Education event

Hospital Finance & Reimbursement Seminar
California Health Benefit Exchange update, Dual Eligibles demonstration, Medi-Cal transition to DRG

June 6, Sacramento
June 12, Glendale
June 13, Irvine

Overview

Dramatic changes are headed our way. Implementation of the ACA’s major provisions includes the launch of the California Health Benefit Exchange, and state- and federal-based Medi-Cal expansion. Medi-Cal payment is transitioning to a DRG-based methodology and the dual eligible demonstration and ICD-10 implementation are on the horizon, as well.

Hospital financial executives will need to move fast to plan for these important transitions. Virtually every key hospital department will be impacted: admitting, managed care, clinical, information systems and finance. All will require training and operational changes to manage the new requirements.

This seminar will inform you on the latest issues impacting health care finance and reimbursement. Make plans now to attend, and learn about the changes to come in delivery and payment of care.

Register now; programs begin soon.

 
Program co-sponsored by: 

Healthcare Financial Management Association Southern California Chapter

Program 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

9:00 a.m. – 12:00 p.m.
Medi-Cal Update

  • Medi-Cal expansion — ACA and state-based requirements
  • Rural expansion update — payment models, timelines
  • Medi-Cal DSH reductions — reform, virtual vs. real
  • AB 97 — litigation update, new legislation to restore DP/NF rates
  • State Budget May Revise — what to expect

Dual Eligibles and the Coordinated Care Initiative

  • Who will be impacted — beneficiaries, demonstration counties
  • Enrollment, default enrollments, excluded duals
  • Plan and provider contracts — negotiations, readiness reviews
  • Case management, authorizations, utilization, discharge

California ICD-10 Implementation

  • Timelines for implementation
  • Anticipated impact on hospitals — clinical, information systems
  • Transition strategies for hospitals — systems, staff, physicians
  • Planning forward — workforce availability, readiness
  • Software considerations

12:00 – 1:00 p.m.
Hosted Luncheon

1:00 – 4:00 p.m.
California Health Benefit Exchange and CalHEERS

  • Qualified health plans — products, premiums, cost-sharing
  • Eligibility and enrollment process, timelines
  • Hospital staffing — clarifying the role of assisters
  • Ethics issues and “steering” patients — ramifications

Medicare Update

  • Highlights of Inpatient Prospective Payment System rule
  • DSH reform — how calculation methods will change
  • Inpatient Part B billing update — rules, timelines, eligible charges
  • Litigation update — cases impacting hospitals

Transitioning to DRGs

  • Implementation timeline and transition period
  • Payment — APR-DRG methodology, policy adjusters, exclusions
  • Updated billing requirements — clinical documentation
  • Simplified treatment authorization requests

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.

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 health care associations and clients on reimbursement, regulations, compliance and disclosure matters.

Jordan B. Keville is a partner in HLB’s Los Angeles offices, where he focuses his practice on reimbursement and regulatory issues for health care providers. Mr. Keville has been actively involved in several large-scale litigation matters related to Medicare and Medicaid reimbursement policies.

Jonathan Wunderlich is the assistant deputy director for Healthcare Financing
at the Department of Health Care Services. In this capacity, Mr. Wunderlich is leading the Department’s efforts to implement a Diagnosis-Related Groups payment methodology for hospital inpatient services in the fee-for-service delivery system. He also works on an array of other financing issues with the fee-for-service and managed care financing divisions within the Department, including the project to increase
primary care physician rates consistent with the Affordable Care Act.

Dawn Weimar, RN, BSN, CORA, is a senior consultant for Payment Method Development at Xerox Government Healthcare Solutions. She has over 20 years’ experience creating, implementing and evaluating solutions for Medicaid and private health plans.  Ms. Weimar is the Project Director for APR-DRG implementation in California, as well as the District of Columbia.

Robin Noda, is a senior project manager in Strategic Planning and Program Management, Network Management with Blue Shield of California. Ms. Noda is member of the California ICD-10 Collaborative.

Catherine Mesnik is a finance director for St. Joseph Health and leads the ICD-10 finance team, as part of the Revenue Cycle Optimization division.  She has over 15 years of experience in the health care industry, providing financial operations, business analytics and revenue cycle expertise to hospitals and medical groups.

Amber Ott is CHA’s vice president of finance and represents members’ financial interests related to Medicare, Medi-Cal, commercial payers and other government entities. In this role Ms. Ott is responsible for advocacy and support on financial and reimbursement issues affecting California hospitals and health systems.

Amber Kemp is CHA’s vice president of health care coverage and provides advocacy and support regarding government-funded programs and other health care coverage policy issues affecting California hospitals and health systems.

Sites

June 6, 2013
Hyatt Regency

1209 L Street
Sacramento, CA 95814

June 12, 2013
Hilton Los Angeles North/Glendale

100 West Glenoaks Boulevard
Glendale, CA 91202

June 13, 2013
Hilton Irvine/Orange County Airport
18800 MacArthur Boulevard
Irvine, CA 92612

Tuition/CEs

Members $325 (CHA member hospitals, CHA associate members and government agencies)
Nonmembers $525 (Limited to: Non-hospital health care providers, clinics, post-acute facilities, and consultants, insurance companies, law firms and other entities that serve hospitals.)

Education programs and publications are a membership benefit and are not available to non-member California hospitals.

Members of co-sponsoring organizations may register at the CHA member rate. (Note: some exclusions may apply.)

Tuition includes CEs, lunch and course materials.

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 or e-mailed to education@calhospital.org. No refunds will be made after these dates. Substitutions are encouraged. Please note: payment is due on or before program. Payments not received by the seminar date will be subject to a 10% late fee. In the unlikely event the program is cancelled, CHA will fully refund paid participants within 30 days.

Special Accommodations or Questions: If you require special accommodations pursuant to the Americans 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 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 one or more of the following areas: Application of Management Practices for the Compliance Professional; Application of Personal and Business Ethics in Compliance; Written Compliance Policies and Procedures; Designation of Compliance Officers and Committees; Compliance Training and Education; Communication and Reporting Mechanisms in Compliance; Enforcement of Compliance Standards and Discipline; Auditing and Monitoring for Compliance; Response to Compliance Violations and Corrective Actions; HIPAA Privacy Implementation. Granting of prior approval in no way constitutes endorsement by CCB of the program content or the program sponsor.  CCB program code # CAHA-040. (Note: CEU recipients for compliance are responsible to send/report a completed version of their certificate to HCCB to obtain CEU credit.)

Health Care Executives — CHA is authorized to award 5.5 hours of pre-approved ACHE Qualified Education credit (non-ACHE) for this program toward the advancement, or recertification in the American College of Healthcare Executives. Participants in this program wishing to have the continuing education hours applied toward ACHE Qualified Education credit should indicate their attendance when submitting application to the American College of Healthcare Executives for advancement or recertification.

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

Commands