Explore the types and methods of malicious
cyber activity and discuss regulatory compliance “in the cloud”
77 Understand the best practices associated with
creating an effective cyber governance program
77 Participate in response to a data breach event, and
learn how to create a cyber-vigilance environment LONG-TERM CARE
PHYSICIAN COMPLIANCE
105 Managing Physician Financial Relationships CHC MONDAY, 11:00 am – 12:00 pm Michelle Pendergrass, Director of Compliance and Privacy Officer, Midland Memorial Hospital Darren Skyles, Attorney, Cotton Bledsoe Tighe & Dawson, PC 77 Review of the federal regulations for physician
business courtesies and recruitment
77 Discuss the policy and process one hospital
created to address the same
77 Describe how the compliance officer and counsel
work together to manage physician relationships LEGAL & REGULATORY
106 Practical Strategies for Minimizing Stark Risk CHC
QUALITY OF CARE
108 One Day at a Time: Compliance and Ethics in the Aftermath of a Tragedy MONDAY, 11:00 am – 12:00 pm Ginger Bandeen, Quality Improvement Manager, Columbia Community Mental Health 77 Explore the lessons learned from a tragic, violent
event in a community mental health agency
77 Discuss the ways that extreme events can impact
compliance and ethics programs
77 Get tips on functioning in the midst of the storm GENERAL COMPLIANCE/HOT TOPICS
109 Navigating the OIG’s Self‑Disclosure Protocol CHC MONDAY, 11:00 am – 12:00 pm Kenneth Coronel, Chief Legal Officer, Verisys Corporation
103 What You Say Can and Will Be Used Against You CHC CHPC CHRC
MONDAY, 11:00 am – 12:00 pm
MONDAY, 11:00 am – 12:00 pm
Robert Wade, Partner, Krieg Devault LLP
Susan Gillin, Deputy Branch Chief, Administrative and Civil Remedies Branch, Office of Inspector General, U.S. Department of Health and Human Services
Barbara Duffy, Shareholder, Lane Powell
77 Significant Stark pitfalls and risks
Laura Laemmle-Weidenfeld, Partner, Patton Boggs
Steven Lack, Supervisory Special Agent (Retired), U.S. Department of Health and Human Services, Office of Inspector General, Office of Investigations 77 Real live examples of documents uncovered in
OIG investigations and how they were used against the Medicare Contractors
77 Places OIG loves to look: Documents that are
fruitful for investigators to build their case
77 How to sensitize your organization to use
language consistent with your compliance goals PRIVACY & SECURITY
104 OCR Reports on Enforcement of the HIPAA Rules CHPC MONDAY, 11:00 am – 12:00 pm David Holtzman, Senior Health IT and Privacy Specialist, HHS Office for Civil Rights 77 Learn how OCR works with the health care
industry to comply with HIPAA Privacy & Security Rules
77 Explore types of issues which are most often
investigated and why
77 Ask questions about what OCR looks for in a
compliance program
www.compliance-institute.org
Dan Roach, VP Compliance and Audit, Dignity Health
77 Strategies for identifying and managing Stark
77 Deciding whether to self-report: the good, the
77 Tools to help employees understand Stark
77 The importance of the pre-report internal
risks
AUDITING & MONITORING
107 Patient Identity Theft: Risk, Controls, and Audit CHPC MONDAY, 11:00 am – 12:00 pm Mark Ruppert, Director Internal Audit, Cedars-Sinai Medical Center 77 Key patient identity theft risks in an academic
bad, and the ugly investigation
77 How to comply with the protocol’s procedural
requirements and present a “best light” report GENERAL COMPLIANCE/HOT TOPICS
110 Compliance Reporting Post ICD-10: Avoiding the Chasm MONDAY, 11:00 am – 12:00 pm
medical center environment (what should be of concern)
Dr. Mike Gallagher, CMIO/CMO, Health Revenue Assurance Associates
77 Effective controls for mitigating those risks (what
management should be doing)
Valerie Rinkle, VP Revenue Informatics, Health Revenue Assurance Associates
77 Audit approaches (including information
77 Ensure continuity across the chasm with a
technology) to ensuring controls are working and risks are mitigated (how and where you should look)
strategy to bridge the transition from ICD-9 to ICD-10 for your measures, reports and scenario analyses
77 Maintain and document methods for compliant
bidirectional use of intelligence and analytics
77 Identify enterprise-wide risks to patient safety,
medical quality, outcomes, financial analysis and strategic planning based on ICD codes
23
Agenda GENERAL COMPLIANCE/HOT TOPICS
111 Conflicts of Interest: What Happens When What Is Reported to You Does Not Match What Is Reported by or to Others? CHC
ADVANCED DISCUSSION GROUP
GENERAL COMPLIANCE/HOT TOPICS
AD2 The Latest Trends in Data Breach Threats CHPC
202 An Integrated Approach to Compliance & Risk CHC
MONDAY, 11:00 am – 12:00 pm
MONDAY, 1:30 pm – 2:30 pm
Ted Kobus, Co-Leader, Privacy & Data Protection, BakerHostetler
Tim Kennedy, Director of Operations, Wolters Kluwer Law & Business
Marti Arvin, Chief Compliance Officer, UCLA Health System
77 Learn why data breaches are so hard to avoid,
Leon Goldman, Principal, Goldman Healthcare Compliance Consulting, LLC
Keisha Lightbourne, Senior Product Manager, Wolters Kluwer Law & Business
77 Learn why healthcare organizations are facing
77 Learn how to align people and processes to
77 Learn how to mitigate data breach costs and risks
77 Learn the critical technology components
MONDAY, 11:00 am – 12:00 pm
77 What data is out there already and what does it
take to find it?
77 How is it being used by the government—are
they getting better and better at data-mining?
77 What can you do to prepare your organization to
mitigate risk and assist your workforce in accurate reporting? HOW TO SUCCEED AS A COMPLIANCE PROFESSIONAL
112 Building a Compliance Program from the Ground Up CHC MONDAY, 11:00 am – 12:00 pm Ryan Meade, Partner, Meade & Roach, LLP Steven Ortquist, VP Chief Ethics & Compliance Officer, Sutter Health 77 Get your arms around the organization:
even with good security programs
investigations, fines, and class-action lawsuits
Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
12:00 – 1:00 pm
Networking Luncheon 1:00 – 1:30 pm
Networking Break 1:30 pm–2:30 pm
BREAKOUT SESSIONS GENERAL COMPLIANCE/HOT TOPICS
evaluating risks & establishing priorities.
201 Non-Profit Governance: What Every Compliance Officer Should Know
will the government want to see?
MONDAY, 1:30 pm – 2:30 pm
77 Building a solid compliance infrastructure: what 77 Situating yourself for success: key relationships &
strategies
ADVANCED DISCUSSION GROUP
AD1 Fighting the Good Fight: Expanding Best Practices Beyond the RAC
Heidi Christianson, Shareholder, Nilan Johnson Lewis 77 Key state corporate governance legal requirements 77 Key federal tax exemption governance
requirements
77 What the IRS will be looking for in a governance
audit
extend the visibility of risk across the enterprise necessary to implement a successful enterprisewide compliance program
77 Understand the potential ROI that can be
achieved through alignment and integration LONG-TERM CARE
203 MDS 3.0: A Compliance Officer’s Nightmare or Nirvana? MONDAY, 1:30 pm – 2:30 pm Steven Littlehale, Executive Vice President/Chief Clinical Officer, PointRight Inc. Donna Maassen, Senior Director & Deputy Compliance Officer, Extendicare Health Services Inc 77 Describe the MDS 3.0 and its intended (and
unintended) purposes
77 Establish an MDS-based strategy for meeting
compliance standards with care delivery and billing
77 Design an audit tool to assess and monitor key
aspects of compliance PRIVACY & SECURITY
204 Patient Privacy Requirements Beyond HIPAA CHPC MONDAY, 1:30 pm – 2:30 pm
MONDAY, 11:00 am – 12:00 pm
Carrie Bill, Associate, Feldesman Tucker Leifer Fidell LLP
Aurae Beidler, Compliance Certificate Program Manager, Pacific University
Jane Hyatt Thorpe, Associate Professor, George Washington University
Monica R. Freedle, Kaiser Westside Medical Center, Hospital Compliance Program Manager
77 Describe patient privacy requirements that extend
77 Executive Dashboards: Getting your point across
in one page or less
77 How much is at risk: demonstrate the value of
tracking regulatory audits
beyond HIPAA (e.g., Part 2 substance abuse confidentiality protections)
77 Provide tools to ensure compliance
77 Consider model patient consent forms
77 What are you missing: expand established tools &
processes to ensure follow-through
SESSION IS FULL. Repeats Monday at 4:30 pm. Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
24
www.compliance-institute.org
Agenda PHYSICIAN COMPLIANCE
QUALITY OF CARE
HOW TO SUCCEED AS A COMPLIANCE PROFESSIONAL
205 Managing Risk in Psychiatric Medication Management
208 Why Compliance Officers Should Care About Improving Quality of Care
MONDAY, 1:30 pm – 2:30 pm
MONDAY, 1:30 pm – 2:30 pm
211 The Role of Compliance in Effectively Managing External Audits CHC CHPC CHRC
Mary Thornton, President, MTA, Inc
Andrew Rowe, CEO, AllMed Healthcare Mgmt Inc
MONDAY, 1:30 pm – 2:30 pm
77 Psychiatric medications—the perfect storm of
77 Ensure the safety of your patients and satisfaction
Timothy Cleary, SVP Compliance, Internal Audit & Privacy, Health Quest Systems, Inc
high risk, high cost, and off-label use
77 Compliance must be more actively involved to
reduce risk
77 A risk profile for medical services is critical for
behavioral health
LEGAL & REGULATORY
206 Compliance Issues in Managed Care MONDAY, 1:30 pm – 2:30 pm David Deaton, Partner, O’Melveny & Myers LLP James Sheehan, Chief Integrity Officer/Executive Deputy Commissioner, New York City Human Resources Administration 77 Enforcement and risk areas for health care
of your members while contributing to financial growth and stability
77 Discover tools designed to ensure that your
organization is following the guidelines of regulators GENERAL COMPLIANCE/HOT TOPICS
209 340B Drug Discount Program: Understanding the Audit Process and Preparing your Pharmacy MONDAY, 1:30 pm – 2:30 pm Rose Marie Babbitt, Vice President, Federal Contracts and Grants, American Pharmacist Association 77 Define the purpose of HRSA audits to ensure
340B program compliance and integrity
Stephen Gillis, Dir, Billing Compliance, Mass General Hospital 77 Discuss how organizations can effectively manage
an ongoing barrage of external audits
77 Learn about compliance’s role in responding to
audits and dealing with external agencies such as RAC, CERT, OIG, MIC, MAC, and TMR
77 Hear about real-life experiences in working with
the above organizations
ADVANCED DISCUSSION GROUP
AD3 Integrating Quality Into Your Compliance Program CHC MONDAY, 1:30 pm – 2:30 pm
organizations
77 Identify key practice areas to regularly review to
Robert Ossoff, Asst Vice Chancellor Compliance, Vanderbilt Medical Center
managed care
77 Describe methods to prepare a 340B entity for
Jeff Wiggins, Vice President, Audit and Compliance, Vidant Health
77 Review of major new regulatory initiatives in 77 Preparing for state and federal audits and
program reviews
AUDITING & MONITORING
207 Understanding Audit Error Rates: How Are We Doing? MONDAY, 1:30 pm – 2:30 pm Tim Renjilian, Sr Managing Director, FTI Consulting Sara Kay Wheeler, Partner, King & Spalding 77 The error rates have been found in the audits and
reviews performed by the government and/or the program contractors (e.g., CERT program; OIG audits; etc.)
