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Medicaid Fraud 101

Lloyd S. Early Special Agent-In-Charge – Health Care Fraud Section, Office of Ohio Attorney General Mike DeWine

• This presentation will highlight the work of the Ohio Attorney General’s Medicaid Fraud Control Unit in combating provider fraud.
• The presentation will offer a historical perspective on Medicaid as well as key state and federal program integrity initiatives, including the establishment of a nationwide network of Medicaid Fraud Control Units.
• The presentation will identify common and statutory definitions of “fraud” and “Medicaid fraud,” and explore the varied schemes by which providers defraud the program.
• And finally, the presentation will outline select investigative techniques and emerging trends in health care fraud.


Update on Post-Acute Care Setting Issues

Andee Koczak, RDN, LD, QCP, IPCO Leaderstat

• Review the changes required for compliance with the revised Requirements of Participation for nursing facilities
• Identify areas of potential risk that the Phase 2 and Phase 3 Requirements pose
• Discuss strategies for assuring compliance with new requirements


Therapy Risk Assessment

Lisa Chambers Chief Quality Officer Blue Sky Therapy
• Risk assessment is more than the OIG Work Plan. The OIG continues to target physical therapists in private practice. Learn how OIG findings for physical therapists in private practice can be used to identify risks in all therapy outpatient venues: hospitals, physician offices, rehab agencies, CORFs and SNF Part B.
• Therapy risk areas generally follow the same themes. Learn how to update your monitoring & auditing program from what is reported in CIA/IA and whistleblower allegations.
• Therapy risk assessment is not all about coding, billing, and documentation. This session will cover vulnerable areas including excluded individuals, marketing activities, patient inducements, transportation, and emerging risk areas of telemedicine and cash payments in violation of the mandatory claims submission rule.


Cyberattacks in the Healthcare Industry

Paulette Thomas Counsel BakerHostetler
• Current cyber-risk landscape
• Incident response and notification
• Risk management strategies to reduce cybersecurity risks


Helpful Hints on the Top Things Every Privacy Officer Needs to Know But Won’t Encounter Every Day

Marti Arvin VP of Audit Strategy Cynergis Tek

• Dealing with release of information in unique circumstances, minors, law enforcement, etc.
• Business associate agreements
• Marketing, fundraising, and research
• Photos, phones, and privacy


The Importance of Diversity and Inclusion in Healthcare

Jennifer Pizio Diversity and Inclusion Associate Director, Office for Diversity and Inclusion at the University of Toledo

• What do we mean when we say diversity and inclusion?
• Why diversity and inclusion is critical in healthcare operations.
• Best practices and tips for compliance.