September 25–27, 2011 - American Health Lawyers Association

2Program AgendaProgram MissionThe AHLA/HCCA Fraud and Compliance Forum will provide practicalguidance on the pressing legal and compliance issues that havearisen in the last twelve months. The program’s uniqueness stems notonly from the important content for health lawyers and complianceofficers, but also from the additional value of bringing together legalcounsel and compliance officers in one educational arena. The Fraudand Compliance Forum is jointly sponsored by the Health CareCompliance Association (HCCA) and the American Health LawyersAssociation (AHLA). It includes an explicit designation of each sessionas “compliance focused” or “legal focused.” The Planning Committee hasincluded enough sessions in each designation that an individual couldattend all “compliance” sessions or all “legal” sessions for the entireprogram. Yet an attendee also has the option of selecting a diversity ofsessions and networking with an expanded group of individuals.Program Goals and Objectives• Gain a greater understanding of the full nature of the variousregulations governing the delivery of healthcare (Stark,False Claims Act)• Recognize emerging regulatory trends that will affect legal andcompliance practices in healthcare• Network with peers and learn about the challenges and risk areasfaced by a wide variety of healthcare settings (hospitals, academicmedical centers, physician practices, long-term care providers,pharmaceutical manufacturers)• Recognize the common issues faced by compliance and legalprofessionals, the roles each play in ensuring compliance and ways inwhich they can effectively work togetherWho Should AttendHealth Law Attorneys / Compliance Professionals / Billing and CodingProfessionals / Third-Party Billing Professionals / Chief ExecutiveOfficers / Chief Operating Officers / Chief Technology Officers / ChiefFinancial Officers / Medical Directors / Physicians / Managed CareProfessionals / Medical Group Managers / Data Managers / EthicsOfficers / Health Insurance Executives / Consultants / GovernmentAgency Employees / Health Administration Faculty / Risk Managers/ Pharmacists / Quality Assurance Professionals / Registered Nurses /Long-Term Care ProfessionalsSunday, September 2511:30 am–5:30 pmRegistration and Information1:00–2:30 pm (Extended Sessions)I. Fraud and Abuse Primer (not repeated)James G. Sheehan••Fraud, abuse, and improper payments-definition and identification••Significant fraud and abuse risk areas for compliance officers and in-housecounsel in healthcare organizations••The fraud and abuse investigative process (public and private) – how is itinitiated, how it develops (including video demo)••Role of effective compliance programs and counsel in preventing fraudand abuse, and minimizing adverse outcomes from investigations••Bad outcomes for organizations from compliance failures (the good onesare seldom public)II. Compliance 101 (not repeated)Debbie Troklus••Factors to consider when developing and implementing a complianceprogram••Elements of an effective compliance program••Keys to maintaing an effective compliance program••Techniques used to assess risk, audit and monitor vulnerabilities, developwork plans and corrective actions, and establish program metricsIII. Healthcare Reform and Beyond: What ComplianceProfessionals Need to Know (not repeated)Shawn Y. DeGroot / Frank E. Sheeder2:45–4:15 pm (Extended Sessions)IV. Stark Primer (not repeated)Joan P. Dailey / David E. Matyas••The Statute and regulatory issuances••Exceptions to the prohibition••Difference between Stark and Anti-Kickback••Current enforcement environment and the Self-Disclosure ProtocolV. Corporate Integrity AgreementsLaura E. Ellis / Charles D. Overstreet / John S. RahVI. Mandatory Compliance ProgramsVernisha Robinson / Brenda Tranchida••Regulatory requirements••Compliance plan effectiveness••Compliance officer and organizational best practices••Compliance plan audit results4:30–5:30 pmVII. Hitchhiker’s Guide to the Anti-Kickback Statute(not repeated)Heidi A. Sorensen••The Statute, its Exceptions and the Safe Harbors••How to analyze an AKS issue••AKS compliance••Enforcement activity and litigation••Self‐disclosureVIII. Anatomy of a Federal Healthcare Fraud InvestigationJack E. Fernandez / Margaret HutchinsonIX. Making IDS Arrangements Work: Fraud andAbuse Considerations for ACOs and Other IntegratedArrangementsJulie E. Kass / Vicki L. Robinson••The requirements to qualify as an ACO under the MSSP••The fraud and abuse provisions relevant to ACOs and other integrateddelivery arrangements••Relevant government guidance••Hypotheticals and potential ways to structure ACOs and other integrateddelivery arrangements to comply with legal requirements5:30–6:30 pmWelcome Reception sponsored by HealthCareAppraisers, Inc. and KPMG (attendees, speakers and registeredcompanions and guests are welcome; Young professionals, please stopby and visit the Young Professionals information table.)