77 The strengths and weaknesses of those various
audits and reviews, and what providers and suppliers need to consider in evaluating them
77 Practical advice regarding the application of this
information to a provider’s audits and reviews and the development of next steps in light of those findings
www.compliance-institute.org
ensure compliant programs internal or external audits
GENERAL COMPLIANCE/HOT TOPICS
Kathleen Yaremchuk, VP Clinical Practice Performance, Henry Ford Health Syst
210 Hidden Liabilities in the EMR
77 Quality and patient satisfaction are integral parts
MONDAY, 1:30 pm – 2:30 pm
77 Processes must be developed to prevent the eleven
Catherine Gray, Director Corporate Compliance, Vidant Health Yolanda Whichard, Medical Internal Auditor, Office of Audit and Compliance, Vidant Health 77 Recognize potential liabilities that exist
throughout the life cycle of an electronic records system
of a compliance program
never events as defined by CMS
77 Compliance must be engaged in documenting
healthcare quality trends
SESSION IS FULL..Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
77 Identify and minimize inherent—but often
forgotten—risks in the EHR such as fraud & abuse, malpractice/e-discovery, and HIPAA violations.
77 Offer some practical tips to avoid the issues
identified
25
Agenda ADVANCED DISCUSSION GROUP
GENERAL COMPLIANCE/HOT TOPICS
PHYSICIAN COMPLIANCE
AD4 What Makes a Compliance Committee Effective? CHC
302 Physician Alignment: Legal and Fair Market Value Compliance
MONDAY, 1:30 pm – 2:30 pm
MONDAY, 3:00 pm – 4:00 pm
305 Anatomy of a Guilty Referral Relationship: Dissecting the Risk Areas and Ensuring Compliance
Steven Ortquist, VP Chief Ethics & Compliance Officer, Sutter Health
Cheryl Camin Murray, Shareholder, Winstead PC
MONDAY, 3:00 pm – 4:00 pm
Donnessa Vessakosol, Manager, Strategic Value Group
Judy Ringholz, Deputy Chief Compliance Officer, Sutter Health
77 Current trends and factors in hospital/physician
LeToia Crozier, Senior Vice President, Compliance Officer, Cogent HMG
77 Determine who should serve on the Compliance
Committee
77 Define the role of the Compliance Committee
and how it relates to the role of the Board
77 Develop tools & processes to enhance the
effectiveness of your Compliance Committee
SESSION IS FULL. Repeats on Tuesday at 11:00 am. Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
ADVANCED DISCUSSION GROUP
AD5 Stark Compliance Practices CHC
alignment strategies
77 Comparison of the valuation methods in moving
from value to price
77 Federal and state legal restrictions impacting
hospital/physician alignment arrangements LONG-TERM CARE
303 2013 OIG Work Plan for Post‑Acute Providers MONDAY, 3:00 pm – 4:00 pm David Cade, Deputy General Counsel, U.S. Department of Health and Human Services
Anna Grizzle, Partner, Bass, Berry & Sims PLC 77 Analysis of hypotheticals highlighting risk
associated with physicians’ relationships with other healthcare providers in areas such as certifications of medical necessity, ordering of services, and financial relationships.
77 Discussion of the potential legal exposure under the
Anti-Kickback Statute, Stark Self-Referral Law, and other laws implicated by these relationships.
77 Suggestions for structuring and managing referral
source relationships
LEGAL & REGULATORY
Richard Church, Partner, K&L Gates LLP
Alan Schabes, Partner, Benesch, Friedlander, Coplan & Aronoff LLP
306 What Is Happening in the Pharmacy?
77 Ensuring payments are consistent with signed
77 Discussion of 2013 OIG Work Plan and
MONDAY, 3:00 pm – 4:00 pm
77 Tracking non-monetary compensation and
77 Discussion of status of PPACA initiatives for
Daniel Fitzgerald, Senior Attorney, Regulatory Law, Litigation & Regulatory Law Department, Walgreen Co.
77 Acquiring and integrating group practices
77 Impact of ZPIC, RAC and PSC contractors on
James S. Mathis, Chief Clinical Enterprise Compliance Officer, Assistant Vice Chancellor for Health Affairs, Office of Compliance & Corporate Integrity
MONDAY, 1:30 pm – 2:30 pm
written agreements
medical staff incidental benefits
SESSION IS FULL. Repeat session on Tuesday at 1:30 pm is full. Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
2:30 – 3:00 pm
Networking Break in Exhibit Hall 3:00 pm–4:00 pm
BREAKOUT SESSIONS GENERAL COMPLIANCE/HOT TOPICS
301 Social Networking: Managing the Risks and Realizing the Benefits MONDAY, 3:00 pm – 4:00 pm Jim Donaldson, Director of Corporate Compliance, Privacy and Security Officer, Baptist Health Care Corp.
implications for post-acute care providers post-acute care providers post-acute care providers PRIVACY & SECURITY
304 The Defining Moments of a Data Breach CHPC MONDAY, 3:00 pm – 4:00 pm John Ford, Principal, Sienna Group LLC Kurt Long, CEO, Founder, FairWarning, Inc. 77 A common data breach scenario and its
organizational impact, including what to do when a breach occurs
77 A crisis management timeline
77 Considerations in developing a breach response
plan in advance of a crisis
77 Usual and customary pricing and the implications
of discount club cards
77 Patient inducement scrutiny on routine retail gifts 77 Medicaid and Prescription Drug Plan audit
initiatives and compliance risks AUDITING & MONITORING
307 Audit Appeals and Preparing for the Future MONDAY, 3:00 pm – 4:00 pm Dawn Crump, Network Director of Audit and Compliance, SSM Healthcare Susan Emanuel, Director, Revenue Services, System RAC Coordinator, Dignity Health Andrew Wachler, Owner/Principal, Wachler & Associates, P.C.
77 Social networking: What is it and why does it
77 Emerging issues in Medicare and Third Party
77 What are the risks and benefits of social
77 Successful appeal strategies and approaches for
77 A case study: Establishing policy to address
77 Valuable guidance for tracking and incorporating
matter?
networking in the workplace?
compliance and ethics concerns
26
Payor Audits
managing appeals
appeal outcomes into future appeals and compliance
www.compliance-institute.org
Want to become
Certified in Healthcare Compliance (CHC) ? ®
BE RECOGNIZED for your experience and knowledge! The Certified in Healthcare Compliance (CHC) designation demonstrates expertise in the healthcare compliance field. Earn yours today: • Meet eligibility requirements in both work experience and continuing education • Pass the CHC exam • Maintain your designation by earning approved continuing education units
Plan now to take the CHC certification exam at the Compliance Institute ®
The exam will be held Wednesday, April 24, from 2:00 – 4:00 pm. See page 7 for more information.
For more details on earning and maintaining this designation, please find the CHC Candidate Handbook or other information at www.compliancecertification.org under the “CHC” tab.
Questions? Contact
[email protected]
Get Certified in Healthcare Research or Privacy Compliance: Take an Exam at the Compliance Institute ®
Are you ready to take the CHPC or CHRC certification exam? • Candidates must meet both the work experience and continuing education requirements before registering for the exam • Persons with one year of full-time (or 1,500 hours) compliance‑related experience are eligible to take the exam (please review the work experience guidelines in the Candidate Handbooks)
Certified in Healthcare Research Compliance Be recognized for your knowledge and experience in healthcare research compliance
• Students completing a program at a CCB‑accredited university are also eligible • Twenty CEUs must be earned in the 12 months prior to taking the exam, 10 of which must come from “live” events or trainings
Visit www.compliance-institute.org for the exam applications and more information Questions? Contact CCB at
[email protected], or call 888-580-8373
The exam will be held Wednesday, April 24, from 2:00 – 4:00 pm. See page 7 for more information.
