Education event

Hospital Reimbursement Seminar
The changing landscape of provider reimbursement: hospital fee, new Medi-Cal payment system, health care reform

June 21, Sacramento; June 28, Glendale;
June 29, Newport Beach

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In this new era of Health Care Reform, what will happen to provider reimbursement? Are continued cuts to Medicare and Medi-Cal sustainable? What is the future of the hospital fee program?

This year’s seminar will explore these and other emerging reimbursement issues in depth. At the state level, participants will be updated on the budget battle, hospital fee program, Medi-Cal Waiver, and a new payment system for Medi-Cal. At the federal level, topics include the alignment of payment and quality, proposed ACO regulations, and future cuts to the Medicare program.

Additional topics include integrity program updates on fraud and abuse and recent audit contractor activity. Plus a session on the new Medicare S-10 cost report will outline charity care reporting requirements, including preparing for audits, and maintaining appropriate documentation.

Make plans to register today.

Co-sponsored by:
Healthcare Financial Management Association Southern California Chapter

Approved by:
Healthcare Financial Management Association Northern California Chapter
Association of California Nurse Leaders
Hospital Council of Northern and Central California
Hospital Association of Southern California
Hospital Association of San Diego and Imperial Counties
United Hospital Association

Agenda

8:30 a.m. – Noon

Medi-Cal Update

  • The California budget—deal or no deal
  • Litigation updates—impact of high profile cases
  • California’s plan for HACs and RACs

Medicare Update

  • How ACA is changing the rules
  • Payment reform—bundled, value-based purchasing
  • Regulatory update—IPPS rule and more
  • New case developments and challenges to reform

A Bridge to Reform: Medi-Cal Waiver

  • County-based coverage update
  • Financing and available funds
  • Mandatory enrollment of seniors and persons with disabilities in managed care

Integrity Programs

  • Fraud and abuse updates
  • Audit contractors—recent activity, new players
  • Overpayment issues—disclosures, timelines, penalties

Noon – 1:00 p.m. Hosted Luncheon

1:00 – 4:30 p.m.

Accountable Care Organizations

  • Putting the regulations into practice
  • Working within the law, avoiding Stark
  • Alignment considerations
  • The shape of things to come—possible models

S-10: The New Medicare Cost Report

  • Charity care reporting requirements
  • Today’s data — tomorrow’s payment
  • Audit trails

A New Medi-Cal Payment System

  • Research and development
  • Movement to transparency and fairness
  • Incentives to provide appropriate, cost-effective care

The Hospital Fee—Past, Present and Future

  • Why a fee—driving factors
  • Evolution of the fee, companion programs
  • The federal agenda and what to expect after reform

Faculty

Lloyd A. Bookman is a founding partner in the Los Angeles law office of Hooper, Lundy & Bookman, Inc. (HLB). Mr. Bookman has specialized in Medicare and Medicaid reimbursement since 1979 and represents health care providers in fraud and abuse matters involving false claims and anti-kickback issues and in self-referral matters. He serves as counsel in civil and administrative litigation and investigations and as special counsel in criminal matters.

Patric Hooper is a founding partner in the Los Angeles office of HLB and a former Deputy Attorney General with the California Department of Justice. Since 1976, Mr. Hooper has advised and represented health care organizations regarding reimbursement, certification and licensure issues associated with business transactions and combinations, fraud and abuse issues, and on state anti-kickback and referral issues.

John R. Hellow is a partner in the Los Angeles office of HLB and chairs the firm’s Regulatory Department. His practice focuses on Medicare and Medicaid payment policy issues and he represents hospitals and hospital systems in Medicare and Medicaid payment disputes before federal and state administrative agencies and courts. Mr. Hellow advises national health care associations in preparing regulatory comments and in drafting legislation and also advises clients on reimbursement and other regulatory implications of their business transactions, and in compliance and disclosure matters.

Laurence Getzoff is a partner in the Los Angeles office of HLB. Mr. Getzoff specializes in federal and state reimbursement law, federal and state regulatory compliance issues, medical staff and hospital operations, licensing, certification, and accreditation issues, physician contracting, medical records issues, EMTALA and emergency patient care, and the special problems of mental health providers. He also maintains an active mediation practice.