Program AgendaMonday, September 267:00 am–5:15 pmRegistration and Information7:00–8:00 amContinental Breakfast sponsored by HealthCareAppraisers, Inc. and KPMG (attendees, speakers and registeredspouses and guests are welcome)General Session8:00-8:15 amWelcome and IntroductionsDinetia M. Newman, AHLA President‐ElectFrank E. Sheeder, HCCA President8:15-9:00 amKeynote AddressLanny A. Breuer, Assistant Attorney General, Criminal Division,Department of Justice9:00–9:30 amCoffee Break sponsored by HealthCare Appraisers, Inc.and KPMG9:30–10:30 am (concurrent sessions)101. False Claims Act Primer (not repeated)Patric Hooper••Qui tam issues and limits on whistleblower actions••Liability theories, including express and implied certification issues••Damages and penalties issues••Legal and practical defenses102. e-Discovery: A Tactical Approach to Managing Riskand Reducing Cost (not repeated)Kenneth C. Koch / Dennis McKinnie••Identification of potentially relevant ESI within the enterprise: wheredata can exist and how to identify possible locations; mapping yourorganization’s ESI••Preserving/collecting ESI in a defensible manner: broad vs. targetedcollections; forensic imaging; audit trail/chain of custody••Search methods and tools: the latest in technological aides; pitfalls toavoid••Document review, analysis and support workflow processes••Benefits of taking a proactive approach: rapid cost projection; articulatingburden to requesting parties; building competence in-house103. Investigator Beware: Legal Ethical Issues inDefending Government InvestigationsJason E. Bring••Conducting the investigation – “Corporate Miranda” warnings andinterviewing employees••Who do you represent: the employee, the company, or the board?••Benefits and risks of joint representation••Avoiding a claim of obstruction – responding to subpoenas and producingdocuments••Do false statements to counsel that counsel relays to the government supportan obstruction charge?••Joint defense/common interest agreements and key provisions to avoidconflicts issues104. Auditing an Electronic Medical RecordLori A. Laubach / Schawn Pedersen••Pre- and post-implementation audits••AHIMA areas of concern••ARRA: Qualifying for incentives••Authorship integrity questions105. Compliance Clinical Documentation in the Era ofHealth Reform: ACOs, MACs/RACs and Facts (not repeated)Amy S. Leopard / Paul L. Weygandt••Traditional risks associated with clinical documentation, with updates onrecent fraud and abuse cases••New clinical information requirements in health reform initiativesinvolving ACOs, EHR Meaningful Use, bundled payments, readmissionmanagement and patient engagement••Ways to engage physicians appropriately without creating new risks••Compliance safeguards that help manage risks CDI programs face andsuccessfully defend the hospital in the event of investigations and the RACappeals106. Analyzing Data to Identify Fraud, Waste and AbuseJudi McCabe / Craig Spotser••How data can be used to identify aberrant utilization patterns and identityfraud, waste and abuse••Case Study: Using a business intelligence platform for data analysis toidentify fraud, waste and abuse10:45 am–12:15 pm (Extended Sessions)201. Advanced Stark (not repeated)S. Craig Holden / Kevin G. McAnaney••CMS Voluntary Disclosure Protocol••Impact of Bradford on physician practice acquisitions••Recent case law developments••New regulations effecting physician‐owned hospitals••Accountable Care Organizations202. Hospital-Physician Alignment and AcquisitionStrategies: Addressing Structural and ValuationChallenges and Recent Legal DevelopmentsGary W. Herschman / Hal McCard / Jason L. Ruchaber••Structural issues in light of recent decisions (e.g., Bradford), and recentgovernment arguments/positions (e.g., Tuomey appeal)••Challenges in applying traditional valuation methods and in usingtraditional transaction models••Practical recommendations (do’s, don’ts and maybe’s) for structuringphysician alignment strategies in light of recent legal developments••Practical advice for valuing physician acquisitions and compensationarrangements in the current (uncertain) regulatory environment••What to do about existing financial relationships that “may” not be noncompliant?203. Enforcement Initiatives against Individual Officers,General Counsel and Compliance OfficersMichael W. Paddock204. A Compliance Officer’s Guide to Mitigating StarkRisks (not repeated)Dwight Claustre / Dan R. Roach••Understanding: what every compliance professional should know aboutStark and how it can affect your organization••Education: a key to an organization compliance with Stark. What shouldit provide?• • Risk/reward: making it beneficial to leadership to focus on Starkcompliance3

