Education event

Hospital Finance and Reimbursement Seminar
Medi-Cal and Medicare updates, Quality Assurance Fee, Covered California evolves

Register Now
June 23, Pasadena

Overview

Government has been busy this year.
There’s been a lot of activity at federal and state levels that will impact how hospitals are reimbursed, and also change the way we care for patients. New this year:

  • Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act will require hospitals to tell Medicare patients when they are receiving care under “observation.”
  • Comprehensive Joint Replacement (CJR) program participation is now mandatory for many California hospitals.
  • Physicians have a “permanent doc fix” for reimbursement under the Medicare Access & CHIP Reauthorization Act (MACRA), but need to choose between payment models.
  • Covered California is actively working to change their delivery system, requiring new quality reporting criteria and payment tied to outcomes.
  • Medi-Cal is considering implementing readmission measures, and updates to the APR-DRG system are on the horizon.
  • Two important ballot initiatives have the potential to significantly impact your hospital’s bottom line.

Learn how these and other key finance and reimbursement issues will change the way hospitals conduct business.

Make plans now to attend. First program is June 15.

Recommended for:

Chief executive officers, chief financial officers, chief operating officers, reimbursement directors, patient financial services directors, revenue cycle directors, controllers, managed care directors, compliance officers, in-house legal counsel and financial consultants.

Program co-sponsored by:

Healthcare Financial Management Association Northern California Chapter
Healthcare Financial Management Association Southern California Chapter
(Members of the co-sponsoring organizations may register at the CHA member rate.)

Agenda

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

  • Medi-Cal litigation update — important cases impacting hospitals
  • Financial relief for DPNFs
  • EHRs — review of federal audits, implications for what is uncovered
  • Quality Assurance Fee program — November initiative, legislation, CHOWs
  • APR-DRG operational improvements — fixes and changes to come
  • 340B Drug Pricing Program — proposed Omnibus Guidance, pending litigation

California Health Care Coverage Update

  • Ensuring access to care for Medi-Cal patients, addressing network adequacy
  • Medi-Cal 2020 waiver renewal — impact on hospitals
  • State initiatives to coordinate care for vulnerable populations
  • Impact of Medicaid Managed Care Rule in California
  • Covered California delivery system reforms — upcoming quality reporting requirements

12:00 – 1:00 p.m. Hosted Luncheon

1:00 – 4:00 p.m.
Medicare Updates

  • Inpatient Prospective Payment System (IPPS) updates
  • Medicare DSH — litigation, S10 data 
  • Medicare revalidation — new enrollment rules
  • NOTICE Act — new patient notification of observation status
  • MACRA — choosing MIPS or APM reimbursement models
  • 60-day rule for overpayment

What Should be on Your Medicare Radar

  • Critical intersection of quality of care and payment
  • Section 603 — site-neutral payment for new outpatient clinics
  • Medicare Part B new drug payment model
  • Two-midnight rule and QIO reviews
  • Comprehensive Joint Replacement (CJR) payment model

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 former chair of the firm’s Regulatory Department. Mr. Hellow focuses his practice on Medicare and Medicaid payment policy issues and represents hospitals and hospital systems in Medicare and Medicaid payment disputes before federal and state administrative agencies and courts. He also advises clients on reimbursement and other regulatory implications of their business transactions, and in compliance and disclosure matters. (Southern California seminars)

Robert Roth, managing partner of HLB’s Washington, D.C. office, advises clients on matters arising under Medicare and Medicaid, focusing on payment, compliance, and licensing issues.  A former senior attorney for the Centers for Medicare & Medicaid Services of the U.S. Department of Health and Human Services, and a former Assistant Attorney General for the State of Maryland, Mr. Roth represents a wide range of clients on federal and state regulatory and business matters. (Sacramento seminar)

Alyssa Keefe is California Hospital Association’s (CHA) vice president of federal regulatory affairs and is responsible for policy development and analysis of federal regulation impacting California hospitals and health systems. Ms. Keefe serves as a liaison between CHA and federal agencies, including the Centers for Medicare & Medicaid Services.

Amber Kemp provides advocacy and support regarding government-funded programs and other health care coverage policy issues affecting California hospitals and health systems. Previously, Ms. Kemp worked at the Department of Health Care Services (DHCS) where she managed the implementation of the Medi-Cal Section 1115 Waiver for the Delivery System Reform Incentive Payments (DSRIP) for designated and non-designated public hospitals. Prior to joining DHCS, she served as a special assistant to state Board of Equalization member Betty Yee.

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

Sites

June 23, 2016
Hilton Pasadena

168 S. Los Robles Avenue
Pasadena, CA 91101
Website

Tuition/CEs

New: Presentations will be available online only
To conserve resources and protect the environment, CHA will no longer provide printed presentations. You will receive an email before the event with instructions on how to download the presentations to your laptop/tablet for viewing on-site, or to print and bring with you. Be sure to download the materials in advance; WiFi access on-site may be limited.

*Members $335
**Nonmembers $535

Members of the co-sponsoring organizations (with the exception of nonmember California hospitals) may register at the CHA member rate.

* Members are CHA member hospitals, CHA associate members and government agencies. ** Nonmembers are 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 eligible nonmember hospitals.

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 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 may 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 professional license number. CE certificates will be emailed.

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. (Note: CE recipients are solely responsible for retaining a copy for their records and for reporting credits to CCB)

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 participatory activity has been approved for 5.5 hours of MCLE credit. Provider #1980.

Resources

The California Hospital Compliance Manual is the only publication written for hospital compliance officers that integrates California law and federal law on high-risk compliance areas. Written by Hooper, Lundy & Bookman, PC, and CHA, the 2016 edition has been updated to reflect changes through Jan. 1, 2016.

The manual focuses on the key topics and laws that must be addressed in an effective compliance program. To learn more or to order, click here.

Commands