Certified in Healthcare Privacy Compliance Be recognized for your knowledge and experience in healthcare privacy compliance
Agenda QUALITY OF CARE
HOW TO SUCCEED AS A COMPLIANCE PROFESSIONAL
ADVANCED DISCUSSION GROUP
308 Compliance as a Quality of Care Metric
311 Monitoring, Measuring, and Mitigating Social Media Risk CHPC
AD8 EMR: Use the Tool to Enhance Rather Than Hinder Compliance
MONDAY, 3:00 pm – 4:00 pm
MONDAY, 3:00 pm – 4:00 pm
MONDAY, 3:00 pm – 4:00 pm
Carrie Bill, Associate, Feldesman Tucker Leifer Fidell LLP
Yo Delmar, Vice President, GRC Solutions, MetricStream Inc,
James Taylor, Physician, Kaiser Permanente
Adam Falcone, Partner, Feldesman Tucker Leifer Fidell LLP 77 Address transition of healthcare toward quality of
care-driven delivery/payment system
77 Consider how this requires new models of
provider affiliation/coordination
77 Discuss compliance risks inherent in these models GENERAL COMPLIANCE/HOT TOPICS
309 Utilizing Data to Identify Fraud, Waste, and Abuse CHC MONDAY, 3:00 pm – 4:00 pm Judi McCabe, Director, Surveillance & Utilization Review, Medical Review and Medical Policy TMF Health Quality Institute Earl Smith III, Chief Medical Officer, TMF Health Quality Institute 77 Define fraud, waste and abuse and understand
common fraud schemes
77 Discuss methods and tools to obtain and
analyze data
77 Identify aberrant utilization patterns: a case study
in understanding the data
77 Threat that Social Media poses to the healthcare
77 Minimizing the use of copy-and-paste and other
program by embedding social media risk management principles
77 Configuration strategies for the EMR that drive
77 How to strengthen your organization’s compliance
77 Role of technology in managing social media risks ADVANCED DISCUSSION GROUP
AD6 Lessons From the Field: Analysis and Solutions of Audience Submitted Case Studies MONDAY, 3:00 pm – 4:00 pm D. Scott Jones, Senior Vice President, Claims, Risk Management, and Corporate Compliance, HPIX Richard Moses, Physician/Attorney 77 Contact the speakers and submit your compliance
issues for discussion
77 Examine compliance concerns from a
compliance, operations, risk management, medical malpractice, physician and non-physician clinician perspective
Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
ADVANCED DISCUSSION GROUP
MONDAY, 3:00 pm – 4:00 pm
AD7 Compliance Program Self Assessment CHC CHPC CHRC
Kelly Willenberg, Owner, Kelly Willenberg, LLC
MONDAY, 3:00 pm – 4:00 pm
77 Fair Market Value means what to whom?
John Falcetano, Chief Audit & Compliance Officer, Vidant Health
77 Budgeting clinical trials can be difficult without
knowing budget numbers from independent physician practices who do research with their facility
77 How does this fit into compliance?
compliant physician documentation
industry
GENERAL COMPLIANCE/HOT TOPICS
310 Fair Market Value and Clinical Trial Budgets CHRC
77 Discuss configuration decisions to ensure
cloned functions in the EMR
compliance built into the clinic workflow
SESSION IS FULL. Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
4:00 – 4:30 pm
Networking Break in Exhibit Hall 4:30 pm–5:30 pm
BREAKOUT SESSIONS GENERAL COMPLIANCE/HOT TOPICS
401 UMDNJ: Compliance after Deferred Prosecution MONDAY, 4:30 pm – 5:30 pm Bret Bissey, Senior Vice President, Ethics & Chief Compliance Officer, UMDNJ 77 Learn about the compliance program at the
country’s largest public sciences University following a Deferred Prosecution
77 Learn about the robust Corporate Integrity
Agreement obligations that followed Deferred Prosecution
77 Learn how Compliance was utilized to alert the
University’s culture and image
GENERAL COMPLIANCE/HOT TOPICS
77 Why do a self-assessment?
402 Analyzing Risk in Hospital/ Physician Transactions
77 Self assessment tools
MONDAY, 4:30 pm – 5:30 pm
77 What do you assess?
SESSION IS FULL. Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
David Pursell, Partner, Husch Blackwell David Thompson, Director, CBIZ 77 Understanding compliance risk in hospital/
physician transactions
77 Understanding the role of the valuation expert
and the key issues of a valuation report
77 Distinguishing FMV and Commercial
Reasonableness Risks
www.compliance-institute.org
29
Agenda LONG-TERM CARE
LEGAL & REGULATORY
GENERAL COMPLIANCE/HOT TOPICS
403 Provider Predictive Modeling: Utilizing SNF Data to Mitigate Risk
406 Private Contractor Actions: RACs, ZPICs, etc.
409 Using RAC Data Mining to Improve Compliance
MONDAY, 4:30 pm – 5:30 pm
MONDAY, 4:30 pm – 5:30 pm
MONDAY, 4:30 pm – 5:30 pm
Shawn Halcsik, Director of Compliance, Evergreen Rehabilitation
Thomas Beimers, Special Counsel, Faegre Baker Daniels
Samuel Donio, President, CBIZ KA Consulting, LLC
Ralph Wuebker, Chief Medical Officer, Executive Health Resources
William Segal, Corporate Compliance Officer, St. Joseph’s Healthcare System
77 Examples of ZPIC actions and influence on
77 Use data mining to proactively review only the
77 What is the legal basis for ZPIC investigations
77 From data mining, determine documentation or
77 Appeals of private contractor determinations and
77 Correct identified documentation and process issues
Paula Sanders, Principal, Health Care Group Chair, Post & Schell, PC 77 Identify SNF claims data used in predictive
modeling by the FI/MAC, RAC and ZPICs
77 Understand how to use your data to perform
internal predictive modeling and create your own risk score
77 Learn to analyze data and not get caught up in
tunnel vision to identify areas of risk; explore options for protecting internal reviews PRIVACY & SECURITY
404 Mobile Threats and How Healthcare Can Reduce Risks
enforcement decisions and actions?
the procedural and substantive basis for appeal
specific accounts at RAC risk
process shortfalls that lead to potential denials
GENERAL COMPLIANCE/HOT TOPICS AUDITING & MONITORING
407 Who Is Looking at Your Electronic Medical Record? A Practical Guide to Building an Audit Plan CHC
410 Research Participants Rights and Privacy CHRC Tammy Stewart, Director of Research Integrity, Regional Health
MONDAY, 4:30 pm – 5:30 pm
Jenny Bernhard, Privacy Officer, Regional Health
MONDAY, 4:30 pm – 5:30 pm
Sandy Gilmore, HIPAA Compliance, Legacy Health
77 Review of history leading to current regulations
Rick Kam, President & Co-Founder, ID Experts
77 Start with a thorough inventory
Ted Kobus, Co-Leader, Privacy & Data Protection, BakerHostetler
77 How to complete a risk assessment of users of
77 Mobile device use in healthcare is skyrocketing;
77 Write the audit plan you can actually perform
posing risks to patient info
77 Wireless medical devices are connected to IT
networks making them remotely accessible
77 Tips: how to minimize risks and reduce privacy
incidents
PHYSICIAN COMPLIANCE
405 Trends in Physician Compensation Arrangements MONDAY, 4:30 pm – 5:30 pm Jen Johnson, Partner, VMG Health 77 Address the reason for growth in physician
alignment and provide examples of various types of compensation
77 Address the latest Pay for Performance models 77 Discuss the risks and rewards of setting
your electronic systems
QUALITY OF CARE
408 Not a Quality Expert? How to Integrate Quality into Your Compliance Program MONDAY, 4:30 pm – 5:30 pm Donna Abbondandolo, Director of Compliance, Catholic Health Services of LI Patricia Ariel, VP & Chief Compliance Officer, Westchester Medical Center 77 Identify the basics
77 Get on board with the Quality team 77 Integrate the data
77 Review of regulations and agencies serving to
protect the basic rights of research participants
77 Review of proposed changes to HIPAA and The
Common Rule
HOW TO SUCCEED AS A COMPLIANCE PROFESSIONAL
411 Failing and/or Thriving as a Compliance Officer CHC MONDAY, 4:30 pm – 5:30 pm Brian Beard, Director Compliance & Ethics, McKesson Specialty Health Kenneth Zeko, Director, KPMG 77 Embedding compliance by building and
leveraging internal relationships through collaboration and communication
77 Effectively implementing, documenting and
validating compliance program activities
77 Evaluating internal controls of your compliance
program and assessing compliance risks of your organization
compensation internally
30
www.compliance-institute.org
Agenda ADVANCED DISCUSSION GROUP
AD9 Tools for Business Ethics Leaders MONDAY, 4:30 pm – 5:30 pm Bruce Anderson, Chief Ethics Officer, Health Net, Inc
TUESDAY, APRIL 23
11:00 am – 12:00 pm
BREAKOUT SESSIONS
7:30 am – 4:00 pm
Conference Registration
GENERAL COMPLIANCE/HOT TOPICS
7:30 – 8:30 am
501 Annual Reporting: Documenting Compliance Programs CHC
77 Dive into the elements of an ethics program
Continental Breakfast
TUESDAY, 11:00 am – 12:00 pm
Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
8:30 am – 8:40 am
Sarah Campbell, Director, Policies & Procedures Management, Tenet Healthcare Corporation