Program Agenda405. PPACA and Accountability for Quality in Hospitalsand Nursing Homes (not repeated)Teresa Generous / Harvey M. Tettlebaum••Is deeming done? What hospitals can learn from the SNF experience withdirect surveys••When quality deficits become evidence of fraud or abuse••The difference in process: collaboration v. adversity••The whistle‐blower among us••Needed hospital and SNF compliance program changes to accommodatePPACA quality standards, new payment, collaboration and coordinationmodels and the shared savings program406. When Silence Isn’t Golden: Working with PotentialWhistleblowers and Avoiding Future LitigationDavid L. Haron / Sal A. Barbera••Tips for appropriately responding to potential whistleblowers and to helpavoid False Claims Act litigation••Myths about the typical whistleblower will be addressed and debunked4:15–5:15 pm501. Anti-Kickback Statute Current Developments(not repeated)Thomas S. Crane••How the new intent standard makes convictions easier••The importance of the anti-kickback statute as a health care offense••Linkage to the False Claim Act••Developments in the “one purpose” rule502. Fraud and Abuse Issues in Home Health, DME andHospice (not repeated)William A. Dombi••Compliance issues related to Medicare and Medicaid coverage of services••Provider qualifications and enrollment concerns and considerations••Patient referrals and solicitations under Stark and antikickback laws••Recent prosecutions, enforcement actions and OIG activity••New legislative and regulatory initiatives503. Repayments and Disclosures: Legal Authorities andthe Roles of RACs and MICsKatherine A. Lauer / Robert L. Roth••Legal authorities relating to repayments and disclosures under Medicareand Medicaid, including the Mandatory Repayment Provisions of thePatient Protection and Affordable Care Act (“PPACA”)••The significance of the heightening of Federal False Claims Act (“FCA”)liability by the mandatory repayment provisions in PPACA••Practical steps to take in response to the changes made by PPACA and thechanges made to the FCA by the Fraud Enforcement and Recovery Act of2009 (“FERA”)••How far back for overpayments you go/how far back the government cango; what is the effect of administrative finality••To which agency should you report and what should you say, includingthe effect of PPACA’s Medicare Self-Referral Disclosure Protocol••Special repayment and disclosure issues that arise from RAC/MIC Audits504. Winning Strategies in Claims Audit Appeals(not repeated)Frank W. Carsonie / Cornelia M. Dorfschmid••Appeal process and contractors••Stages of appeal process••Statistical and medical review criteria as part of the appeal strategy••Decision points••Do’s and don’ts in the appeals process505. Administrative Application of the ResponsibleCorporate Officer Doctrine (not repeated)Larry J. Goldberg / Thomas E. Herrmann••Legal standards governing the imposition of sanctions on health carecompany corporate officials and new authorities following health carereform••Implementation of OIG’s authority to exclude from Federal health careprograms owners, officers, and managing employees of sanctionedcompanies—recent guidance and actions••Strategies for mitigating corporate officer exposure to administrativesanctions506. Health Information Exchange Participation andManagementKelly M. Jolley••Determining who may participate in the HIE and who has the ability toparticipate••Selecting HIE technical and governance structure••Creating a sustainable HIE with grants, funding, like-kind donations andparticipation fees••Choosing local, regional and national partners for HIE••Defining permitted purposes, privacy and security policies, and patientconsent models••Developing and negotiating participation and other “trust” agreements5:15–6:30 pmReception sponsored by HealthCare Appraisers, Inc. andKPMG (attendees, speakers and registered spouses and guests arewelcome)Tuesday, September 277:00 am–4:00 pmRegistration and Information7:00–8:00 amContinental Breakfast sponsored by HealthCareAppraisers, Inc. and KPMG (attendees, speakers and registeredspouses and guests are welcome)General Session8:00-9:00 amKeynote Address: Back to the Future: Anti-fraudEnforcement Trends: The Prosecutor, Whistleblower, andDefense PerspectivesKathleen McDermott (moderator) / Thomas A. Corcoran /Stephen J. Immelt / Susan Strawn9:00–9:30 amCoffee Break sponsored by HealthCare Appraisers, Inc.and KPMG5

Program Agenda9:30–10:30 am (Concurrent Sessions)601. Federal and Administrative Sanctions (not repeated)Gabriel L. Imperato••Private contractor sanctions••Federal sanction authority under HIPAA, the Balanced Budget Act andthe Affordable Care Act••Mandatory and permissive exclusion under the Medicare program andtermination under state Medicaid programs••Coordination between Federal and state authorities involving exclusionand sanction actions602. Settling False Claims Act Cases in the HealthcareFraud and Enforcement World: Tips and Traps forProviders and PayorsLaura F. Laemmle-Weidenfeld / Robert T. Rhoad••Assessing if and when to initiate settlement discussions••How settlement dynamics can differ in intervened vs. non-intervened quitam cases••Roles of DOJ/USAO, HHS-OIG, relator’s counsel, and defendant’s counselin qui tam settlement negotiations••Calculating settlement value, including damages, off-sets for valueprovided, appropriate multiplier, penalties and qui tam relator attorneyfees and costs••Related HHS-OIG negotiations regarding permissive exclusion waiver andCorporate Integrity Agreements (“CIAs”) you can live under603. Medical Necessity Documentation to MeetReimbursement Requirements and Avoid FraudAllegationsTimothy P. Blanchard / Joan