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Compliance Symposium Agenda
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8:00 am – 10:00 am - Breakfast (Included in Registration Fee) 

 


 

9:00 am – 9:15 am - Welcome 

 



9:15 am – 10:15 am - Opening Session – Regulatory Enforcement Actions: Compliance Issues Impacting Orthopedics

Robert Liles, JD, MBA, MS, Managing Partner, Liles/Parker, LLC

 

This opening session will set the tone for the rest of the day. Led by Robert Liles, JD, MPH, CPC of Liles / Parker in Washington, DC, the session will provide a thorough breakdown of the biggest gotchas ortho practices have to be aware of to successfully navigate the waters of healthcare compliance. Some of the topics to be discussed include: The Health Care Fraud Statute, The False Claims Act, Qui Tam (Whistleblower), Stark, “Misprision of Felony,” and much more. Don’t miss this opportunity to have a former Deputy Director of the Fraud Task Force at the DOJ provide you with a clear understanding of which landmines to be aware of.

 

About the Presenter:

Robert Liles’s background is somewhat unique. In addition to a law degree, he holds both an MBA and an MS in Health Care Administration. Liles has worked on the provider side as a federal prosecutor and now represents healthcare providers around the country in Medicare / Medicaid / Private Payor audits, state board actions, and FCA cases. While working as a federal prosecutor, Liles served as the country’s first National Health Care Fraud Coordinator for the Executive Office for U.S. Attorneys. In this capacity, he advised federal prosecutors regarding fraud statutes, schemes, investigative tools, privacy, and compliance issues.

 


 


10:15 am – 11:00 am – The Most Commonly Targeted Orthopaedic Services: Determining an Appropriate Sample and Performing a Proper Audit

Frank Cohen and Pam Vanderbilt of DoctorsManagement, LLC 

 

This session will explore sampling and extrapolation and how to ensure payors are complying with the Medicare Program Integrity Manual; specifically, Section 8.4. Learn how to structure your sample based on what you are trying to achieve, get the information you need about the most heavily scrutinized CPT codes billed by orthopedic surgeons, and learn how to ensure your documentation holds up during an audit. The presenters will also look at the most overused and abused modifiers in orthopedics and how to avoid making costly mistakes.

 

During this session, you will learn:

  • Modifiers in orthopedics - is your practice at risk?
  • Audits and extrapolation
  • Do's and don'ts
  • Tips and tricks
  • What is your best defense?

About the Presenters:

Frank Cohen is the Director of Analytics and Business Intelligence for Doctors Management, a Knoxville-based healthcare consulting firm. He is a computational mathematician with specific focus on applied statistics, data mining and predictive analytics. Mr. Cohen is the author of several books, including his newest, Don’t Do Something, Just Stand There: A Primer on Evidence-based Thinking. Mr. Cohen has participated in and published numerous articles and studies and trained thousands of physicians, administrators, CPAs and other healthcare professionals in all areas of healthcare analytics.

 

Pam Vanderbilt helps to ensure that clients maintain sound systems for all aspects of their coding and documentation as well as revenue cycle management. She is also an instructor for the National Alliance of Medical Auditing Specialists (NAMAS, an educational division of DoctorsManagement), teaching both auditing and E&M auditing courses.

 

 


 

11:15 am – 12:00 pm – Integrity without Ignorance

Eric Christensen, CHCP, Director of Client Services, Healthcare Compliance Pros 

 

When working within the healthcare industry, it is especially important to work with the utmost integrity in how responsibilities are carried out. There are constant challenges to maintaining integrity, for instance, by not simply looking the other way when something should be addressed. It takes bravery and integrity to speak up. This session will cover what it is to have integrity and the applications of integrity while working in the healthcare industry.

  

During this session, you will:

  

  • Learn how to educate staff in a process of honesty and accuracy with patient care, billing, coding, and with interpersonal relationships with co-workers and patients. 

  • Understand how to address and report breaches, and how these are learning opportunities for your practice. 