77 Learn practical tools to increase your personal
effectiveness as an ethics leaders
77 Is an ethics program worth the cost?
Opening Remarks
Al Josephs, Sr Director Policy and Training, Tenet Healthcare Corporation
8:40 am – 9:40 am
77 Benefits of annual reports
AD10 Preparing Compliance Program Effectiveness Reports CHC
General Session: ACO/Healthcare Reform
77 Potential uses of annual report
MONDAY, 4:30 pm – 5:30 pm
Moderator: John Falcetano, Chief Audit & Compliance Officer, Vidant Health
ADVANCED DISCUSSION GROUP
Gary Herschman, Chair, Health Care Practice Group, Sills Cummis & Gross P.C. 77 How to prepare Annual Reports to your Board
Shawn DeGroot, Associate Director, Navigant Frank Sheeder, Partner, DLA Piper
demonstrating the “effectiveness” of your compliance program
Troy Barsky, Director, Division of Technical Payment Policy, Chronic Care Policy Group, Center for Medicare, Centers for Medicare & Medicaid Services
topics covered & data needed
Mary Fischer, CEO, Southern Prairie Community Care
77 Practical section-by-section walk through of 77 Sample workpaper forms & Annual Reports
SESSION IS FULL..Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
ADVANCED DISCUSSION GROUP
AD1b/repeat Fighting the Good Fight: Expanding Best Practices Beyond the RAC MONDAY, 4:30 pm – 5:30 pm Aurae Beidler, Compliance Certificate Program Manager, Pacific University Monica R. Freedle, Kaiser Westside Medical Center, Hospital Compliance Program Manager 77 Executive Dashboards: Getting your point across
in one page or less
77 How much is at risk: demonstrate the value of
tracking regulatory audits
77 What are you missing: expand established tools &
processes to ensure follow-through
9:40 am – 10:25 am
77 Components of the annual report
GENERAL COMPLIANCE/HOT TOPICS
502 Conflicts of Interest: The Compliance Officer’s Role in Assuring the Process of Disclosure Is Effective CHC TUESDAY, 11:00 am – 12:00 pm Sheryl Vacca, SVP/Chief Comp & Audit Officer, University of CA
General Session: Decisive: How to Make Better Choices in Life and Work
77 Identify three key areas which should be covered
Dan Heath, co-author of the best-sellers Switch and Made to Stick, and the new book Decisive
77 Discuss tools which could be useful in the COI
10:25 – 11:00 am
Networking Break in Exhibit Hall
in the COI process
77 Discuss ideas for auditing or monitoring this area
process
LONG-TERM CARE
503 100 Ways to Prevent an Overpayment TUESDAY, 11:00 am – 12:00 pm Pat Newberry, Director Clinical Education, AIS Inc. Bill Ulrich, President, Consolidated Billing Srvcs Inc 77 Common Medicare billing mistakes that result in
overpayment
77 Systems every long term care provider should
have in place to prevent overpayment
77 Best practices in resolving an overpayment
Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
5:30 – 7:00 pm
Networking Reception in Exhibit Hall www.compliance-institute.org
31
Agenda PRIVACY & SECURITY
504 HHS/OCR & HIPAA/HITECH Audits: Report and Findings CHPC TUESDAY, 11:00 am – 12:00 pm Linda Sanches, Sr. Health Information Privacy Specialist, Office for Civil Rights 77 Learn about how HHS/OCR implemented its
pilot HIPAA/HITECH audit program
77 Examine the protocols used to evaluate covered
entities of all types and sizes
77 Review the audit findings and identify
compliance gaps and best practices PHYSICIAN COMPLIANCE
505 Compliance Risks with Non-Physician Practitioners TUESDAY, 11:00 am – 12:00 pm Kimberly Huey, President, KGG Coding & Reimbursement Consulting
AUDITING & MONITORING
507 Don’t Take Those Old Records off the Shelf: Change Your Tune Using Real-Time Monitors to Focus on Risks Identified by OIG, CMS and Other Regulators TUESDAY, 11:00 am – 12:00 pm Andrei Costantino, Director Organizational Integrity, Trinity Health 77 Step-by-step instructions for developing real-time
data monitors using provider internal claims data
77 Examples of outpatient, inpatient, and physician
real-time data monitors and benchmarking reports
77 Discussion of how to use statistical measures to
interpret results and develop auditing plans and auditing strategies QUALITY OF CARE
GENERAL COMPLIANCE/HOT TOPICS
510 Advanced Principles of Compliance Program: Bringing It All Together CHC TUESDAY, 11:00 am – 12:00 pm Dawnese Kindelt, System Compliance Dir/Clinics, Dignity Health Lisa Silveria, System Compliance Director, Dignity Health 77 Plan your fiscal year—from Risk Assessment to
Work Plan
77 Leverage limited resources to oversee a complex
compliance program
77 Encapsulate your program in a single reference
tool for internal and external stakeholders
HOW TO SUCCEED AS A COMPLIANCE PROFESSIONAL
511 Avoiding Career Burnout In Healthcare Compliance TUESDAY, 11:00 am – 12:00 pm
77 Specific compliance issues when billing for non-
508 Enhancing Patient Quality & Safety with Compliance
Shawn DeGroot, Associate Director, Navigant
77 Medicare regulations related to different sites
TUESDAY, 11:00 am – 12:00 pm
77 Burnout occurs when work-life balance is in a
physician practitioners
of service when billing for non-physician practitioners
77 Risk areas as related to specific specialties LEGAL & REGULATORY
506 Anti-Kickback Statute 101 CHC TUESDAY, 11:00 am – 12:00 pm Robert Brown, Senior Compliance Specialist, UW Medicine Compliance, University of Washington Anjana Patel, Vice Chair, Health & Hospital Law Practice Group, Sills Cummis & Gross P.C. 77 Overview of key regulatory provisions affecting
healthcare marketing
77 Discussion of recent developments, including
internet-based marketing
77 Discussion of compliance strategies for
organizational marketing
John Kalb, Operational Excellence Executive/ Compliance & Privacy Officer, Kootenai Health 77 A successful compliance program enhances
patient safety and quality
77 A robust culture around disclosure, transparency
and reporting is important to success
77 Supportive tone at the top, and systems and
structures, are essential
GENERAL COMPLIANCE/HOT TOPICS
509 Settlement Is Not Always the Final Chapter TUESDAY, 11:00 am – 12:00 pm Rebekah Plowman, Partner, Jones Day
Robert Ossoff, Asst Vice Chancellor Compliance, Vanderbilt Medical Center state of disequilibrium
77 Compliance professionals are at a significant risk
of developing burnout
77 Strategies for avoiding, early detection and
treatment of burnout will be emphasized ADVANCED DISCUSSION GROUP
AD2b/repeat The Latest Trends in Data Breach Threats CHPC TUESDAY, 11:00 am – 12:00 pm Ted Kobus, Co-Leader, Privacy & Data Protection, BakerHostetler 77 Learn why data breaches are so hard to avoid,
even with good security programs
William Priest, Chief Compliance Officer, SouthernCare Inc
77 Learn why healthcare organizations are facing
77 The Department of Justice is not necessarily your
77 Learn how to mitigate data breach costs and risks
friend when it declines prosecution of postSettlement qui tam cases
77 The FCA and particularly the now-
investigations, fines, and class-action lawsuits
Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
Constitutional ACA Amendments to the FCA authorize whistleblowers to bring parasitic lawsuits post-Settlement
77 Use of the public disclosure bar to dismiss
parasitic lawsuits is currently under attack even by the Justice Department
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Agenda ADVANCED DISCUSSION GROUP
AD3b/repeat Integrating Quality Into Your Compliance Program CHC TUESDAY, 11:00 am – 12:00 pm Jeff Wiggins, Vice President, Audit and Compliance, Vidant Health Kathleen Yaremchuk, VP Clinical Practice Performance, Henry Ford Health Syst 77 Quality and patient satisfaction are integral parts
1:30 pm–2:30 pm
BREAKOUT SESSIONS GENERAL COMPLIANCE/HOT TOPICS
601 The Road to a Compliant Culture though the Bridge of Communication and the Vehicle of Education CHC TUESDAY, 1:30 pm – 2:30 pm
of a compliance program
Deann Baker, Sutter Care at Home Compliance Officer, Sutter Health
never events as defined by CMS
77 Share examples of the external and internal
77 Processes must be developed to prevent the eleven 77 Compliance must be engaged in documenting
healthcare quality trends
SESSION IS FULL..Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
ADVANCED DISCUSSION GROUP
AD4b/repeat What Makes a Compliance Committee Effective? CHC TUESDAY, 11:00 am – 12:00 pm
business and human resources, examples regarding the opportunities to educate on what’s inspected and how to safely cross the barriers
77 Build the bridge of communication to create
an ethical culture throughout all levels of the organization (buy-in and stakeholder input)
77 Discuss the four wheels of successful education: 1)
Audience, 2) Subject, 3) Method, and 4) Delivery GENERAL COMPLIANCE/HOT TOPICS
Judy Ringholz, Deputy Chief Compliance Officer, Sutter Health
602 Keeping Up, Moving Ahead: Practical Guidance for Success and Survival in the Modern World of Government Audits
77 Determine who should serve on the Compliance
TUESDAY, 1:30 pm – 2:30 pm
Steven Ortquist, VP Chief Ethics & Compliance Officer, Sutter Health
Committee
77 Define the role of the Compliance Committee
and how it relates to the role of the Board
77 Develop tools & processes to enhance the
effectiveness of your Compliance Committee
SESSION IS FULL..Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
12:00 – 1:00 pm
Networking Luncheon 1:00 – 1:30 pm
Networking Break
Daniel Gospin, Attorney, Epstein Becker & Green Corey Perman, Compliance Officer-North Region/ Legal Counsel, Advocate Health Care 77 Understand the broadening impact of pervasive
government audits on Compliance operations and areas of focus
77 Explore proactive steps and organizational
tools in responding to governmental audits and identifying corrective measures
77 Appreciate the need to allocate sufficient staffing
and financial resources to minimize risk and exposure
LONG-TERM CARE
603 A View From New York: Compliance Mandates You May See in Your State TUESDAY, 1:30 pm – 2:30 pm Carol Booth, Compliance Specialist, NY Office of Medicaid Inspector General Susan Kayser, Partner, Duane Morris LLP 77 Required elements of an effective compliance plan 77 Effectiveness reviews and certifications
77 Exclusion authority and provider obligations PRIVACY & SECURITY