C. Ragsdale••Current auditing activity focusing on medical necessity documentation••Auditing standards and protocols: Clinical guidelines vs. complex medicaljudgment••How to get accurate concurrent documentation of clinical decisionmaking••Proactive ways to facilitate complete documentation••Preparing for, and responding to, medical necessity audits604. Bridging the Compliance/Operational Gap from theBoard Room to the Operating Room (not repeated)Charlotte L. Kohler / Linda Pilla••Operational impact of a government enforcement action on anorganization••How risk assessment and alignment principles can be employed to avoidor mitigate potential government enforcement actions••Doctrine of self regulation and principles of sound operational practice••Important concepts and lessons learned605. The Role of Compliance in ICD-10 ImplementationTerrance Byrne / John E. Steiner••General differences between ICD-9 and ICD-10••Impact on people, process, technology••Governance structures for effective planning and implementation••Managing the process606. Health Information Exchange Participation andManagement (repeat of 506)10:45 am –12:15 pm (Extended Sessions)701. Corporate Integrity Agreements (repeat of V)702. Physician Practice Acquisitions and ValuationChallenges (repeat of 202)703. Enforcement Initiatives against Individual Officers,General Counsel and Compliance Officers (repeat of 203)704. Saved for Hot Topic705. Managing And Mitigating Privacy Breaches: Whatto Do Before—and After—the OCR Comes Knocking(not repeated)Marie Crepeau Moseley••Before: Identify key issues in avoiding penalties••During: Ten important tips for responding to the OCR••After: Case study: Real-world examples of OCR investigations706. Update on DOJ’s Defibrillator Investigation(not repeated)Lynn M. Adam / Kevin Cornish / Frank E. Sheeder••Development and scope of the Justice Department’s ICD Investigation••Medicare coverage policy for ICDs••FCA implications for hospitals••Role of a physician’s medical judgment••Practical considerations for hospitals12:15–1:30 pmLunch on your own or attend the HCCA MembershipLuncheon (additional fee; limited attendance; pre-registrationrequired)1:45–2:45 pm801. Investigator Beware: Legal Ethical Issues inDefending Government Investigations (repeat of 103)802. Strategies for Self-Disclosures (repeat of 403)803. Repayments and Disclosures: Legal Authorities andthe Roles of RACs and MICs (repeat of 503)804. When Silence Isn’t Golden: Working withPotential Whistleblowers and Avoiding Future Litigation(repeat of 406)3:00–4:00 pm901. Medical Necessity Documentation to MeetReimbursement Requirements and Avoid FraudAllegations (repeat of 603)902. Settling False Claims Act Cases in the HealthcareFraud and Enforcement World: Tips and Traps forProviders and Payors (repeat of 602)903. Auditing an Electronic Medical Record (repeat of 104)904. Analyzing Data to Identify Fraud, Waste and Abuse(repeat of 106)6

SpeakersPlanning CommitteeJoan P. Dailey, Esq., Senior Attorney, USDepartment of Health and Human Services ,Office of the General Counsel, Washington, DCShawn Y. DeGroot, CHC-F, CCEP, CHRC, VicePresident of Corporate Responsibility, RegionalHospital, Rapid City, SDKevin G. McAnaney, Esq., Law Offices of KevinMcAnaney, Washington, DCKathleen McDermott, Esq., Morgan Lewis &Bockius LLP, Washington, DCJenny O’Brien, Chief Medicare ComplianceOfficer, UnitedHealthcare Medicare & Retirement,Minnetonka, MNMichael W. Paddock, Esq., Crowell & Moring LLP,Washington, DCFrank E. Sheeder, III, Esq., Partner, DLA Piper,Dallas, TXDebbie Troklus, CHRC, CHC-F, CCEP-F, CHPC,Managing Partner, Aegis Compliance and EthicsCenter, Chicago, ILSpeakersLynn M. Adam, Esq., King & Spalding LLP, Atlanta,GASal A. Barbera, FACHE, EthicSolutions LLC,Parkland, FLRobert Belfort, Esq., Manatt Phelps & PhillipsLLP, New York, NYBetty Bibbins, CHC, DocuComp LLC, CapeCharles, VATimothy P. Blanchard, Esq., Blanchard |Manning LLP, Orcas, WALanny A. Breuer, Esq., Assistant AttorneyGeneral, Criminal Division, US Department ofJustice, Washington, DCJason E. Bring, Esq., Arnall Golden Gregory LLP,Atlanta, GAJulie Burns, Esq., Office of the General Counsel,US Department of Health and Human Services,Washington, DCTerrance Byrne, Director, Risk Management andCompliance, Parma Community General Hospital,Parma, OHFrank W. Carsonie, Esq., Benesch FriedlanderCoplan & Aronoff LLP, Columbus, OHDwight Claustre, CHC, CHRC, Health CareCompliance Professional, Sun City West, AZThomas A. Corcoran, Esq., US Attorney, Districtof Maryland, Baltimore, MDKevin Cornish, National Director Healthcare,Navigant, Phoenix, AZRobert Corrato, MD, MBA, Executive HealthResources, The Physician Advisor Company,Newtown Square, PAThomas S. Crane, Esq., Mintz Levin Cohn FerrisGlovsky & Popeo PC, Boston, MADavid M. Deaton, Esq., O’Melveny & Myers LLP,Los Angeles, CAGreg Demske, Assistant Inspector General forLegal Affairs, HHS Office of Inspector General,Washington, DCWilliam A. Dombi, Esq., Vice President for Law,National Association for Homecare, Washington,DCCornelia M. Dorfschmid, PhD, Executive VicePresident, Strategic Management Systems, Inc.,Alexandria, VAGary W. Eiland, Esq., King & Spalding LLP,Houston, TXLaura