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Handouts - 2016 - Regional - Nashville

Nashville Regional Conference
Friday, November 18, 2016
Nashville, TN

Conference Brochure

HCCA Update 60-Day Overpayment Rule Considerations

Sara Kay Wheeler, Partner, King & Spalding

  • Identifying an overpayment
  • Defining ‘credible information’
  • Quantifying an overpayment
  • Practical tips for implementation

Presentation (2 slides/page)
Presentation (3 slides/page)

The Art of Combining Data Analytics and Compliance Monitoring: 340B Revealed

Suzann Hall, CPA, ACDA, Data Analytics Audit Manager, CHAN, LLC
Tim Krzeminski, Healthcare Compliance Director, PwC

  • What is Data Analytics? Understanding how its use can help identify, mitigate, and continuously monitor quantifiable risks.
  • Using Data Analytics to track and aggregate data from disparate systems for compliance purposes and goals.
  • Highlight the transformative role Data Analytics can play in the 340B Drug Discount Program by identifying key areas of risk, reducing instances of non-compliance, and establishing opportunities to improve the administration and internal controls of the overall program.

Presentation (2 slides/page)
Presentation (3 slides/page)

OIG Enforcement Update

Tony Maffei, Special Agent, U.S. Department of Health and Human Services – Office of Inspector General

  • Successful OIG investigations based on proactive data analysis
  • Cases and schemes in the urine toxicology industry
  • Recent trends in national healthcare fraud enforcement

Presentation (2 slides/page)
Presentation (3 slides/page)

Cyber Threats in Healthcare

Bart Lane, MBA, CISSP, CISM, Director, Information Security Assurance, Parallon Information Security
Scott E. Augenbaum, Special Agent, Federal Bureau of Investigation

  • Are transnational criminal enterprises and foreign intelligences services targeting my organization and are we prepared to handle a data breach?
  • Why being HIPAA compliant in not the same as being cybersecure.
  • What do all data breaches have in common?
  • How do I get my C-suite to understand the threat?
  • What can we do today to reduce our attack surface?

Presentation (2 slides/page)
Presentation (3 slides/page)

Telemedicine: Healthcare Market Changes and Emerging Compliance Risks

Ethan Bachrach, MD, MBI, FACEP, Chief Medical Informatics Officer, TeamHealth
​​​​​​​Nesrin Tift, Bass, Berry & Sims PLC

  • Provide a description of current healthcare market changes in the United States, and how these will influence the rapid scaling and deployment of telemedicine into novel healthcare settings
  • Describe the current reimbursement landscape and recognize areas for growth
  • Identify regulatory and compliance challenges for telemedicine deployments, including information security and privacy obligations, scope of practice restrictions, and corporate practice of medicine prohibitions

Presentation (2 slides/page)
Presentation (3 slides/page)

The Evolving Relationship Between Counsel and the Compliance Officer

Matthew F. Tormey, Chief Compliance Officer, TeamHealth
​​​​​​​Lisa Ohrin Wilson, Esq.

  • How important is the relationship between a compliance officer and counsel?
  • Identifying and managing conflicts of interest between counsel and compliance officer
  • Are your investigative and other strategies always aligned?
  • Corporate, board, and individual liability

Presentation (2 slides/page)
Presentation (3 slides/page)

Patient Safety and Medical Peer Review

Jeffrey Dickstein, Attorney, Phillips & Cohen
​​​​​​​Lisa Rivera, Partner, Bass, Berry & Sims PLC

  • Current enforcement trends in medical necessity and quality of care cases
  • Ramifications of quality measurements and enforcement
  • Patient safety compliance procedures – are they are sufficient given today’s enforcement trends?
  • Peer review protections and limitations

Presentation (2 slides/page)
Presentation (3 slides/page)

Medicare Advantage Organizations’ Attestation Requirements and Implications

Chris Thomason, MBA, CHC, Director, Corporate Compliance and Privacy, CHSPSC, LLC
​​​​​​​John C.J. Barnes, Partner, King & Spalding
Stephanie F. Johnson, Senior Associate, King & Spalding

  • Regulatory obligations of MAO attestation requirements
  • Hurdles and pitfalls to attesting before assessing compliance

Presentation (2 slides/page)
Presentation (3 slides/page)

Handout (docx)

Hot Topics

Michael Rosen, Esq.,, Co-Founder, ProviderTrust
​​​​​​​Walter Mann, Community Health Systems
Tyler Golden, Community Health Systems
Jerod J. Holloway, CIA, CFE, CHC, CICA, Director, PricewaterhouseCoopers LLP

  • Expansion of Exclusion Authority
  • OCR Audit Protocol
  • OIG Compendium – formerly the Orange Book

Presentation 1 (2 slides/page)
Presentation 1 (3 slides/page)

Presentation 2 (2 slides/page)
Presentation 2 (3 slides/page)

Presentation 3 (2 slides/page)
Presentation 3 (3 slides/page)