604 Managing Privacy & Security of Patient EHR Portals CHPC TUESDAY, 1:30 pm – 2:30 pm Adam Greene, Partner, Davis Wright Tremaine LLP Jacki Monson, Privacy Officer, Sutter Health 77 Identify privacy challenges of EHR portals, such
as access to records of minors
77 Integrate an EHR portal into your security
program
77 Understand when EHR portal satisfies HIPAA PHYSICIAN COMPLIANCE
605 Proof Positive: Identify Your “Statistically-Hot” Providers (Before the Feds Do) TUESDAY, 1:30 pm – 2:30 pm Jared Krawczyk, Chief Product Architect, Fi-Med Management, Inc. Curtis Udell, Director, Corporate Compliance, Center for Vein Restoration 77 Identify and overcome benchmarking
challenges—reassess your current process to increase meaningful data for action
77 Benefits of applying statistically-based code
benchmark analysis—empowering your results with 95 percent of confidence
77 Reveal your “statistically-hot” outliers—
integrating statistical modeling into your monitoring, audits and trending corrective efforts
www.compliance-institute.org
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Agenda LEGAL & REGULATORY
606 DMEPOS Compliance Issues TUESDAY, 1:30 pm – 2:30 pm Denise Fletcher, Attorney, Brown & Fortunato, P.C. Nathaniel Lacktman, Senior Counsel, Foley & Lardner LLP 77 Understand key compliance issues specific to the
DMEPOS industry
77 Explore best practices, solutions and tools to
address DMEPOS risks
77 Discuss supplier standards, telemarketing, closets,
valid orders, referrals and reimbursement AUDITING & MONITORING
607 Auditing the Physician Credentialing Process TUESDAY, 1:30 pm – 2:30 pm Mark Eddy, VP Internal Audit, HCA 77 Risks in the physician credentialing process 77 How to conduct an audit of the physician
credentialing process
77 Different models of physician credentialing QUALITY OF CARE
608 CEOs Perspectives: Operational Viability & Compliance: Challenges & Opportunities Les Leech, CEO, Sunrise, Inc. Dennis Felty, President/CEO, Keystone Human Services 77 Hear from CEOs from large not-for-profit health
care organizations that have well-established Compliance Programs
77 Learn how they ensure compliance needs are met
GENERAL COMPLIANCE/HOT TOPICS
ADVANCED DISCUSSION GROUP
609 Congressional Priorities for 2013: What Every Healthcare Provider Needs to Know
AD5b/repeat Stark Compliance Practices CHC
TUESDAY, 1:30 pm – 2:30 pm
Richard Church, Partner, K&L Gates LLP
Kim Brandt, Chief Healthcare Investigative Counsel for Senate Finance Committee, US Senate Finance Comm, Min Staff
77 Ensuring payments are consistent with signed
77 Overview of key health policy issues Congress
will be considering in the 113th Congress
77 Healthcare legislative priorities for the key
committees of jurisdiction
77 Discussion of ongoing and future efforts to curb
fraud, waste and abuse
GENERAL COMPLIANCE/HOT TOPICS
610 The Future of Compliance: Where Law Students and New Attorneys Fit In TUESDAY, 1:30 pm – 2:30 pm Anna Dolinsky, Associate, Akin Gump Strauss Hauer & Feld, LLP
TUESDAY, 1:30 pm – 2:30 pm
written agreements
77 Tracking non-monetary compensation and
medical staff incidental benefits
77 Acquiring and integrating group practices
SESSION IS FULL. Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
ADVANCED DISCUSSION GROUP
AD6b/repeat Lessons From the Field: Analysis and Solutions of Audience Submitted Case Studies TUESDAY, 1:30 pm – 2:30 pm D. Scott Jones, Senior Vice President, Claims, Risk Management, and Corporate Compliance, HPIX Richard Moses, Physician/Attorney
Hannah Levinson, Candidate Class of 2013, University of Maryland Francis King Carey School of Law
77 Contact the speakers and submit your compliance
Debbie Troklus, Managing Director, Aegis Compliance & Ethics Center
77 Examine compliance concerns from a
77 The benefits law clerks and entry-level attorneys
bring to compliance programs
77 What compliance officers and industry specialists
should look for in law school graduates
77 How to recruit law students and what law schools
to recruit from
HOW TO SUCCEED AS A COMPLIANCE PROFESSIONAL
issues for discussion
compliance, operations, risk management, medical malpractice, physician and non-physician clinician perspective
Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
ADVANCED DISCUSSION GROUP
AD7b/repeat Compliance Program Self Assessment CHC CHPC CHRC
while continuing to deal with government cuts to reimbursement and other operational challenges and realities
611 Know Thy Customer: Credentialing & Compliance
tips about ways to make your compliance program successful in your organization, and engage in a lively discussion with the CEOs!
Regina Gurvich, Chief Compliance Officer, Manhattan’s Physician Group
77 Why do a self-assessment?
77 Completing gap analysis of the process
77 Self assessment tools
77 Take the opportunity to ask questions, learn a few
TUESDAY, 1:30 pm – 2:30 pm
77 Realizing efficiencies within multiple sets of
requirement
77 Compliance through CQI (“Continuous Quality
Improvement”)
TUESDAY, 1:30 pm – 2:30 pm John Falcetano, Chief Audit & Compliance Officer, Vidant Health 77 What do you assess?
SESSION IS FULL. Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
2:30 – 3:00 pm
Networking Break
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www.compliance-institute.org
Agenda 3:00 pm–4:00 pm
BREAKOUT SESSIONS
PRIVACY & SECURITY
TUESDAY, 3:00 pm – 4:00 pm
707 Auditing Considerations Related to Implantable Devices Replaced Under Recall or Warranty
Eric Dieterich, Sunera
TUESDAY, 3:00 pm – 4:00 pm
77 Learn to perform affordable enterprise privacy
Debi Weatherford, Executive Director Internal Audit, Piedmont Healthcare
TUESDAY, 3:00 pm – 4:00 pm
77 Understand difference between privacy impact
77 Government initiatives related to this area
Leon Rodriguez, Director of the Office for Civil Rights, U.S. Department of Health and Human Services
77 Learn about tools to evaluate an organization
GENERAL COMPLIANCE/HOT TOPICS
701 A Dialogue on HIPAA/HITECH Compliance: Considerations Now that the HITECH Rules Are Here
77 The HITECH Statute and the recently
released HHS omnibus privacy regulation have dramatically transformed compliance with health information privacy and security requirements
77 Increased scrutiny of covered entity compliance
704 Conducting a Privacy Risk Assessment CHPC
AUDITING & MONITORING
risk assessments
assessment and enterprise privacy risk assessment
PHYSICIAN COMPLIANCE
705 ACA: From a Practical, Practice Perspective CHPC
77 Medicare payment considerations: outpatient
versus inpatient
77 Auditing and controls review QUALITY OF CARE
708 The Role of Quality and Performance Management in Compliance
by the HHS Office for Civil Rights comes at the same time as new substantive requirements and above all, the extension of liability to business associates and their subcontractors
TUESDAY, 3:00 pm – 4:00 pm 77 Understand key, unique differences in compliance
Dr. Kristine Koontz, Quality Management Director, Keystone Human Services, Inc.
compliance with these important rules
77 Identify how compliance activity is already
77 Continual engagement of operations and
77 This session will cover practical considerations for
GENERAL COMPLIANCE/HOT TOPICS
702 Programming Your Program TUESDAY, 3:00 pm – 4:00 pm Nancy Vogt, Director of Compliance, Aurora Health Care 77 Using technology to track all program activities:
annual work plan, hotline calls, investigations, etc.
77 Designing tracking to report compliance program
metrics
77 Using low-tech solutions for creative training LONG-TERM CARE
Frank Ruelas, Principal, HIPAA College program content present
77 Assemble a compliance program using simple
tools
LEGAL & REGULATORY
706 Creative Arguments to Avoid/Defend Overpayments TUESDAY, 3:00 pm – 4:00 pm David Glaser, Shareholder, Fredrikson & Byron PA Gabriel Imperato, Managing Partner, Broad and Cassel 77 The statutory obligation to return a “known
overpayment” and its application in criminal and civil enforcement proceedings
703 The Making of a Successful Quality of Care CIA
77 The basis for liability for “retention of a known
TUESDAY, 3:00 pm – 4:00 pm
77 The “identification” of a “known overpayment”
Tamar Abell, President, Care 2 Learn Katie Arnholt, Senior Counsel, Administrative and Civil Remedies Branch, Office of Inspector General, U.S. Department of Health and Human Services
overpayment” under the United States False Claims Act
and the time requirements for disclosure and return of the overpayment
other stakeholders in identifying, measuring, monitoring and responding to key performance metrics vital to services
77 Leveraging extant data within an organization
(e.g., operations, HR, Clinical, Finance) through data mining and analysis
77 Embedding established Quality management
methodologies and support into the daily management repertoire GENERAL COMPLIANCE/HOT TOPICS
709 Developments in the 340B Program TUESDAY, 3:00 pm – 4:00 pm Richard Bucher, Compliance Manager, Intermountain Healthcare Edwin Rauzi, Partner, Davis Wright Tremaine LLP 77 Location, location, location 77 Diversion
77 Manufacturer and government audits
77 OIG Expectations and Provider Challenges
77 Development of the monitoring relationship over
time
77 What is a successful Quality of Care CIA?
www.compliance-institute.org
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Agenda GENERAL COMPLIANCE/HOT TOPICS
ADVANCED DISCUSSION GROUP
GENERAL COMPLIANCE/HOT TOPICS
710 One OIG, Many Tools: Strategic Approaches to Protecting Integrity in an Evolving Health Care Landscape
AD9b/repeat Tools for Business Ethics Leaders
POSTAM2 The Effective Use of Valuations for FMV Compliance
TUESDAY, 3:00 pm – 4:00 pm
WEDNESDAY, 8:00 am – 9:45 am
TUESDAY, 3:00 pm – 4:00 pm
Bruce Anderson, Chief Ethics Officer, Health Net, Inc
Timothy Smith, President, Touchstone Valuation, LLC
Brian P. Ritchie, Assistant Inspector General for Centers for Medicare & Medicaid Audits, Office of Audit Services, Office of Inspector General
77 Learn practical tools to increase your personal
77 Identify the range of options for determining
Jennifer A. Trussell, Special Agent in Charge, Investigations Branch, Office of Investigations, Office of Inspector General