E. Ellis, Esq., Senior Counsel, Office of theInspector General, US Department of Health andHuman Services, Washington, DCJack E. Fernandez, Esq., Zuckerman SpaederLLP, Tampa, FLJudith Geisler, Director, Division of Formularyand Benefit Operations, Centers for Medicare andMedicaid Services, Baltimore, MDTeresa Generous, Esq., Director, Division ofRegulation and Licensure, Missouri Department ofHealth and Senior Services, Jefferson City, MOSusan E. Gillin, Esq., Deputy Branch Chief,Administrative and Civil Liberties Branch, Office ofInspector General, US Department of Health andHuman Services, Washington, DCLarry J. Goldberg, Esq., Principal DeputyInspector General, Office of Inspector General,US Department of Health and Human Services,Washington, DCDavid L. Haron, Esq., Frank Haron Weiner PLC,Troy, MIThomas E. Herrmann, JD, Vice President,Strategic Management Services LLC, Alexandria,VAGary W. Herschman, Esq., Sills Cummis & GrossPC, Newark, NJLynda Hilliard, CCEP, CHC, Deputy ComplianceOfficer, University of California, Oakland, CADavid R. Hoffman, Esq., David Hoffman &Associates PC, Philadelphia, PAS. Craig Holden, Esq., OBER | KALER, Baltimore,MDPatric Hooper, Esq., Hooper Lundy & Bookman,Inc., Los Angeles, CAJoseph C. Hudzik, Esq., Deputy Director, Divisionof Technical Payment Policy, Centers for Medicareand Medicaid Services, Baltimore, MDMargaret Hutchinson, Esq., Assistant USAttorney, Chief Deputy for Affirmative Litigation,Civil Division, US Attorney General’s Office EasternDistrict of Pennsylvania, Philadelphia, PAStephen Immelt, Esq., Hogan Lovell, Baltimore,MDGabriel L. Imperato, Esq., Broad & Cassel, FortLauderdale, FLKelly M. Jolley, Esq., McNair Law Firm PA, HiltonHead Island, SCJulie E. Kass, Esq., OBER | KALER, Baltimore, MDKenneth C. Koch, Managing Director, KPMG LLP,Atlanta, GACharlotte L. Kohler, CEO, President, KohlerHealth Care Consulting, Inc., Woodstock, MDLaura F. Laemmle-Weidenfeld, Esq., PattonBoggs LLP, Washington, DCLori A. Laubach, Esq., Moss Adams LLP, Tacoma,WAKatherine A. Lauer, Esq., Latham & Watkins LLP,San Diego, CAAmy S. Leopard, Esq., Walter & Haverfield LLP,Cleveland, OHJ. Tri MacDonald, Director Health Analytics, BRGHealth Analytics, Washington, DCDavid E. Matyas, Esq., Epstein Becker & GreenPC, Washington, DCJudi McCabe, RN, CHC, CPHQ, Surveillance andUtilization Review (SUR), TMF Health QualityInstitute, Austin, TXHal McCard, Esq., Vice President and AssociateGeneral Counsel Division IV, Community HealthSystems Professional Services Corporation,Franklin, TNDennis McKinnie, Esq., Executive Director,Counsel on Call, Atlanta, GAMarie Crepeau Moseley, BSN, CNNP, MPH, JD,CHC, CHPC, UHS Regulatory Specialist/PrivacyOfficer, University Health Systems of EasternCarolina, Inc., Greenville, NCRoann Nichols, Assistant U.S. Attorney, HealthCare Fraud Coordinator, District of Maryland,Baltimore, MDCharles D. Overstreet, Senior ManagingDirector, FTI Consulting, Inc., Brentwood, TNSchawn Pedersen, Esq., Moss Adams LLP,Scottsdale, AZLinda Pilla, Esq., Vice President and CorporateResponsibility Officer, St. Joseph Medical Center,Towson, MDJoan C. Ragsdale, JD, CEO, MedManagement LLC,Birmingham, ALJohn S. Rah, Esq., Morgan Lewis & Bockius LLP,Washington, DCRobert T. Rhoad, Esq., Crowell & Moring LLP,Washington, DCDan R. Roach, Vice President Compliance andAudit, Catholic Healthcare West, San Francisco, CAVernisha L. Robinson, Health InsuranceSpecialist, Centers for Medicare and MedicaidServices, Baltimore, MDVicki L. Robinson, Esq., Senior Advisor forHealthcare Reform, Office of Inspector General,US Department of Health and Human Services,Washington, DCRobert L. Roth, Esq., Hooper Lundy & BookmanInc., Washington, DCMarla Rothouse, Esq., Director, Division ofPharmaceutical Manufacturer Management,Centers for Medicare and Medicaid Services,Baltimore, MDJason L. Ruchaber, CFA, ASA, HealthCareAppraisers, Inc., Castle Rock, COWilliam A. Sarraille, Esq., Sidley Austin LLP,Washington, DCJennifer Shapiro, Director, Division of BenefitPurchasing and Monitoring, Centers for Medicareand Medicaid Services, Baltimore, MDJames G. Sheehan, Esq., Former – Office ofMedicaid Inspector General, Albany, NYHeidi A. Sorensen, Esq., Foley & Lardner LLP,Washington, DCCraig Spotser, Criminal Investigator, TexasMedicaid Fraud Control Unit, Office of theAttorney General, Austin, TXJohn E. Steiner, Jr., Esq., Chief ComplianceOfficer, Cancer Treatment Centers of America,Schaumburg, ILSusan Strawn, Executive Director, TaxpayersAgainst Fraud Education Fund, The False ClaimsAct Legal Center, Washington, DCHarvey M. Tettlebaum, Esq., Husch BlackwellSanders LLP, Jefferson City, MOBrenda Tranchida, Director of ProgramCompliance and Oversight Group, Centers forMedicare and Medicaid Services, Baltimore, MDSheryl Vacca, CHC-F, CHRC, CCEP, CHP, SeniorVice President and Chief Compliance and AuditOfficer, University of California, Oakland, CAJudith A. Waltz, Esq., Foley & Lardner LLP, SanFrancisco, CAJack Wenik, Esq., Sills Cummis & Gross PC,Newark, NJPaul L. Weygandt, MD, JD, MPH, MBA, VicePresident Physician Services, J A Thomas &Associates, Atlanta, GA,7

