Agenda

Tuesday, October 13

8:15 – 9:15 am

General Session: Hot Topics from the Center for Medicare and Medicaid Services

Kimberly Brandt, Director Program Integrity Group, Centers for Medicare & Medicaid Services

9:30 – 10:30 am

General Session: OIG Hot Topics

David M. Blank, Senior Counsel, Office of Counsel to the Inspector General, Administrative and Civil Remedies Branch Division,
Department of Health and Human Services

11:00 am – 12:00 pm

501 De-Nile Ain’t Just A River in Egypt

Susan Welsh, MHA, CPC, CPC-I, PCS, Compliance Manager, HMA

• Identifying your hit list of denials
  
• How to ‘root cause’ your denials
  
• Improving the process to eliminate the denials

502 Theories of Liability and Defenses under the False Claims Act

Gabriel Imperato, Esq., CHC, Managing Partner, Broad & Cassel

• A review of cases involving claims for services not provided, but claimed; claims not provided as claimed and quality of care theories of liability and evidentiary proof in these types of false claims cases
  
• A review of issues arising in a false claims case premised on a violation of the Anti-Kickback Statute and/or the Stark Law
  
• A review of recent amendments to the False Claims Act and the impact on physicians and other providers of health care service

12:00–1:00 pm Lunch

1:00 – 2:00 pm

601 When to Hold Your Tongue: The Benefits and Risks of Self‑Disclosure

Michael F. Schaff, Esq., LLM, MBA, Chair, Corporate & Healthcare Departments, Wilentz, Goldman & Spitzer, PA
Alyson M. Leone, Esq., Associate, Wilentz, Goldman & Spitzer, PA

• Overview of OIG’s Provider Self-Disclosure Protocol, including recent changes to protocol
  
• Why Self-Disclose? What are the benefits? Why hold your tongue? What are the risks?
  
• How are other physicians implementing the Self-Disclosure Protocol?

602 Identity Theft Prevention: The FTC’s Red Flags Rules and Health Care Providers

Rebekah A.Z. Monson, Senior Attorney, Pepper Hamilton LLP

• A discussion of Medical Identity Theft and the FTC’s Red Flags Rules
  
• Exploring who must comply with the Red Flags Rules and where health care providers fit in
  
• Establishing an identity theft prevention program, including the FTCs Guidelines on Developing and Implementing a Written Program

2:30 – 3:30 pm

701 Risky Business: Physical Therapy in the Physician Office

Sheila K. Nicholson, Esq., MBA, MA, PT, Partner, Quintairos, Prieto, Wood & Boyer, P.A.
Nancy Beckley, MB, MBA, CHC, President, Bloomingdale Consulting Group, Inc.

• Analyzing: why rehab and therapy services offered “incident-to” are being targeted for compliance audits and overpayment recovery
  
• Accountability: in delivery and billing for therapy services
  
• Improving: internal controls for compliance in therapy services
  
• Documentation: do your therapy forms facilitate compliance proactively?

702 Does Coding Affect Compliance?

Ronda Tews, CPC, CHC, CCP-P, Corporate Compliance Project Manager, St. John’s Health System

• Coding accurately and responsibly
  
• Coding and Compliance go hand-in-hand
  
• Why is the OIG motivated?

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