77 Is an ethics program worth the cost?
Robert K. DeConti, Assistant Inspector General for Legal Affairs, Office of Counsel to the Inspector General Vicki L. Robinson, Senior Counsel for Policy, Office of Inspector General
effectiveness as an ethics leaders
77 Dive into the elements of an ethics program Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
77 Understanding the range of tools OIG utilizes
TUESDAY, 3:00 pm – 4:00 pm
HOW TO SUCCEED AS A COMPLIANCE PROFESSIONAL
Gary Herschman, Chair, Health Care Practice Group, Sills Cummis & Gross P.C. 77 How to prepare Annual Reports to your Board
demonstrating the “effectiveness” of your compliance program
711 Compliance Issues in Mergers and Acquisitions
77 Practical section-by-section walk through of
TUESDAY, 3:00 pm – 4:00 pm
77 Sample workpaper forms & Annual Reports
John Fisher II, Health Care & Compliance Counsel, Ruder Ware, LLSC 77 When will you be liable for the liabilities of an
entity you are acquiring?
77 What is the appropriate role of compliance in the
transaction?
77 Defining the scope of due diligence and
addressing compliance issues
ADVANCED DISCUSSION GROUP
AD8b/repeat EMR: Use the Tool to Enhance Rather Than Hinder Compliance TUESDAY, 3:00 pm – 4:00 pm James Taylor, Physician, Kaiser Permanente 77 Discuss configuration decisions to ensure
SESSION IS FULL. Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
WEDNESDAY, APRIL 24 7:30 am – 12:00 pm
Conference Registration 8:00 am–9:45 am POST-CONFERENCE BREAKOUT SESSIONS GENERAL COMPLIANCE/HOT TOPICS
POSTAM1 NCD-LCD Education: A Proactive Approach to Denials WEDNESDAY, 8:00 am – 9:45 am Andrew Conkovich, VP Corporate Responsibility Officer, Carondelet Health Network
cloned functions in the EMR
Greg Harlow, Director–Clinical Trials Operations, Carondelet Health Network
compliance built into the clinic workflow
77 Proactively determine which procedures/
77 Configuration strategies for the EMR that drive SESSION IS FULL. Pre‑registration is required for Advanced Discussion Groups (see Step 3 on registration form). Attendance limited to 50 participants.
36
topics covered & data needed
compliant physician documentation
77 Minimizing the use of copy-and-paste and other
arrangements to evaluate what resources should be utilized to establish FMV
77 Implement best practices for valuations in a
ADVANCED DISCUSSION GROUP
Erin C. Bliss, Director, External Affairs, Office of Inspector General
address emerging and priority areas
77 Learn how to risk assess transactions and
FMV compliance program
AD10b/repeat Preparing Compliance Program Effectiveness Reports CHC
77 Highlights of how OIG deploys its tools to
FMV, including internal analysis, use of surveys, and engaging third-party appraisers
treatments are at risk for audit
GENERAL COMPLIANCE/HOT TOPICS
POSTAM3 State Development of Medicaid ACO WEDNESDAY, 8:00 am – 9:45 am Keith Halleland, Shareholder, Halleland Habicht PA 77 Overview of what some states are considering to
better meet financial constraints and demand for quality care and outcomes for people covered by Medicaid
77 Overview of what some creative providers are
proposing to meet these goals
77 Regulatory frameworks and compliance
considerations for government funded ACOs PRIVACY & SECURITY
POSTAM4 Your Personalized Road Trip to HIPAA/HITECH Compliance Land CHPC WEDNESDAY, 8:00 am – 9:45 am Erika Bol, Privacy Officer, Colorado Dept of Health Care Policy & Financing Shallie Bryant, HIPAA Privacy & Security Assistant Manager/ Deputy Privacy & Security Officer, CaroMont Health Stephanie Heline, Owner, Strategic Design Studio 77 Map your trip: Be ready to navigate the twists
and turns to comply with HIPAA/HITECH
77 Do your maintenance, don’t wait to break down
on the side of the road: Move towards proactive compliance and build a culture of privacy and confidentiality
77 See the sites and tell your friends: How to
communicate a complex subject to different audiences and still have fun.
77 Develop focused educational materials that are
clinician friendly
77 Develop key organizational partnerships
www.compliance-institute.org
Agenda PHYSICIAN COMPLIANCE
POSTAM5 E/M Documentation: Deal or No Deal? CHC WEDNESDAY, 8:00 am – 9:45 am Maggie Mac, Director of Compliance Operations, SL Quality Diagnostic and Treatment Center Dennis Mihale, President & Chief Medical Officer, Chelsea Management Group 77 Understand the highlights of E/M
documentation rules for non-coders and physicians
77 Learn to spot high risk E/M documentation and
compliance errors
77 Common sense tips for E/M code assignment
and documentation compliance LEGAL & REGULATORY
POSTAM6 Hospice/Nursing Home Partnership: Do it Right! WEDNESDAY, 8:00 am – 9:45 am Rachel Hold-Weiss, Partner, Arent Fox LLP Connie Raffa, Partner, Arent Fox LLP 77 Describe Hospice/SNF relationships and the
attendant regulatory, compliance and quality of care barriers and collaborations
77 Review of Hospice/SNF contract requirements in
the COPs and the differences in reimbursement, Medical Director functions, patient goals, admission and election criteria
77 Discussion of fraud and abuse issues in Hospice/
SNF relationships noted by HHS, CMS, OIG, RAC, MIP, MedPac, State Medicaid programs AUDITING & MONITORING
POSTAM7 Painless Statistics for Compliance Professionals WEDNESDAY, 8:00 am – 9:45 am Frank Castronova, Health Care Management Biostatistician, Blue Cross Blue Shield of Michigan Andrea Merritt, Director, Compliance & Audit Svcs, Nova Compliance Group 77 Present basic descriptive statistical measures and
inferences
HOW TO SUCCEED AS A COMPLIANCE PROFESSIONAL
POSTAM8 Keeping It All Straight: Compliance Resources at Your Fingertips WEDNESDAY, 8:00 am – 9:45 am
10:00 am–11:45 am
POST-CONFERENCE BREAKOUT SESSIONS GENERAL COMPLIANCE/HOT TOPICS
Dawnese Kindelt, System Compliance Dir/Clinics, Dignity Health
POSTAM10 Importance of Compliance Training CHC CHPC CHRC
Lisa Silveria, System Compliance Director, Dignity Health
WEDNESDAY, 10:00 am – 11:45 am
77 Detail your program in a single tool for internal
and external stakeholders
Al Josephs, Sr Director Policy and Training, Tenet Healthcare Corporation
77 Centralize your department processes and
communication
Ryan Whitehill, Mgr Ethics & Compliance Training, Tenet Healthcare Corporation
77 Take away templates and documents you can
77 Compliance training ensures transparency,
easily duplicate in your organization GENERAL COMPLIANCE/HOT TOPICS
POSTAM9 Make Culture Matter! How to Show Leadership that Culture is the Key to Performance CHC CHPC CHRC WEDNESDAY, 8:00 am – 9:45 am David Gebler, President, Skout Group, LLC 77 Understand how to quantitatively measure and
manage your organization’s culture and the role culture and values play in supporting the key transitions facing healthcare organizations
a culture of compliance, and a better work environment
77 Compliance training helps with change (change
agent) and increases organizational efficiency and productivity
77 Compliance training ensures uniformity and
standardization; risk management GENERAL COMPLIANCE/HOT TOPICS
POSTAM11 Best Practices for Denials Management WEDNESDAY, 10:00 am – 11:45 am
77 Learn best practices in managing mergers and
Ralph Wuebker, Chief Medical Officer, Executive Health Resources
77 Take away tools to effectively deploy
77 Current trends in commercial payor denials and
integration of practice groups
accountability-based safety and patient care programs
9:45 – 10:00 am
Networking Break
appeals by region, payor, and case mix
77 Consistent medical necessity compliance
processes across all patient populations and payor types
77 Documentation for claim status determination GENERAL COMPLIANCE/HOT TOPICS
POSTAM12 Healthcare Reform: The Road Ahead WEDNESDAY, 10:00 am – 11:45 am Kevin Lyles, Partner, Jones Day Diane Meyer, Chief Compliance & Privacy Officer, Stanford University Medical Center Frank Sheeder, Partner, DLA Piper
77 Discuss sampling principles for audit and
77 Compliance and enforcement trends in the next
77 Discuss extrapolation techniques and appropriate
77 Practical approaches to preventing compliance
compliance purposes based on OIG guidance follow-up procedures
www.compliance-institute.org
year
exposure
37
Agenda PRIVACY & SECURITY
LEGAL & REGULATORY
GENERAL COMPLIANCE/HOT TOPICS
POSTAM13 Privacy Officer Roundtable: OCR Enforcement— Are You Ready? CHPC
POSTAM15 Negotiating False Claims Act Settlements and Corporate Integrity Agreements
POSTAM17 A Compliance Officer’s Approach to Fair Market Value Analyses: Practical Advice and Dilemmas
WEDNESDAY, 10:00 am – 11:45 am
WEDNESDAY, 10:00 am – 11:45 am
WEDNESDAY, 10:00 am – 11:45 am