Program at a GlanceSunday, September 2511:30 am–5:30 pm Registration and Information1:00–2:30 pm(ExtendedSessions)2:45–4:15 pm(ExtendedSessions)LEGAL FOCUSEDI. Fraud and Abuse Primer (not repeated)SheehanIV. Stark Primer (not repeated)Dailey / Matyas4:30–5:30 pm VII. Hitchhiker’s Guide to the Anti-KickbackStatute (not repeated)SorensenII. Compliance 101TroklusV. Corporate Integrity AgreementsEllis / Overstreet / RahVIII. Anatomy of a Federal Healthcare FraudInvestigationFernandez / HutchinsonCOMPLIANCE FOCUSEDIII. Healthcare Reform and Beyond: WhatCompliance Professionals Need to KnowDeGroot / SheederVI. Mandatory Compliance ProgramsRobinson / TranchidaIX. Making IDS Arrangements Work: Fraudand Abuse Considerations for ACOs andOther Integrated ArrangementsKass / Robinson5:30–6:30 pm Welcome Reception sponsored by HealthCare Appraisers, Inc. and KPMG (attendees, speakers and registered companions and guests arewelcome)Monday, September 267:00 am–5:15 pm Registration and Information7:00–8:00 am Continental Breakfast sponsored by HealthCare Appraisers, Inc. and KPMG (attendees, speakers and registered spouses and guests are welcome)8:00-8:15 am Welcome and Introductions Newman / Sheeder8:15-9:00 am Keynote Address Breuer9:00–9:30 am Coffee Break (sponsored by HealthCare Appraisers, Inc. and KPMG)9:30–10:30 am 101. False Claims ActPrimer (not repeated)Hooper10:45 am–12:15 pm(ExtendedSessions)201. Advanced Stark(not repeated)Holden / McAnaneyLEGAL FOCUSED102. e-Discovery: ATactical Approachto Managing Riskand Reducing Cost(not repeated)Koch / McKinnie202. Hospital-Physician Alignmentand AcquisitionStrategies:AddressingStructural andValuation Challengesand Recent LegalDevelopmentsHerschman / McCard/ Ruchaber103. InvestigatorBeware: LegalEthical Issuesin DefendingGovernmentInvestigationsBring203. EnforcementInitiatives againstIndividual Officers,General Counsel andCompliance OfficersPaddock104. Auditing anElectronic MedicalRecordLaubach / Pedersen204. A ComplianceOfficers Guide toMitigating StarkRisks (not repeated)Claustre / RoachCOMPLIANCE FOCUSED105. ComplianceClinicalDocumentation inthe Era of HealthReform: ACOs,MACs/RACs andFacts (not repeated)Leopard / Weygandt205. Above andBeyond theBasics: MeasuringComplianceEffectiveness toIncrease ProgramValue (not repeated)Hilliard / Vacca106. Analyzing Datato Identify Fraud,Waste and AbuseMcCabe / Spotser206. CMS HotTopics: PerformanceMonitoring andBest Practices(not repeated)Geisler / Rothouse /Shapiro12:15–1:30 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)1:45–2:45 pm 301. Fraud andAbuse IssuesAffecting AMCs(not repeated)EilandLEGAL FOCUSED302. Enrollment/PaymentSuspensions(not repeated)Burns / WaltzLEGAL FOCUSED303. Anatomy of aFederal HealthcareFraud Investigation(repeat of VIII)Fernandez /Hutchinson304. Hospital’sGrowingResponsibilityin AssuringPhysician-EmployeeDocumentationCompliance(not repeated)BibbinsCOMPLIANCE FOCUSED305. Making IDSArrangements Work:Fraud and AbuseConsiderationsfor ACOs andOther IntegratedArrangementsKass / RobinsonCOMPLIANCE FOCUSED306. HospitalInpatient versusOutpatient MedicalNecessity: FromAudit to Error toFraud (not repeated)Corrato / Hoffman8

Program at a Glance3:00–4:00 pm 401. PhysicianInteractionswith Industry(not repeated)Sarraille4:15–5:15 pm 501. Anti-KickbackStatute CurrentDevelopments(not repeated)Crane402. A Collision atthe Intersection ofthe Anti-KickbackStatute andManaged Care(not repeated)Deaton / MacDonald502. Fraud andAbuse Issues inHome Health, DMEand Hospice (notrepeated)Dombi403. Strategies forSelf-DisclosuresHudzick / Wenik503. Repaymentsand Disclosures:Legal Authoritiesand the Roles ofRACs and MICsLauer / Roth404. ManagingCompliance Risksin Vendor Contracts(not repeated)Belfort504. WinningStrategies in ClaimsAudit Appeals(not repeated)Carsonie / Dorfschmid405. PPACA andAccountability forQuality in Hospitalsand Nursing Homes(not repeated)Generous /Tettlebaum505. AdministrativeApplication ofthe ResponsibleCorporateOfficer Doctrine(not repeated)Goldberg / Herrmann5:15–6:30 pm Reception sponsored by HealthCare Appraisers, Inc. and KPMG (attendees, speakers and registered spouses and guests are welcome)Tuesday, September 277:00 am–4:00 pm Registration and Information406. WhenSilence Isn’tGolden: Workingwith PotentialWhistleblowers andAvoiding FutureLitigationBarbera / Haron506. HealthInformationExchangeParticipation andManagementJolley7:00–8:00 am Continental Breakfast sponsored by HealthCare Appraisers, Inc. and KPMG (attendees, speakers and registered spouses and guests are welcome)8:00-9:00 am Keynote Address: Back to the Future: Anti-Fraud Enforcement Trends: The Prosectuor, Whistleblower, and Defense PerspectivesMcDermott (moderator) / Corcoran / Immelt / Strawn9:00–9:30 am Coffee Break sponsored by HealthCare Appraisers, Inc. and KPMG9:30–10:30 am 601. Federal andAdministrativeSanctions(not repeated)Imperato10:45 am –12:15 pm(ExtendedSessions)701. CorporateIntegrity Agreements(repeat of V)Gillin / Overstreet/ RahLEGAL FOCUSED602. Settling FalseClaims Act Cases inthe Healthcare Fraudand EnforcementWorld: Tips andTraps for Providersand PayorsLaemmle-Weidenfeld/ Rhoad702. PhysicianPracticeAcquisitions andValuation Challenges(repeat of 202)Herschman / McCard/ Ruchaber603. MedicalNecessityDocumentationto