Education event

Hospital Compliance Seminar
Compliance for integrated care models and quality initiatives, self and regulator audits

February 2, 2012 – Sacramento
February 8, 2012 – Glendale

Overview

Our health care delivery system is changing and so should your
hospital compliance program.

Hospital compliance programs will need to address new integrated delivery models, quality and payment initiatives, heightened scrutiny on payments and sophisticated data audits.

This year’s program will provide hospital compliance officers with the information and tools needed to reshape their programs to meet today’s requirements. Participants to the program will learn:  

  • The impact of integrated care delivery on hospital compliance programs
  • What your compliance program should include when implementing new care delivery models
  • How the new quality initiatives will change the way you approach compliance
  • Why failure to meet quality measures will impact your reimbursement
  • Process updates for self and regulator auditing including  RACs, MACs, MICs, ZPICs
  • The details on CMS’ new Recovery Auditor Prepayment Review Demonstration Project
  • The Office of Inspector General’s enforcement focus areas for 2012
  • Compliance program essentials—what every compliance officer should know and more.

Free Compliance 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 2012 edition focuses on high-risk compliance issues and the key components of an effective compliance program.

This year’s updates reflect changes to Medicare and Medi-Cal reimbursement requirements including physician supervision, GME and IME, observation status, and much more. 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.

Register now for this once-a-year program.

Program co-sponsored by:

Healthcare Financial Management Association Southern California Chapter

Agenda

9:00 a.m. – 12:00 p.m.
Compliance and Integrated Delivery Models

  • When delivery models change, so do compliance plans 
  • ACOs, bundled payment, physician integration
  •  Sensitive areas: billing, Stark, AKS, tax-exempt issues

Impact of Quality on Compliance and Reimbursement

  • Intersection of quality and reimbursement
  • Laws, initiatives, medical necessity audits
  • What healthcare-associated conditions apply
  • Impact on payment
  • Prevention measures—internal audits, monitoring and reporting

12:00 – 1:00 p.m. Hosted Luncheon

1:00 – 4:00 p.m.
Compliance Audits—Self and Regulator

  • Practicality of self-audits
  • External audits—RACs, MACs, MICs, ZPICs
  • New Recovery Auditor Prepayment Review Demonstration Project
  • Recent activity, trends for audit
  • How to prepare and respond if you find a problem

OIG 2012 Work Plan

  • Impact of changes to FCA, ACA
  • Responding to investigations and requests for information  
  • Medicare payment initiatives—reliability of data to support payments, outlier reconciliation, secondary payer, observation services
  • Accuracy of hospital-reported quality data

Compliance Primer—Essential Knowledge for Compliance Officers

  • The basic foundation—policies, contracts and more
  • The compliance net—casting wide to cover all operations
  • Building your team
  • Understanding the law for sound policy development
  • Checks and balances—creating self audit procedures
  • Disclosures—what to do if you find something amiss

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. 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 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.

Charles B. Oppenheim is a partner in the Los Angeles office of HLB where he heads the firm’s ACO Task Force. 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.

Judy Ringholz, RN, JD, CHC is the Director of Compliance Training & Program Effectiveness and Deputy Chief Compliance Officer for Sutter Health. Ms. Ringholz has over 30 years experience in the health care field helping providers and other organization identify and manage internal risks, assess the effectiveness of their compliance programs, and identify opportunities for strengthening their efforts to promote a culture of compliance. Ms. Ringholz has lectured extensively on health care compliance and is past-chair of the Health Law and Compliance Section of The American Association of Nurse Attorneys.

Sites

February 2
Sheraton Grand Sacramento
1230 J Street
Sacramento, California  95814
(916) 447-1700
Directions

February 8
Hilton Los Angeles North/Glendale
100 West Glenoaks Boulevard
Glendale, CA 91202
(818) 956-5466
Directions

Tuition/CEs

Members $345
Nonmembers $545

Tuition includes CEs, lunch, course materials and a free copy of CHA’s updated 2012 California Hospital Compliance Manual.

Members of the co-sponsoring organizations may register at the CHA member rate.

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. Granting of prior approval in no way constitutes endorsement by CCB of the program content or the program sponsor.  CCB program code #CAHA-031.

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. 

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 2012 edition has been expanded and revised to incorporate the 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
  • Other Laws
  • Repayment and Self-Disclosure
  • Responding to Government Audits and Investigations

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

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