Enforcement Trends Update
Linda Wawzenski Deputy Chief Civil Division U.S. Attorney’s Office
• DOJ Strike Force and U.S. Attorney’s Office initiatives
• Case law developments including post-Escobar decisions
• Recent DOJ policies and their impac
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OIG Self-Disclosures: Benefits, Eligibility, Requirements, and Resolution
David Fuchs Senior Counsel OIG
• Benefits: There are significant advantages to disclosing potential fraud
• Eligibility: What is proper for the SDP and what should be disclosed to another authority
• Requirements: Internal investigations and reported findings • Resolution: Cooperation, coordination, and reconciliation
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Think Different: A New Take on Managing Physician Compensation Arrangements
Adam Klein ECG Management Consultants
David Glaser Fredrikson & Byron P.A.
Mindy Phillips System VP, Chief Corporate Responsibility Officer, SSM Health
• What process should you use to determine FMV and commercial reasonableness, and what should your policy look like?
• How do you use surveys? What are the risks inherent in using survey data and how can you mitigate them?
• What do you do with physicians who are paid outside of policy limits (i.e., outliers)?
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Calculating Repayments Using Extrapolation: Practical Tips and Pitfalls to Avoid
Heather Fields, Esq. Reinhart Boerner Van Deuren s.c.
James Rose SunHawk Consulting
Scott Remmich Chief Compliance & Privacy Officer Aspirus, Inc.
• Help compliance professionals better understand extrapolation as it pertains to payment analyses using extrapolation to calculate voluntary repayments–myths, challenges and practical strategies
• Common myths related to advantages of extrapolation; situations to use or not use extrapolation, including example case studies; and best practices to avoid operational delays and challenges when using extrapolation
• OIG and MAC expectations
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Helpful Hints on the Top Things a Privacy Officer Needs to Know But Won’t Encounter Everyday
Marti Arvin VP, Audit Strategy Cynergis Tek Dealing with the release of information in unique circumstances: Minors, law enforcement, etc.
• Business associate agreements
• Marketing, fundraising and research
• Photos, phones, and privacy
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Compliance Auditing and Monitoring in a Value-Based World David Fuchs Senior Counsel OIG
Shawn Halcsik Corporate Compliance Officer Encore Rehabilitation
• How the OIG is using data to fulfill its mission
• Review of the “new” data points in a value based model
• Best practices in auditing and monitoring in a value based model
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