Tuesday, August 30, 2022
General Session
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9:00 AM - 10:00 AM, ET
| 1.00 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM
GS1: OIG Priorities, Enforcement, and Compliance
Andrea Treese Berlin; Thomas Brannon
This session will provide updated information about the Office of Inspector General for the Department of Health and Human Services (OIG) including an overview of the OIG’s structure, mission, current priorities, recent settlements, and data analytics. These topics will be incorporated into tips for enhancing compliance policies and procedures for coders.
Breakout Session 1
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10:15 AM - 11:30 AM, ET
| 1.25 CEUs CPMA, COC, CPC, CPC-P, CEMC, CPB, CPCO, CPPM
1A: Telemedicine – Regulations
Kyle Faget
This session will focus on key telehealth regulatory and compliance issues faced by healthcare providers. Topics include key terms, licensure, practice standards, required modalities, prescribing controlled substances, privacy, and coverage and reimbursement. Standards applied during the public health emergency will also be addressed.
10:15 AM - 11:30 AM, ET
| 1.25 CEUs CPMA, COC, CPC, CPC-P, CEMC, CPB, CPCO, CPPM
1B: 2021 E/M Guidelines – Risk Associated With Coding for Time and Compliance Concerns for Medically Relevant History and Exam
Jaci J. Kipreos, COC, CPC, CDEO, CPMA, CRC, CPC-I, CEMC; Raemarie Jimenez, CPC, CDEO, CIC, CPB, CPMA, CPPM, CPC-I, CANPC, CRHC
In this session we will discuss the new E/M guidelines that go into effect January 1, 2023. We will review best practices we learned during the implementation of the 2021 E/M guidelines for office and other outpatient services to assist with this new round of revisions. We will discuss areas of risk and how to address through compliance polices.
Breakout Session 2
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12:30 PM - 1:45 PM, ET
| 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM
2A: Enforcement Trends, Compliance, and the False Claims Act
Michael E Paulhus; Kasey Ashford
This session will cover OIG enforcement trends, the current state of the False Claims Act, and important legal cases, along with compliance pointers for evolving enforcement trends.
12:30 PM - 1:45 PM, ET
| 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM
2B: No Surprise Billing
Stacy Nicole Harper , JD, MHSA, CPC
Effective January 1, 2022, the Federal No Surprises Act went into effect and providers are required to be in compliance with both the Good Faith Estimate and Out of Network billing requirements. These new regulations are certain to change the way that health care providers interact with uninsured and out-of-network patients. This presentation will focus on the initial requirements and impacts to health care providers and facilities. We will discuss the requirements under the No Surprises Act, review the notice requirements for uninsured and out-of-network patients, develop strategies for provision of the good faith estimate, and analyze the notice and consent process for out-of-network services. With the foundation of the current requirements, we will identify the additional requirements that are coming later in 2022 and talk about things that every provider needs to know and best practices to ensure compliance and minimize risk of non-compliance or enforcement.
Breakout Session 3
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2:15 PM - 3:30 PM, ET
| 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM
3A: Fraud and Abuse Anti-kickback
Stephen Angelette
This session will provide outside counsel perspectives on the Anti-kickback Statute and Stark Law, when they apply, their role in transactional matters from strategic and operational design to implementation, and the life cycle of investigations into allegations of violations of the Anti-kickback Statute and Stark Law. New and interesting enforcement activity will be discussed, as well as strategies for responding to government investigations.
2:15 PM - 3:30 PM, ET
| 1.25 CEUs CPMA, COC, CPC, CPC-P, CDEO, CPB, CPCO, CPPM
3B: Best Practices Under Attorney Client Privilege
Michael D Miscoe, Esq, CPC, CPCO, CPMA, CASCC, CCPC, CUC
This presentation will discuss the scope, limits, and exceptions to the rule that protects certain communications between an attorney and a client from disclosure. We will also discuss how this rule applies to consulting and testifying experts and, where applicable, how to mark such written communications. Attendees will also be advised of the more common ways that privilege is lost or waived (overtly or accidentally) and what to do if privileged information is erroneously disclosed.
Breakout Session 4
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4:00 PM - 5:15 PM, ET
| 1.25 CEUs CPMA, COC, CPC, CPC-P, CDEO, CPB, CPCO, CPPM
4A: Effectiveness of Compliance Programs
Rhonda Buckholtz, CPC, CDEO, CPMA, CRC, CENTC, CGSC, COBGC, COPC, CPEDC, Approved-Instructor
In this session we will talk about how to develop, maintain, and monitor compliance policies that are most beneficial to your practice. Through hot spots, benefits, and template use, attendees will learn the skills needed to enact a diverse compliance program.
