brochure - The American Health Lawyers Association

More documents

Recommendations

Info

4 Program Agenda 202. Medicaid Fraud Enforcement Update Mark Moskovitz/ Richard Roberson/Jack Wenik 203. False Claims Acts Practice—It Ain’t the Same Since It All Changed: Real World Update Margaret Hutchinson/Kathleen McDermott ••Since the 2009 and 2010 amendments, False Claims Act practice has been transformed by a shift in legal elements and a new civil investigative demand (CID) practice which allows civil Assistant U.S. Attorneys to seek records, interrogatories and depositions at the infancy of an investigation and share the information with enforcement partners and the whistleblower’s counsel ••The False Claims Act amendments and DOJ enforcement priorities signal that the conventional wisdom of False Claims Act practice is changing; our assumptions and forecasts need a tune-up ••What’s going on and what you can expect in a False Claims Act investigation in this new era of enforcement 204. Compliance and Criminal and Civil Liability for Overpayments David M. Glaser/Gabriel L. Imperato ••The criminal statutory obligation to return a “known overpayment” and how compliance professionals can avoid traps for the unwary ••Liability for retention of a “known overpayment” under the False Claims Act and Civil Money Penalty Statute and why this is a game changer ••The rules implementing the obligation to return a “known overpayment” including scope of liability and time for disclosure and repayment ••A compliance professionals “road map” for responding to the potential for organizational overpayment liability 205. Electronic Health Records: Auditing Quality and Compliance (not repeated) Amy Bailey‑Muckler/Laura Roberts ••Implementing an EMR for successful documentation to support coding, billing and quality of care ••Auditing the final product ••Mitigate your risk and promote compliance 206. RACs, MACs, ZPICs and Other Audit Contractors: Latest Developments and Successful Strategies for Combating Medicare Audits (not repeated) Steven Greenspan/Andrew B. Wachler ••Recent developments related to RAC, MAC, and ZPIC audit activity and emerging issues, including the RAC pre-payment demonstration program, Medicaid RAC activity, and the interplay of audits and CMS’s proposed rule regarding overpayment identification and reporting ••Successful appeal strategies for healthcare providers defending against RAC, MAC and ZPIC audits, including new developments regarding effectuating full Part B reimbursement when the inpatient hospital admission is denied as not medically necessary ••The impact of RACs, MACs and ZPICs on fraud and compliance considerations and how providers can prospectively mitigate risks by integrating key compliance strategies. 12:15–1:30 pm Lunch on your own or attend the AHLA Fraud and Abuse Practice Group Luncheon, sponsored by PYA (additional fee; limited attendance; pre-registration required; see page 11) Emerging Trends in False Claims Act Enforcement Laura F. Laemmle‑Weidenfeld, Esq. (Moderator), Patton Boggs LLP, Washington, DC Daniel R. Anderson, Esq, Deputy Director, Civil Division, U.S. Department of Justice, Washington, DC Paul Kaufman, Esq., Assistant U.S. Attorney, EDNY, Chief, Civil Healthcare Fraud, Brooklyn, NY CONCURRENT SESSIONS 1:45–2:45 pm 301. Enrollment/Payment Suspension as Enforcement Tools (not repeated) Julie Burns/Judith A. Waltz ••Provider/supplier enrollment actions ••Temporary enrollment moratoria ••Billing privileges deactivations/revocations ••Medicare and Medicaid payment suspensions, including new ACA authorities for suspensions based on investigations of credible allegations of fraud 302. ACO Valuation Issues and Economic Challenges in Light of the Regulatory Guidance Thomas E. Bartrum/Albert D. Hutzler ••The “fair market value” standard for ACO transactions in light of the government waivers—which valuation standards apply and when ••The IRS guidance and factors, including proportionality factor and how to determine proportionality of contributions to an ACO ••The Medicare Shared Savings Program risk profile tracks and their impact on transaction terms and values ••ACOs involving private insurance carriers in the current climate ••Risk of government revisions to the waivers and potential unwind provisions 303. Exclusions and Administrative Penalties Robert M. Penezic/Richard Westling 304. Integrating Quality into Your Compliance Program (not repeated) Shawn Y. DeGroot/Robert H. Ossoff ••Why quality of care needs to be integrated into a compliance program ••The eleven “Never Events” ••Why compliance must be more engaged in the quality of documentation 305. Why Healthcare Employees Become Whistleblowers (not repeated) Joseph E.B. White ••What pushes employees to become whistleblowers ••The right way to work with would-be whistleblowers ••How corporate executives and boards of directors undermine compliance efforts 306. Effective Vendor Risk Management: A Streamlined Approach (not repeated) Cliff Baker/LeeAnn Foltz ••The common challenges organizations face when managing vendor risk ••The steps and activities of an efficient and effective approach to managing vendor risk ••How technology can best be used to support vendor risk management activities 3:00–4:00 pm 401. Strategies for a Medical Necessity Case– From Investigation to Final Resolution (not repeated) Ankur J. Goel/Daniel J. Mulvanny ••Identifying and consistently evaluating medical necessity issues ••Strategies for communication with patients, physicians, Board members, and the community ••Mitigating adverse consequences on the community, the provider, the employees, and physicians ••How and when medical necessity issues become False Claims Act cases ••Strategies for self-disclosure, and defense and resolution of medical necessity investigations
