Education event

Hospital Compliance Seminar
Physician/hospital arrangements, self-disclosure, compliance plan improvements

February 9, Glendale
February 16, Sacramento

 

Overview

Ensuring your hospital’s compliance is a tall order. With the advent of health care reform and the development of new delivery models it’s more important than ever to make sure your compliance plans are current, part of the corporate culture, and that your facility is following the letter of the law.

It’s no small task and potential liability is greater than ever. Enforcement activity is on the rise and with it comes increased scrutiny and the potential for fines, penalties and even criminal liability.

This year’s program will bring hospital compliance officers up to date on recent changes in the law and complex new requirements. Participants to the program will learn:

  • The impact of health care reform on hospital compliance
  • How to pinpoint problem areas in physician/hospital arrangements and work toward resolution
  • When to refund overpayments and how to self-disclose
  • Who the audit contractors are, what they can ask for, and how to prepare and respond
  • Ways to update and improve your compliance plans and make them living documents
  • New state and federal requirements for charity care and discounted pay practices
  • The Office of Inspector General’s enforcement focus areas for 2011
  • And more.

Register now for this once-a-year program.

Agenda

9:00 a.m. – 12:15 p.m.

Health Care Reform’s Impact on Hospital Compliance

  • Compliance issues related to integrated care models including ACOs and medical homes
    • Antitrust, anti-kickback, civil monetary penalties, tax-exempt status, physician employment restrictions 
  • Refunding of overpayments—timelines, disclosure issues
  • Increased enforcement and fines
  • Enrollment and suspension
  • Other changes—enforcement data sharing and coordination, increased data mining

Audit Contractors—RACs, MACs, MICS, ZPICs

  • Who they are and what they can do
  • What are the rules?
  • How hospitals can prepare and respond

Taking a Fresh Look at Your Compliance Plan

  • Bringing your plan up to date
  • Leveraging hospital resources to improve your plan
  • “Walk the Walk”—putting policy into practice
  • Reform—what to incorporate now, preparing for the coming years

12:15 – 1:15 p.m. Hosted Luncheon

1:15 – 4:00 p.m.

Billing the Patient

  • Charity care and enforcement
  • Emergency physician charity care
  • What happens when you bill—new charity and discounted care requirements under reform

Imperfect Doctor/Hospital Arrangements

  • Documentation problems in financial relationships—missing, incomplete or inaccurate written documentation
  • Issues arising from recent litigation—how to determine fair market value, what not to do 
  • Stark self-disclosure—what to do when an error is made

OIG 2011 Work Plan

  • Impact of changes to FCA, ACA
  • Responding to investigations and requests for information  
  • Quality reporting
  • Provider-based status 
  • Readmissions
  • Hospital discharges from inpatient rehabilitation

Faculty

Lloyd A. Bookman is a founding partner in the Los Angeles law office of Hooper, Lundy & Bookman, PC (HLB). He has specialized in Medicare and Medicaid reimbursement and compliance since 1979. Mr. Bookman also represents health care providers in fraud and abuse matters involving false claims and anti-kickback issues, in self-referral matters—serving 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, he has specialized in representing health care providers in litigation against the federal and state governments. Mr. Hooper regularly advises 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. Mr. Hellow’s practice focuses on  Medicare and Medicaid payment disputes before federal and state administrative agencies. In addition, he advises clients on reimbursement and other regulatory implications of their business transactions. Mr. Hellow’s noteworthy Medicare appeals include representing 700 hospitals in successful challenges to Medicare’s Malpractice Rules and labor/delivery room day policy, and representing 1400 hospitals in a challenge to Medicare outlier payments.

Charles B. Oppenheim is a partner in the Los Angeles office of HLB and has been practicing health law for nearly 20 years. His practice includes all aspects of transactional, operational and regulatory health care law, including acquisitions, joint ventures and integrated delivery systems. A nationally-recognized expert on anti-kickback and Stark Law issues, Mr. Oppenheim authored the 2008 American Health Lawyers Association Monograph on Stark Law, the fourth edition of a treatise he first wrote in 1998.

 

 

 

Carole Klove is the special projects officer with University of California San Francisco (UCSF) Medical Center. Ms. Klove is a nurse attorney with nearly 25 years experience in the health care field. Prior to joining UCSF, she served as chief compliance officer and privacy officer for UCLA Health System and Medical Sciences.  Ms. Klove’s compliance work has involved CMS and Office of Inspector General audits and investigations, compliance audits, and developing standards for various health care providers including Corporate Integrity Agreements (CIAs) and Independent Review Organizations (IROs).

 

Sites

February 9
Hilton Los Angeles North/Glendale
100 West Glenoaks Boulevard
Glendale, CA 91202
(818) 956-5466
Driving directions

February 16
Hyatt Regency Sacramento
1209 L Street
Sacramento, CA 95814
(916) 443-1234
Driving directions

Tuition/CEs

Members $335
Nonmembers $535
Tuition includes CEs, lunch, course materials and a free copy of CHA’s updated California Hospital Compliance Manual.

 

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 6.6 Compliance Certification 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-027.

Health Care Executives—CHA is authorized to award 5.5 hours of preapproved Category II (non-ACHE) continuing education credit for this program toward advancement, recertification or re-appointment in the American College of Healthcare Executives.

Legal—CHA is a State Bar of California approved MCLE provider. This activity has been approved for 5.5 hours of MCLE credit.

Nursing—Provider approved by the California Board of Registered Nursing, Provider #CEP 11924, for 6.6 Contact Hours. (This certificate must be retained by the licensee for a period of four years.)

Free Manual

All participants will receive a free copy of CHA’s updated California Hospital Compliance Manual. Written by Hooper, Lundy & Bookman, PC, and CHA, the 2011 edition has been expanded and revised to incorporate the new federal health care reform laws. The manual focuses on high-risk compliance issues and the key components of an effective compliance program. A model compliance plan that hospitals can adapt to fit their operations is also included on the free CD. The manual includes legal citations and an index of key terms. Topics covered are:

  • Hospital Compliance Plans
  • Federal and State False Claims Acts
  • Submission of Accurate Claims Information
  • Proper Cost Reporting Practices
  • Physician Self-Referral Laws
  • Federal and State Anti-Kickback Laws
  • Hospital Fair Pricing Policies
  • Issues for Tax-Exempt Hospitals
  • Fundamentals of Hospital Licensing and Certification
  • Screening for Excluded Providers (new)
  • Other Laws
  • Repayment and Self-Disclosure
  • Responding to Government Audits and Investigations (new)

For more information, or to purchase additional manuals, click here.

Attendees

To view a list of Glendale attendees, click here.

To view a list of Sacramento attendees, click here.

 

 

Commands