4:00 PM - 5:15 PM, ET
| 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM
4B: Managing Conflicts of Interest
Josephine Nelson Harriott; Charise R Frazier
The session will identify situations that may give the appearance of a conflict of interest, explore ethical considerations for compliance officers and attorneys, identify organizational and employee actions that can be taken to mitigate any potential conflict of interest, and explain responsibilities of individual employees.
Wednesday, August 31, 2022
General Session
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9:00 AM - 10:15 AM, ET
| 1.25 CEUs CPMA, COC, CPC, CPC-P, CIC, CPB, CPCO, CPPM
GS2: COVID-19 Compliance Investigations
Christopher Adam Parrella, CPC, CPCO; Courtney Tito; Leonta Williams, CPC, CPCO, CRC, CEMC, CHONC; Stephanie M Sjogren, COC, CPC, CDEO, CPMA, CPC-I
Many regulations were lessened during COVID-19 such as telemedicine, remote patient monitoring as well as increased funding for many practices. Audits have shown areas of fraud and these services and funds are continuously being investigated to make sure we complied with the regulations and other requirements. This panel session will help you get your top questions answered on compliance and what to look for.
Breakout Session 5
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10:30 AM - 11:45 AM, ET
| 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM
5A: Understanding the (Not So) Voluntary Disclosure Rule
Michael D Miscoe, Esq, CPC, CPCO, CPMA, CASCC, CCPC, CUC
This session will address the voluntary disclosure and refund requirements imposed under the FERA and ACA amendments to the False Claims Act. Each element of the rule will be addressed in detail, including when the 60-day reporting clock begins to run, what constitutes credible information of a potential overpayment, and what constitutes reasonable diligence once credible information of an overpayment is received. The session will also address how audit findings should be drafted to preclude inappropriate disclosure liability, risks, and penalties for non-compliance, as well as the submission requirements when an overpayment is discovered.
10:30 AM - 11:45 AM, ET
| 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM, CRC
5B: Current Issues and Practical Advice on Doing Risk Adjustment Right
Jeffrey B Miller Esq; Sheri Poe Bernard, COC, CPC, CDEO, CRC, CPC-I
Stakes are in the billions as the OIG and DOJ go after large settlements against Medicare Advantage plans and providers accused of false claims tied to risk adjusting diagnosis codes. Attorney Jeffrey Miller and Sheri Poe Bernard will discuss CMS’ patterns in targeting and predicting organizational audit risks and also provide insight and advice on actions to take now to prevent future negative audit results.
General Session
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11:45 AM - 12:45 PM, ET
| 1.00 CEUs COC, CPC, CPC-P, CPB, CPPM
GS3: Networking Lunch
Breakout Session 6
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12:45 PM - 2:00 PM, ET
| 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM
6A: The Compliance Board
Rhonda Buckholtz, CPC, CDEO, CPMA, CRC, CENTC, CGSC, COBGC, COPC, CPEDC, Approved-Instructor
Making sure your compliance program meets all the recommendations for an effective compliance program is important — but making sure the compliance program has the proper oversight from a governing board or compliance committee is paramount to its success. This session will cover compliance program oversight expectations of boards, best practices in roles and responsibilities as they relate to the board, and lessons learned from boards that did not meet their compliance oversight responsibilities.
12:45 PM - 2:00 PM, ET
| 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM
6B: MS-DRG Validations
Todd Husty, DO
MS-DRGs drive inpatient reimbursement. There are many factors that support the proper MS-DRG assignment. In this session we will discuss the importance of MS-DRG validation and best practices for compliance.
Breakout Session 7
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2:30 PM - 3:45 PM, ET
| 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM
7A: HIPAA Update and Enforcement
Astara N Crews, CPC, CPEDC
HHS-OCR has announced several updates and enforcement discretions. Additionally, proposed changes to the Privacy Rule while OCR continues to enforce violations against providers for potential information blocking. This webinar provides an overview of some of these items, as well as addressing key concepts in the context of protecting the confidentiality, integrity, and availability of protected health information.
2:30 PM - 3:45 PM, ET
| 1.25 CEUs CPMA, COC, CPC, CPC-P, CPB, CPCO, CPPM
7B: Opioid Enforcement and Compliance Risks
CJ Wolf MD MEd CPC COC, COC, CPC
As public health efforts continue to try to slow the opioid epidemic in the United States and federal law agencies fight on the enforcement front, it’s important that your healthcare organization’s compliance program addresses risks associated with this devastating epidemic. This session will focus on recent DOJ and OIG enforcement actions against healthcare providers associated with opioid diversion and/or overprescribing; compliance program strategies for addressing compliance risks associated with opioids; and free tools, resources, and clinical guides specifically designed to help healthcare organizations address opioid epidemic risks.