Charles B. Oppenheim is a partner in the Los Angeles office of HLB and chairs the firm’s ACO Task Force. He has been practicing health law for more than 20 years. Mr. Oppenheim’s practice includes all aspects of transactional, operational and regulatory healthcare law, including acquisitions, joint ventures and integrated delivery systems. He is a nationally-recognized expert on anti-kickback and Stark Law issues.

Mark S. Hardiman is a partner in the Los Angeles law office of HLB, specializing in the defense of health care fraud, abuse, and compliance issues. A former federal prosecutor, he has extensive experience representing hospitals in federal False Claims Act cases and routinely represents providers in Medicare and Medi-Cal administrative appeals and related mandamus proceedings.

Timothy S. Loechl is a principal with Clark Koortbojian & Associates. Mr. Loechl is responsible for the firm’s hospital accounting services and its government reporting practice, which includes preparation of Medicare and Medi-Cal reports, responding to cost report audits, and preparing appeals. He provides hospitals and attorneys with consultation relative to OIG investigations, including pre-Settlement issue analysis and post Settlement compliance and reporting requirements.

Kevin Quinn is vice president, Payment Method Development, for ACS, a Xerox Company, which will soon assume responsibility as Medi-Cal’s fiscal intermediary. At ACS, Mr. Quinn serves as the managing consultant on Medi-Cal’s project to replace its current payment method for inpatient hospital services with a method based on diagnosis related groups (DRGs). Mr. Quinn has managed similar projects for Medicaid programs in many states and published numerous analyses and articles on Medicaid payment issues.

Anne McLeod is senior vice president of Health Policy for the California Hospital Association and serves as CHA’s health care reform resource for member hospitals. Ms. McLeod coordinates CHA’s efforts on the development and implementation of CHA’s strategic plan for health care reform. Most recently, she provided leadership for the design, development and implementation of the hospital fee program signed into law by Governor Schwarzenegger in 2009.

Matt Absher is director of Reimbursement Programs at the California Hospital Association. At CHA, Mr. Absher represents members’ interests related to reimbursement, including Medicare, Medi-Cal, commercial payers, and other government entities. Prior to joining CHA, he worked for five years for Triage Consulting Group, a hospital revenue recovery firm located in San Francisco.

Sites

June 21, 2011
Sheraton Grand Hotel
1203 J Street
Sacramento, CA 95814

June 28, 2011
Hilton Los Angeles North/Glendale
100 West Glenoaks Boulevard
Glendale, CA 91202

June 29, 2011
Hyatt Regency Newport Beach
1107 Jamboree Road
Newport Beach, CA 92660

Tuition/CEs

Tuition

$325 Member
$450 Nonmember

Tuition includes CEs, lunch and course materials. Members of the co-sponsoring and approving organizations may register at the CHA member rate.

Confirmations: A confirmation will be sent to all registrants who register at least one week in advance. Directions and parking information will be included.

Cancellation Policy/Late Payment: A $50 non-refundable processing fee will be retained for each cancellation. Cancellations must be made in writing seven or more business days prior to the scheduled session and faxed to (916) 552-7506. No refunds will be made after these dates. Substitutions are encouraged. Please note: payment is due one day prior to the program. Payments not received by the seminar date may be subject to a 10% late fee.

Special Accommodations or Questions: If you require special accommodations pursuant to the American’s with Disabilities Act, or have other questions, please call (916) 552-7637.

Continuing Education

Full attendance at the educational session is a prerequisite for receiving professional continuing education. Attendees must sign in at the seminar and, when required, include their state bar or professional license number. CE certificates will be e-mailed.

Compliance—This program has been approved for 7.8 Compliance Certificataion Board (CCB) continuing education units in Compliance Training and Education, and Auditing and Monitoring for Compliance. Granting of prior approval in no way constitutes endorsement by CCB of the program content or the program sponsor. CCB program code CAHA 029. (Note: CE recipients for compliance are responsible to send/report a completed version of their certificate to HCCB to obtain CE credit.)

Health Care Executives—CHA is authorized to award 6.5 hours of pre-approved Category II (non-ACHE) continuing education for the program toward the advancement, recertification or reappointment in the American College of Healthcare Executives.

Legal—CHA is a State Bar of California approved MCLE provider. This activity has been approved for 6.5 hours of MCLE credit.

Attendees

Click here to view the Sacramento attendees.

Click here to view the Glendale attendees.

Click here to view the Newport Beach attendees.

Commands