MeetReimbursementRequirementsand Avoid FraudAllegationsBlanchard / Ragsdale703. EnforcementInitiatives againstIndividual Officers,General Counsel andCompliance Officers(repeat of 203)Paddock604. Bridgingthe Compliance/Operational Gapfrom the BoardRoom to theOperating Room(not repeated)Kohler / Pilla704. Saved for HotTopicCOMPLIANCE FOCUSED605. The Role ofCompliance in ICD-10 Implementation(not repeated)Byrne / Steiner705.Managing AndMitigating PrivacyBreaches: What toDo Before—andAfter—the OCRComes Knocking(not repeated)Moseley12:15–1:30 pm Lunch on your own or attend the HCCA Membership Luncheon (additional fee; limited attendance; pre-registration required)1:45–2:45 pm 801.Investigator Beware: LegalEthical Issues in DefendingGovernment Investigations(repeat of 103)Bring3:00–4:00 pm 901. Medical NecessityDocumentation: The “Who,What, When, Where, Whyand How” of DocumentingMedical Necessity to MeetReimbursement Requirementsand Avoid Fraud Allegations(repeat of 603)Blanchard / RagsdaleLEGAL FOCUSED802. Strategies for Self-Disclosures (repeat of 403)Hudzick / Wenik902. Settling False Claims ActCases in the Healthcare Fraudand Enforcement World: Tipsand Traps for Providers andPayors (repeat of 602)Laemmle-Weidenfeld / Rhoad803. Repayments andDisclosures: Legal Authoritiesand the Roles of RACs and MICs(repeat of 503)Lauer / Roth903. Auditing an ElectronicMedical Record (repeat of 104)Laubach / PedersenCOMPLIANCE FOCUSED606. HealthInformationExchangeParticipation andManagement (repeatof 506)Jolley706. Update onDOJ’s DefibrillatorInvestigation(not repeated)Adam / Cornish /Sheeder804. When Silence Isn’tGolden: Working with PotentialWhistleblowers and AvoidingFuture Litigation (repeat of 406)Barbera / Haron904. Analyzing Data to IdentifyFraud, Waste and Abuse (repeatof 106)McCabe / Spotser9

DetailsDates: September 25–27, 2011Place:Renaissance Baltimore Harborplace Hotel202 East Pratt Street, Baltimore, MD 21202Phone: (410) 547-1200Toll-Free Reservations: (800) 535-1201Registration Fees:Postmarked and paid by September 7, 2011AHLA/HCCA Members................................$820AHLA/HCCA Member Group.................... $745*Non-Members...............................................$1,045Postmarked and paid between September 8and September 21, 2011AHLA/HCCA Members................................$945AHLA/HCCA Member Group.................... $870*Non-Member................................................$1,170Printed Course Materials................................. $65*When an AHLA or HCCA member registers for thisprogram, each additional AHLA or HCCA memberregistered from his/her organization at the same timeis eligible for a discounted registration fee.Pre-registration accepted through September 22,2010. After this date, registrations will be takenon-site on a space available basis, and an on-site feeof $100 will be added to the applicable registrationfee. If you have indicated an incorrect amount dueto errors in addition or are not eligible for a specificrate, AHLA/HCCA will charge the correct amountto the credit card you have supplied.Companion Fee: For an additional $30, spouses andadult guests can register to attend the Sunday andMonday receptions and the continental breakfastson Monday and Tuesday. Please sign up on the registrationform. Children are welcome at attend theseevents at no additional charge.Hotel Reservations:Renaissance Baltimore Harborplace Hotel202 East Pratt Street, Baltimore, MD 21202Hotel accommodations are not included in theregistration fee. Call the Renaissance HarborplaceHotel at (410) 547-1200. When making reservations,please indicate that you are with the AmericanHealth Lawyers Association/Health Care ComplianceAssociation; the room block may sell out priorto the hotel cut-off date, Wednesday, September 7,2011. Room Rates: $229 single or double occupancy.Cancellations/Substitutions: Cancellations must bein writing and must be received no later than September19, 2011. Refunds will not be issued forcancellations received after this date. Registrations,less a $125 administrative fee, will be refundedfollowing the program. If you wish to send a substitute,please call the Member Service Center at(202) 833‐1100 (prompt 5). Please note that the registrationfee will be based on the membership statusof the person who actually attends the program.Airline Reservations: AHLA and HCCA have selectedAssociation Travel Concepts (ATC) as the officialevent travel agency.Airline Discounts: ATC has negotiated discounts withUnited and American and with Avis and Hertzto bring you special airfare and car rental rates.Discounts of 5–15% apply to travel for the dates ofSeptember 23—October 1, 2011. ATC will also searchfor the lowest available fare on ANY airline. Directaccess to ATC online booking tools and live agentsfor discounted meeting travel.Reservations: Make your reservation from one of thefollowing options:• Phone: 800-458-9383• Web: www.atcmeetings.com/ahla• Email: reservations@atcmeetings.com• Fax: 858-362-3153ATC is available for reservations from 8:30 am until8:00 pm Eastern Time, Monday through Friday.Some restrictions may apply. Service fees apply.Special Needs: If you have needs requiring specialassistance or accommodations, including