Program Agenda 402. Lessons from the Front Lines: How Providers Are Responding to the 60-Day Refund Rule Lawrence W. Vernaglia/Jennifer Neyan Willcox ••Key challenges in implementing the new rule ••What does it mean to “identify” an overpayment? ••Applying CMS’s views on the statute and managing exposure ••Should providers be designing institutional policies to respond? ••How has the 60-Day Refund Rule changed practice? 403. Legal Ethics: Legal and Ethical Issues in Defending Multi-Party Healthcare Fraud Investigations Robert M. Brennan ••Determining whether an employee or former employee needs separate counsel ••Upjohn Warnings/Corporate Miranda Warnings and interviews of employees and former employees ••Common interest privilege and joint defense agreements between companies and individuals ••Counseling individuals and the decision whether to cooperate with the company ••Preparing witnesses for civil investigative demand testimony 404. Effective Strategies for Mitigating Stark Risk (not repeated) Daniel R. Roach ••What you should know about Stark and how it can affect your organization ••Simplification, education, and controls: The three keys to Stark compliance 405. Medicare Advantage and Part D Plans: Getting Your House in Order Dorothy DeAngelis/Lauren N. Haley ••Revised compliance guidance: An overview of CMS’s new Compliance Guidelines and expectations for an effective compliance program ••Audits, audits and more audits: CMS performance and outcomes-based audit methodology ••Identified risk areas: Setting oversight priorities and practical strategies to monitor first tier, downstream and related entities 406. FCA Whistleblower Counsel Panel: Candid Observations and Insights by Experienced Counsel (repeat of 102) 4:15–5:15 pm 501. False Claims Act and Litigation Update (not repeated) Laurence J. Freedman/Michael D. Granston ••Noteworthy appellate and district court decisions on the False Claims Act in 2011–2012 that have significance for hospitals and health systems, and other healthcare providers ••Developments in FCA enforcement after the Fraud Enforcement and Recovery Act of 2009 and the 2010 Amendments to the False Claims Act 502. Antikickback and Stark Update Thomas S. Crane ••The importance of health care reform changes to AKS enforcement ••Stark and OIG self-disclosure updates ••Tuomey 4th Circuit Stark law decision ••Recent AKS discount cases ••ACO and demonstration project waivers 503. Understanding the Advice of Counsel Defense in an Era of Increased Healthcare Fraud Enforcement (repeat of 103) 504. Update on the DOJ’s National ICD Investigation (not repeated) Kevin A. Cornish/Frank E. Sheeder III ••Current status of the government’s investigation ••Government themes and hospitals’ defenses ••Practical approaches 505. OCR/Audits (not repeated) Michael Ebert ••Structure and reporting by OCR for the ongoing performance audits mandated by HITECH ••Common issues and readiness ••Why we struggle with compliance with the HIPAA/Hitech rules 506. CIAs–New Standards: What Enhanced Corporate Integrity Obligations Tell Us about OIG Expectations for Compliance Programs (repeat of VIII) 5:15–6:30 pm Reception sponsored by HealthCare Appraisers, Inc. and KPMG (attendees, speakers, and registered companions and guests are welcome) TUESDAY, OCTOBER 2, 2012 7:00 am–4:00 pm Registration and Information 7:00–8:00 am Continental Breakfast sponsored by HealthCare Appraisers, Inc. and KPMG (attendees, speakers, and registered companions and guests are welcome) GENERAL SESSION 8:00–9:00 am Keynote Address Kathleen Sharp 9:00–9:30 am Coffee Break sponsored by HealthCare Appraisers, Inc. and KPMG CONCURRENT SESSIONS 9:30–10:30 am 601. Hospice/Home Health/SNFs: Fraud in Post-Acute Care Settings (not repeated) William A. Dombi/Harvey M. Tettlebaum ••The focus and impact of recent fraud prosecutions in home health care, hospice and SNFs ••RAC and ZPIC targets in home care and SNFs ••Emerging program integrity proposals by the home care and hospice community ••The new frontier of Medicaid oversight in home care services ••2012 OIG Work Plan Items For SNFs ••Nursing Home Transparency Requirements in PPACA 602. Exclusions and Administrative Penalties (repeat of 303) 603. Legal Ethics: Legal and Ethical Issues in Defending Multi-Party Healthcare Fraud Investigations (repeat of 403) 5
Page 1 and 2: September 30-October 2, 2012 Renais
Page 3: Program Agenda VIII. CIAs-New Stand
Page 7 and 8: Speakers PLANNING COMMITTEE (ALSO S
Page 9 and 10: Program at a Glance 3:00-4:00 pm 4:
Page 11 and 12: Registration Fraud & Compliance For

brochure - The American Health Lawyers Association

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?