  • Educate yourself to be a leader in regard to Whistleblowers and Compliance Hotlines

 

 

About the Presenter:

Eric Christensen is a nationally recognized speaker and author on compliance topics and practice management. Eric co-founded Healthcare Compliance Pros in 2011, bringing his 30+ years’ experience in healthcare compliance, IT administration, and education to the organization. Eric’s background in IT administration has been instrumental in providing a technical view of an organization's adherence to HIPAA Privacy and Security policies. Eric’s experience and expertise are highly regarded in the Security Risk Audits he is asked to perform for hundreds of healthcare entities. Eric’s experience brings a unique perspective into compliance and implementation in the medical community. Eric possesses a broad knowledge of telemedicine, e-PHI, MIPS/MACRA, employee hiring and firing, and more. Eric’s educational experience in Healthcare Administration and Information Technology partners well with his many certifications; MCSE, CCNA, CHCP, and others. 

 

 


 

12:00 pm – 12:30 pm – Lunch and Learn (Included in Registration Fee)

Ray McGrogan, President/CEO, CardChoice International

 

As a trusted adviser, actively managing portfolios totaling more than 275 million dollars annually, the presenter will share his expertise as a revenue cycle consultant. During this session, you will learn how to legally and effectively capture patient payments while maintaining PCI compliance. You will receive scripts for front office staff to support the payment card on file program. The presenter will also debunk myths and share facts regarding recent medical record breaches. You will learn ways to help prevent a data breach, store a patient’s credit, debit, or check in a secure vault. Also get the information you need on the hot topic of patient surcharging. Learn about the rules set by Visa and the major credit card companies, such as, can you surcharge a patient for using a credit card, and if so, how?

 

About the Presenter:

Our company was founded in 2004, by Ray McGrogan, CEO, and Steven Kleinberg, COO. Long-term friends who met in high school, Ray and Steve both worked for family businesses before embarking on careers in the financial services industry. As a result, they understand the importance of delivering value and what is required to be successful in business.

Ray and Steve have spent 15 years building impeccable relationships with carefully selected and vetted financial partners. These relationships allow CardChoice International to offer products and services from the most trusted names in the financial services and electronic payment industries. Currently under management, 275 million dollars.

 


 

12:30 pm – 1:15 pm – Game Changer: The Benefits of Laughter: Stress Less

Robert Mac, Celebrity Comedian 

 

Learn how laughter evolved to become a way to reduce stress, as well some of the other benefits of laughing. Finally, you’ll learn 31 stress-reduction techniques, one for every hour of the day. (And day of the week, when you put them together.) Mental-health awareness meets award-winning comedy. Free stress-o-meter for all attendees! 

 

About the Presenter:

Robert Mac's award-winning comedy is smart, subtle, and silly. If you prefer brainy, dead-pan comedy over brain-dead, pandering comedy, check him out. He has won the grand prize of Comedy Central's national stand-up contest, Laugh Riots. He was the talent search winner for the Jerry Lewis Telethon and has been invited to the Just for Laughs Festival in Montreal, the Boston Comedy Festival, and the inaugural Great American Comedy Festival. The Entertainment Business Journal ranked him in the top 100 comedians in the nation.

 

He has appeared on NBC's Last Comic Standing, Comedy Central's Premium Blend, the Learning Channel, and numerous shows that are no longer on the air. He also enjoys long naps on the beach.

  


1:15 pm – 1:45 pm – Incident-To Guidelines: Using Non-Physician Practitioners Correctly in Orthopedics

Jeana Singleton, JD, Brennan, Manna & Diamond, LLC

 

This session will focus on the intricate requirements and pitfalls of billing one of the most scrutinized billing guidelines in the Medicare Program Integrity Manual (PIM) and at the Private Payors. It has not only been heavily scrutinized by the payors, but has also been on the OIG Work Plan for five or more consecutive years. Understanding who can provide what services and when, and the various levels of supervision required to support the billing of Incident-to is critical to mitigating risk. One of the biggest questions regarding these services, “How to Define Immediately Available,” will be thoroughly explored and answered by one of the most respected and sought-after healthcare focused attorneys in the country.