specialdietary needs, or have questions about accessibilityissues at the program, contact our special needscoordinator, Valerie Eshleman at (202) 833-0784 orveshleman@healthlawyers.org.AHLA Membership: Non-members wishing to joinAHLA for one full year can do so by adding $200to the member registration fee. Members receivemonthly mailings and discounts on AHLA publicationsand programs.HCCA Membership: Non-members wishing to joinHCCA for one full year can do so by adding $200 tothe member conference registration fee. Membersreceive monthly mailings and discounts on HCCApublications and programs.Continuing Education Credits: AHLA/HCCA are inthe process of applying for additional certificationfor continuing education credits. Please visitwww.hcca-info.org for updates or contact thecertification department for further informationon ACHE, CCB, and Nursing Credits atccb@hcca-info.org or (888) 580-8373. For moreinformation on CLE and CPE credits, please contactAHLA at programs@healthlawyers.org. Please notethat the continuing education credits listed may besubject to change.AAPC: This program has the prior approval of theAmerican Academy of Professional Coders (AAPC)for 14.0 continuing education hours. Granting of priorapproval in no way constitutes endorsement by AAPCof the program content or the program sponsor.ACHE: The Health Care Compliance Association isauthorized to award 15.0 hours of pre-approved CategoryII (non-ACHE) continuing education credit forthis program toward advancement, or recertification inthe America College of Healthcare Executives. Participantsin this program wishing to have the continuingeducation hours applied toward Category II creditshould indicate on their attendance when submittingapplication to the American College of HealthcareExecutives for advancement or recertification.AHIMA: This program has been approved for 18continuing education units (CEUs) for use in fulfillingthe continuing education requirements of theAmerican Health Information Management Association(AHIMA). Granting prior approval from AHIMA doesnot constitute endorsement of the program content orits program sponsor.Compliance Certification Board (CCB): Certified inHealthcare Compliance (CHC)®, Certified in HealthcareCompliance Fellow (CHC-F), Certified Compliance& Ethics Professional (CCEP)®, Certified Compliance& Ethics Professional Fellow (CCEP-F), Certified inHealthcare Research Compliance (CHRC)®, Certifiedin Healthcare Privacy Compliance (CHPC)®: CCB hasawarded a maximum of 18.9 CEUs for these accreditationsin the following subject areas: Application ofManagement 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; Communicationand Reporting Mechanisms in Compliance Enforcementof Compliance Standards and Discipline; Auditingand Monitoring for Compliance; Response to ComplianceViolations and Corrective Actions; HIPAA PrivacyImplementation and/or Complying with GovernmentRegulations.CPE: AHLA is registered with the National Associationof State Boards of Accountancy (NASBA) as a sponsorof continuing professional education on the NationalRegistry of CPE Sponsors. State boards of accountancyhave final authority on the acceptance of individualcourses for CPE credit. Complaints regarding registeredsponsors may be addressed to the National Registry ofCPE Sponsors, 150 Fourth Avenue North, Suite 700,Nashville, TN 37219-2417. Website: www.nasba.org.This seminar will be worth approximately 18.0 CPEcredits. This program is designed to be an update ondevelopments in the area of fraud and compliance.There are no prerequisites or advanced preparationsrequired to register for this group live program. Thoseseeking accounting credits should be familiar with thebasic concepts of law and terminology associated withthe area of fraud and compliance in order to obtain thefull educational benefit of this program.MCLE/CLE: Participants will be given continuingeducation forms at the program. Forms must be completedand returned to AHLA staff to receive credit.AHLA is an approved sponsor of continuing legaleducation credits in most states. This seminar will beworth approximately 15 continuing education credits(including 1.0 ethics credit) based on a 60-minute hourand 18.1 credits (including 1.2 ethics credits) based on a50-minute hour.Nursing Credit: The Health Care Compliance Associationis preapproved by the California Board ofRegistered Nursing, Provider Number CEP 12990, for amaximum of 18.9 contact hour(s). The following stateswill not accept CA Board of Nursing contact hours:Delaware, Florida, New Jersey and Utah. Massachusettsand Mississippi nurses may submit CA Board of Nursingcontact hours to their state board, but approvalwill depend on review by the board. Please contact theAccreditation Department at ccb@hcca-info.org withany questions you may have. Oncology Nurses whoare certified by ONCC may request CA Nursing Credit(check box or indicate “Nursing” on the CEU form).Register online atwww.healthlawyers.org/programs10

1620 Eye Street NW, 6th FloorWashington, DC 20006‐4010September 25–27, 2011Renaissance Harborplace Hotel | Baltimore, MDSeptember 25–27, 2011Renaissance Harborplace Hotel | Baltimore, MDwww.hcca-info.orgwww.healthlawyers.org