Marti Arvin, Chief Compliance Officer, UCLA Health System
Daniel Anderson, Assistant Director, US Department of Justice
Rick Cameron, Managing Director, Healthcare, Navigant
Brian Beard, Director Compliance & Ethics, McKesson Specialty Health
Roger Goldman, Partner, Latham & Watkins LLP
Greg Endicott, Managing Director, Strategic Value Group, LLC
77 Don’t procrastinate: tips on being prepared for an
Geeta W. Kaveti, Senior Counsel, Office of Counsel to the Inspector General, U.S. Department of Health and Human Services
Lawrence W. Vernaglia, Partner & Chair of the Health Care Industry Team, Foley and Lardner LLP
77 Living under an OCR resolution agreement:
Marc Raspanti, Paetragallo Gordon Alfano Bosick & Raspanti, LLP
77 Compliance officer’s education on legal and
77 What the future might hold
77 A discussion of factors which typically result in
OCR audit
hindsight is 20/20
PHYSICIAN COMPLIANCE
POSTAM14 Design a Useable Compliance Policy CHC CHPC CHRC WEDNESDAY, 10:00 am – 11:45 am Jacqueline Bloink, Director of Compliance, Arizona Community Physicians 77 Design the Compliance Policy for your small or
large physician group. Bring your lap top
77 Keep it to (3) pages or less to ensure that it is read
and used at your facility
77 Use the October 2000 Federal Register as the
guide
practical issues relating to use of valuation, fair market value and commercial reasonableness
the settlement of False Claims Act cases with the Department of Justice and/or Relator
77 Discussion of hypothetical valuation firms’
aspects of negotiating settlements under the False Claims Act with the United States Attorney and Department of Justice and the Office of Inspector General of Health and Human Services
77 Role-play by regarding the waiver of attorney/
77 An overview of the most common issues and
77 A discussion of the challenges for organizations
which have assumed obligations under a Corporate Integrity Agreement AUDITING & MONITORING
POSTAM16 Tips for Auditing/ Monitoring of Medicare Documentation for PT, OT, and Speech WEDNESDAY, 10:00 am – 11:45 am Carol Novak, Practice Specialist, Kaiser Foundation Health Plan Philip Yuson, Practice Specialist, Rehabilitative Services, Kaiser-Permanente, Southern California Region 77 Develop objective and measurable metrics to
monitor Medicare compliance in the areas of outpatient PT, OT, and Speech Therapy
77 Discuss Medicare requirements for appropriate
disagreement on determination of emergency department on-call pay for physicians in a “stacked” compensation arrangement client privilege
HOW TO SUCCEED AS A COMPLIANCE PROFESSIONAL
POSTAM18 ICD-10 for the (Non‑Coder) Compliance Officer WEDNESDAY, 10:00 am – 11:45 am Betty Bibbins, President & Chief Med Officer, DocuComp LLC Nicole Harper, Dir Training & Dev/Process ImprovementRevenue Cycle Operations, St. Vincents Health 77 Communicate the positive outcome/WIIFM
in understanding ICD-10 implications for Compliance and Administrator stakeholders within healthcare facilities and systems
77 Explore into how ICD-10 compliance impacts all
of the non-clinical pieces of the revenue cycle
77 Discuss strategies to mitigate loss (i.e. Quality of
Care Profile Reporting, payments, compliance, regulatory agencies)
therapy documentation and coding (e.g., conditions of medical necessity)
2:00 – 4:00 pm
foster Medicare documentation compliance and quality clinical practice
CHC, CHPC, and CHRC Certification Exams
77 Present examples of operational changes that
38
Andrea M. Ferrari, Manager, HealthCare Appraisers Inc.
www.compliance-institute.org
Exhibitors at the 2013 Compliance Institute
®
Meet with representatives from more than 90 companies with solutions for you Accreditation Commission for Health Care AHA Solutions Inc AllClear ID Altegra Health Association of Healthcare Internal Auditors (AHIA) Atlantic Information Services Atlas Systems Basha LLC d/b/a Ascpro BESLER Consulting Blass Consulting & Compliance Bloomberg BNA Inc BluePrint HIT The Bonadio Group BridgeFront Captain Integrity/Krieg DeVault LLP CaseWare IDEA CBIZ KA Consulting Certiphi Screening Inc CHAN HEALTHCARE Clearwater Compliance, LLC CliftonLarsonAllen LLP Code Blue Coding The Coding Network LLC Coding Strategies, Inc. Compliance Concepts, Inc Compliance 360 – an SAI Global Company Compliant Films Copyright Clearance Center Craneware, Inc CynergisTek Inc
Deloitte Doctors Management eHealthcare IT eProtex Epstein Becker Green Ernst & Young Executive Health Resources Experian FairWarning Fi-Med Management Inc FTI Consulting The George Washington University GNYHA Ventures Hall Render Killian Heath & Lyman– Ntracts Hamline University Health Law Institute HCPro Health Care Compliance Strategies (HCCS) Health Endeavors Health Revenue Assurance Assoc HealthCare Appraisers, Inc Healthcare Cost Solutions HEALTHDOX HealthPort HIPAA Solutions LLC HireRight HiSoftware, Inc. Huron Healthcare (Huron Consulting Group) Iatric Systems, Inc. iContracts ID Experts
ID Theft Solutions Identity Finder LLC IMA Consulting INCompliance Inovaare Corporation Intersect Healthcare Kforce Healthcare Inc. Kinney Services Inc KIWI-TEK Kroll Advisory Solutions Lockpath Loyola University Chicago McBee Associates Inc MCN Healthcare MDAudit MD Ranger, Inc Meade, Roach & Annulis/Aegis Compliance MedeAnalytics Medelearn MedHOK Healthcare Solutions Medical Electronic Attachment, Inc. (MEA) MediTract MedSafe MetricStream MRO NAVEX Global Navigant Nova Compliance Group, a Hall Render Company Online Tech Pacific University
Panacea Healthcare Solutions Inc PharmaSeek Financial Services Pinnacle Healthcare Consulting PolicyMedical Inc Post Acute Advisors PowerDMS By Innovative Data Solutions Precheck Inc PricewaterhouseCoopers Prospective Payment Specialists Protiviti Inc Proven Healthcare Solutions Qualifacts Systems, Inc. Quorum Health Resources RegScan, Inc. Reimbursement Management Consultants, Inc Reptrax/IntelliCentrics Rippe & Kingston Systems Inc Strategic Management Streamline Verify TeachPrivacy, LLC UHC–AAMC Faculty Practice Solutions Center Vendor Credentialing Service Vendormate Verisys WeComply Widener University School of Law Wolters Kluwer Law & Business YEI Healthcare ZHealth Zix Corporation
Tweet at the 2013 Compliance Institute #HCCAci twitter.com
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39
Save Now When You Pre-order the 2013 Compliance Institute Session Recordings ®
HCCA’s 2013 Compliance Institute is just around the corner. We have hundreds of educational sessions lined up for you, but with so much to choose from, it’s impossible to attend them all. That’s why we offer the Compliance Institute Session Recordings. Learn at your own pace and attend the sessions you miss, and continue your professional development year-round. Be sure to add the Compliance Institute Session Recordings to your 2013 Compliance Institute registration—just fill out your choice of DVD or online learning on your registration form.
But don’t delay. Prices will increase on‑site, so place your order now.
Affinity Group Meetings in 2013 Make the Compliance Institute the Site for Your Next Off-Site Team Meeting ®
Meeting with your team can be difficult, especially at the office with so many distractions. Why not use your time at the Compliance Institute for an off-site meeting? HCCA will make it easier by providing your organization with a private meeting space, along with a complimentary refreshment break. This will enable you to gain the most from your meeting experience. Additionally, all members from your organization will receive the HCCA member rate to attend the Compliance Institute. Meeting space is limited, so act now to reserve yours before we run out. Requests must be sent to Jennifer Power at
[email protected]. Affinity group meetings may be held: 77 Saturday,
April 20
77 Wednesday, 77 Thursday,
40
April 24
April 25
Approved requests will receive complimentary meeting room space at the conference hotel, Gaylord National Harbor, and your choice of one of the following complimentary refreshment options: Continental breakfast, morning snack/beverage break, or afternoon snack/beverage break. (All additional food and beverage, decorating, or audio visual orders must be arranged directly with the hotel and are not part of the complimentary offer.)
Contact Jennifer Power at 952-405-7916 or
[email protected] to learn more
www.compliance-institute.org
REGISTRATION 17th Annual Compliance Institute 7 April 21–24, 2013 7 National Harbor, MD (DC Metro Area) 7 Gaylord National ®
Full Name
(please type or print)
Sharing your demographic information with HCCA will help us create better networking opportunities for you. Thank you for filling out this brief form.
