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Registration and Continental Breakfast (provided) 7:30 – 8:00 am
Welcome / Introduction 8:00 – 8:15 am
Introduction to Healthcare Compliance 
  • The seven essential elements of an effective compliance program
  • Organizational steps necessary to implement a successful compliance program
  • The laws, rules, and regulations pertinent to healthcare compliance
  • Challenges confronting compliance officers
8:15 – 10:15 am
Break 10:15 – 10:30 am
Compliance Oversight and Infrastructure
  • Understand the importance of structure vs. operations
  • The components of an effective compliance infrastructure
  • Implementation of a compliance program, selection of qualified staff, and budgeting for program
10:30 am – 12:15 pm
Lunch (provided) 12:15 – 1:15 pm
Standards, Policies, and Procedures 
  • The importance of have a Standard of Conduct to provide the ethical culture of the organization.
  • Compliance-related policies, which are current to regulatory requirements and organizational expectations, are the cornerstone of an effective compliance program
  • The differences between policy and procedures
  • The essential components of compliance policies
  • Developing, implementing, and evaluating the adequacy of compliance program policies
1:15 – 2:45 pm
Break 2:45 – 3:00 pm

HIPAA Privacy and Security

  • An overview of the HIPAA Privacy and Security regulations
  • A breakdown of these regulations in an easy to understand format
  • Understanding how to apply the Privacy and Security Regulations to their daily compliance activities
3:00 – 5:00 pm


Continental Breakfast (provided) 7:30 – 8:00 am
CHC Certification Discussion 8:00 – 8:15 am

Risk Assessment and Internal Controls

  • What is risk and how can it be assessed?
  • Who should be involved in risk assessments?
  • What is the risk assessment process and how does it differ for non-profits and publicly traded for-profits?
  • What are ways to identify risk areas?
  • How do you rank and prioritize risks?
  • How does risk assessment relate to auditing and monitoring?
  • What do you with the results of a risk assessment?
  • How does risk assessment relate to compliance effectiveness?
  • Tools to implement a risk assessment process
8:15 – 10:00 am
Break 10:00 – 10:15 am

Routine Auditing and Monitoring

  • The basic components of auditing and monitoring including different considerations for developing an audit
  • Examples of reporting formats to communicate auditing and monitoring results
  • Developing a compliance audit plan and soliciting management’s involvement in that plan
10:15 am – 12:00 pm
Lunch (provided) 12:00 – 1:00 pm

Education and Training

  • Understanding how adults learn
  • Adult learning techniques, effective teaching styles, topics of interest, and evaluation of the educational programs
  • The adequate length of sessions, who should be included, and how often training should be held
  • The difference between general and focused/targeted education
1:00 – 2:45 pm
Break 2:45 – 3:00 pm

Organizational Ethics

  • What are the duties we, as professionals, owe to the public, our clients and the profession?
  • What do we do when confronted with misconduct?
  • What is our duty to keep the board informed?
  • How do we deal with limits placed on our professional judgment?
3:00 – 4:45 pm
Networking Dinner (optional) 5:30 pm


Continental Breakfast (provided) 8:00 – 8:30 am

Conflicts, Discipline, and Incentives

  • The nature of conflicts of interest in health care, including regulatory oversight, industry guidance, and other documents that impact compliance professionals’ oversight of this area
  • A practical approach to implementing a Conflicts of Interest process and how it differs for non-profits and publicly traded for profits
  • How Conflicts of Interest relates to Auditing and Monitoring and Compliance Program Effectiveness
  • How discipline and incentives should be integrated into the compliance program
  • How discipline and incentives relate to Auditing and Monitoring and Compliance Program Effectiveness
8:30 – 10:00 am
Break 10:00 – 10:15 am

Stark and Anti-Kickback

  • Severe civil and even criminal penalties can result from compliance failures involving these important healthcare legal requirements
  • An overview of each law
  • Discussion of recent enforcement actions, similarities and differences in the two laws, and strategies that can be implemented to promote compliance
10:15 am – 12:00 pm
Lunch (provided) 12:00 – 1:00 pm

Enterprise-Wide Billing and Reimbursement

  • Basic compliance terminology as it relates to Health Care Services
  • Information on billing and reimbursement risk areas that have been identified by Governing Authorities
  • Controls and mitigating activities to address billing and reimbursement risk areas and healthcare fraud and abuse
1:00 – 2:45 pm
Break 2:45 – 3:00 pm

Internal and External Investigations

  • Government agencies that can be involved in an investigation of a healthcare provider
  • The many factors that compliance professionals and their organizations must consider before, during, and after an internal investigation
  • The use of experts and consultants
  • Details about the attorney-client privilege and attorney work product doctrine
  • Practical advice on how to conduct investigations
3:00 – 4:45 pm


Continental Breakfast (provided) 7:30 – 8:00 am

Legal Risks and Self-Disclosure

  • The legal risks associated with health care compliance
  •  Self Disclosure of Non-compliant Activity and Government Expectations
  • The considerations that compliance professionals must address when designing, implementing and administering compliance programs.
8:00 – 9:30 am
Break 9:30 – 9:45 am

Effectiveness and Evaluation

  • A historical review of what various government agencies consider when determining what makes a compliance program effective
  • Industry research and best practices related to effectiveness and evaluation
  • Methodologies for evaluating and measuring the effectiveness of a compliance program
9:45 – 11:30 am
Academy Ends 11:30 am
CHC Exam Check-In Time 12:45 pm
Exam Time — Certified in Healthcare Compliance (CHC)® Exam (optional)

The CHC exam is optional. You must apply and pay for the exam separately from the Academy.
1:00 – 4:30 pm

Agenda is subject to change