1 Demographic information What is your functional job title? Please select one. Academic/Professor Administration Asst Compliance Officer Attorney (In-House Counsel) Attorney (Outside Counsel) Audit Analyst Audit Manager/Officer Billing Manager/Officer Charger Master Chief Compliance Officer CEO/President Chief Financial Officer Chief Information Officer Chief Medical Officer Chief Operating Officer Clinical Coder Compliance Analyst Compliance Coordinator Compliance Director Compliance Fraud Examiner Compliance Officer Compliance Specialist
Consultant Controller Ethics Officer Executive Director General Counsel HIM Professional HIPAA/Privacy Officer Human Resources Medical Director Nurse Nurse Manager Patient Safety Officer Pharmacy Director Physician Quality Assurance/Quality of Care Regulatory Officer Reimbursement Coordinator Research Analyst Risk Manager Trainer/Educator Vice President Other (please list below)
List others not listed here:
Please tell us if you are a first-time attendee of the Compliance Institute: This is my first Compliance Institute
What is your primary health care entity? Academic Ambulance/Transportation Behavioral Health Consulting Firm Durable Medical Equipment Government Provider Health System Health System/Teaching Home Care/Hospice Hospital Hospital/Teaching Integrated Delivery System Integrated Health System Laboratory Law Firm
Long-Term Care Managed Care Medical Device Manufacturer Medical/Clinical Research Nursing Other Provider of Services/ Products to Health Care Entities Payor/Insurance Pharmaceutical Manufacturer Physician Practice Rehabilitation Retail Pharmacy Third-Party Billing Other (please list below)
List others not listed here:
What certifications do you hold? Select all that apply. BA BBA BS BSN CCEP CCEP-F CCEP-I CEM CCS CCS-P
CFE CHC CHC-F CHE CHP CHPC CHRC CIA CPA CPC
CPHQ DDS ESQ FHFMA JD LLM MA MBA MHA MPA
MPH MS MSHA MSN MT NHA PhD RHIA RHIT RN
List others not listed here:
REGISTRATION CONTINUES ON NEXT PAGE (OVER)
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REGISTRATION 17th Annual Compliance Institute 7 April 21–24, 2013 7 National Harbor, MD (DC Metro Area) 7 Gaylord National ®
2 Please type or print your contact information Mr.
Mrs.
Ms.
Dr.
Member ID
First
MI
Last
Credentials
Title
4 Choose your options
Place of Employment
prices listed reflect savings on/after 4/1/13
HCCA Members..................................................................$1,099 Membership Renewal & Registration..................................$1,394 Non-Members....................................................................$1,249 New Membership & Registration........................................$1,299
Mailing Address
City State
Zip
New members only (dues regularly $295 annually)
Pre-Conference Registration Morning.....................................$175 Pre-Conference Registration Afternoon...................................$175 Post-Conference Registration.................................................$175 Discount for 5 or more from the same company...................($100)
Phone Fax
Compliance Institute Session Recordings
Email (required for confirmation notification)
PURCHASE on/before 4/24/13
3 Select your sessions Please select ONE session per time slot. Advanced Discussion Groups marked with are limited to 50 participants. You must pre-register to reserve admission * to these sessions. SUN, APRIL 21
PRE-CONFERENCE 7:30 – 8:30 am SpeedNetworking
BREAKOUTS 9 am – 12 pm
PREAM1 PREAM2 PREAM3 PREAM4 PREAM5 PREAM6 PREAM7 PREAM8 PREAM9 PREAM10 PREAM11 PREAM12 PREAM13 BREAKOUTS
1:30 – 4:30 pm
PREPM14 PREPM15 PREPM16 PREPM17 PREPM18 PREPM19 PREPM20 PREPM21 PREPM23 PREPM24 PREPM25 PREPM26
MON, APRIL 22
TUES, APRIL 23
BREAKOUTS
BREAKOUTS
101 102 103 104 105 106 107 108 109 110 111 112 AD1* FULL AD2*
301 302 303 304 305 306 307 308 309 310 311 AD6* AD7* FULL AD8* FULL
BREAKOUTS
BREAKOUTS
11 am – 12 pm
1:30 – 2:30 pm
201 202 203 204 205 206 207 208 209 210 211 AD3* FULL AD4* FULL AD5* FULL
3 – 4 pm
BREAKOUTS
11:00 am – 12:00 pm BREAKOUTS BREAKOUTS 1:30 – 2:30 pm 3 –4 pm 501
502 503 504 505 506 507 508 509 510 511 AD2b* AD3b* FULL AD4b* FULL
4:30 – 5:30 pm
601 602 603 604 605 606 607 609 610 611 AD5b* FULL AD6b* AD7b* FULL
WED, APRIL 24 401 POST-CONFERENCE 402 BREAKOUTS BREAKOUTS 403 8 – 9:45 am 10 – 11:45 am 404 POSTAM1 POSTAM10 405 POSTAM2 POSTAM11 406 POSTAM3 POSTAM12 407 POSTAM4 POSTAM13 408 POSTAM5 POSTAM14 409 POSTAM6 POSTAM15 410 POSTAM7 POSTAM16 411 POSTAM8 POSTAM18 AD9* POSTAM9 AD10* FULL AD1b*
3:30 – 4:30 pm SpeedMentoring
Register online at
www.compliance-institute.org
702 703 704 705 706 707 708 709 710 711 AD8b* FULL AD9b* AD10b* FULL
after 4/24/13
Non-attendees: Online learning...................... $699......................$799 Non-attendees: DVDs..................................... $799......................$899 Registered Attendees: Online learning............ $299......................$399 Registered Attendees: DVDs........................... $399......................$499 Multi-user licensing fee.................................... $99........................$99
TOTAL $
5 Choose your payment method Check enclosed (payable to HCCA) Invoice me
Purchase Order
I authorize HCCA to charge my credit card (choose card below): American Express MasterCard Visa
credit card:
Credit Card Account Number
Credit Card Expiration Date
Cardholder’s Name
Cardholder’s Signature
How to Register MAIL Include registration form with check payable to: HCCA, 6500 Barrie Road, Suite 250, Minneapolis, MN 55435 ONLINE Visit www.compliance-institute.org FAX Include billing information and fax to 952-988-0146 QUESTIONS? Call 888-580-8373 or email helpteam @ hcca-info.org
CI0413
Group Discounts 5 or more: $100 discount for each registrant 10 or more: $150 discount for each registrant Discounts take effect the day a group reaches the discount number of registrants. Please send registration forms together to ensure that the discount is applied. A separate registration form is required for each registrant. Note that discounts will NOT be applied retroactively if more registrants are added at a later date, but new registrants will receive the group discount.
Continuing Education Units HCCA is in the process of applying for continuing education units, and these credit totals are subject to change. If you have questions, please call 888‑580‑8373 or email ccb @ compliancecertification.org. Visit the Compliance Institute website, www.compliance-institute.org, for the latest updates. Prerequisites/Advanced Preparation None.
Make Your Hotel Reservation Now Gaylord National Hotel and Convention Center 201 Waterfront Street National Harbor, MD 20745 The group rate is $271.00 per night single/double occupancy plus tax(es). Upgraded rooms are available for additional fees. To make guest room reservations call 1-301-965-4000 and reference HCCA–Healthcare Compliance Institute to reserve your room or visit the Compliance Institute website at www.compliance-institute.org and click on the Location tab to book online. This rate is good through March 29, 2013, or until the group block is sold out, whichever comes first. The hotel requires a first night’s deposit when reserving your room. Included in your guest room rate is high-speed Internet access in each guest room, wireless Internet access in the atriums, local phone calls up to 20 minutes ($.10/minute thereafter), toll-free and credit card calls up to 20 minutes ($.10/minute thereafter), bottled water (two per room, per day), a daily newspaper, and access to the resort’s state-of-the-art Fitness Center.
Details Registration Payment Terms Checks are payable to HCCA. Credit cards
accepted: American Express, MasterCard, or Visa. HCCA will charge your credit card the correct amount should your total be miscalculated.
Tax Deductibility All expenses incurred to maintain or improve skills in your profession may be tax deductible; including tuition, travel, lodging and meals. Please consult your tax advisor.
Meals Continental breakfast and lunch are provided on Monday and Tuesday. Coffee will be served on Sunday and Wednesday. Conference Handouts will be available online approximately
two weeks prior to the date of the conference. We will also have Internet Cafés available on-site where you can print session handouts. All handouts will also be available on the mobile App.
Special Needs/Concerns Prior to your arrival, please
call HCCA at 888‑580‑8373 if you have a special need and require accommodation to participate in the Compliance Institute.
Dress Code Business casual dress is appropriate for conference attendees.
Agreements & Acknowledgements I agree and acknowledge that I am undertaking participation in HCCA events and activities as my own free and intentional act, and I am fully aware that possible physical injury might occur to me as a result of my participation in these events. I give this acknowledgement freely and knowingly and assert that I am, as a result, able to participate in HCCA events, and I do hereby assume responsibility for my own well-being. I agree and acknowledge that HCCA plans to take photographs and video at the HCCA Compliance Institute and reproduce them in HCCA educational, news, or promotional material, whether in print, electronic, or other media, including the HCCA website. By participating in the HCCA Compliance Institute, I grant HCCA the right to use my name, photograph, video footage, and biography for such purposes.
Cancellations/Substitutions You may send a substitute in your place or
request a conference credit. Conference credits are issued in the full amount of the registration fees paid and are good for 12 months from the date of the cancelled event. Conference credits may be used toward any HCCA service. If you need to cancel your participation, notify us prior to the start date of the event by email at
[email protected] or by fax at 952-988-0146. Please note that if you are sending a substitute, an additional fee may apply.
HEALTH CARE COMPLIANCE ASSOCIATION 6500 Barrie Road, Suite 250, Minneapolis, MN 55435 888-580-8373 (p) / 952-988-0146 (f) www.hcca-info.org / helpteam @ hcca-info.org
www.compliance-institute.org
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Health Care Compliance Association 6500 Barrie Road, Suite 250 Minneapolis, MN 55435 www.hcca-info.org
®
FINAL
AGENDA HCCA’s 17th Annual
COMPLIANCE
INSTITUTE
®
April 21–24, 2013 Gaylord National National Harbor, MD (DC Metro Area)
Learn more & register at www.compliance-institute.org