 

About the Presenter:

Jeana Singleton is an attorney at Brennan, Manna & Diamond. Her healthcare law practice includes representing systems and services, where she counsels providers on legal issues that impact business performance, corporate strategy, mergers and acquisitions, business alignment models, and heightened payor return. Singleton works with her clients in all aspects of their business--from navigating regulatory updates, to the growth of consumer driven health practices, and the rapid advancement in technology-based medicine, including telemedicine, orthopaedic implants, and other medical technologies advancements. Staying relevant in a transforming industry is key to sustainability and the value that Singleton offers.

 


 

2:00 pm – 2:45 pm - 5 Compliance Issues You Should be Looking at in Your Organization

Eric Christensen, CHCP, Director of Client Services, Healthcare Compliance Pros 

 

Regulatory compliance in healthcare is a complex, ever-changing industry. Regulatory change means constant vigilance is necessary to prevent serious vulnerabilities that will lead to costly penalties and fines. During this presentation, we will discuss the following five compliance topics that you need to consider in your organization:

  1.  Security Risk Analysis (SRA) - Including an insufficient EMR or Checklist
  2.  Current Cybersecurity Trends
  3.  Social Media Policy and Procedures Missing or Not Being Followed
  4.  Exclusion Screening Not Being Performed Correctly, or at All!
  5.  Mobile Device Usage  

 

Join us as we discuss the importance of addressing these topics and providing practical recommendations for ensuring these 5 compliance topics are not a compliance burden for your organization.  

 

About the Presenter:
Eric Christensen is a nationally recognized speaker and author on compliance topics and practice management. Eric co-founded Healthcare Compliance Pros in 2011, bringing his 30+ years’ experience in healthcare compliance, IT administration, and education to the organization. Eric’s background in IT administration has been instrumental in providing a technical view of an organization's adherence to HIPAA Privacy and Security policies. Eric’s experience and expertise are highly regarded in the Security Risk Audits he is asked to perform for hundreds of healthcare entities. Eric’s experience brings a unique perspective into compliance and implementation in the medical community. Eric possesses a broad knowledge of telemedicine, e-PHI, MIPS/MACRA, employee hiring and firing, and more. Eric’s educational experience in Healthcare Administration and Information Technology partners well with his many certifications; MCSE, CCNA, CHCP, and others.

 


 

2:45 pm – 3:15 pm – Reducing Compliance Costs through Risk Assessments

Jeana Singleton, JD, Brennan, Manna & Diamond, LLC

 

What does it mean to have an effective compliance program? Is it enough to have policies and procedures in a three-ring binder? What is an LBD and how do you create a culture of compliance within your organization to deter investigators and/or prosecutors? This session will not only focus on the “core” elements of a compliance program but will also focus on the eighth step of a compliance plan: risk assessment. This will not be your run-of-the-mill session on how to build a compliance plan. The presenter will dispel the myths of compliance plans in a box and will show you how to strategically position your practice for success without the exorbitant costs and headaches.

 

About the Presenter:

Jeana Singleton is an attorney at Brennan, Manna & Diamond. Her healthcare law practice includes representing systems and services, where she counsels providers on legal issues that impact business performance, corporate strategy, mergers and acquisitions, business alignment models, and heightened payor return. Singleton works with her clients in all aspects of their business--from navigating regulatory updates, to the growth of consumer driven health practices, and the rapid advancement in technology-based medicine, including telemedicine, orthopaedic implants, and other medical technologies advancements. Staying relevant in a transforming industry is key to sustainability and the value that Singleton offers.


 

3:15 pm – 4:00 pm – Panel Discussion: The Most Pressing Issues Impacting Orthopedic Practices

 

We have saved the best for last… The final session will bring all of the day’s experts together for an in-depth discussion of the biggest risk areas orthopedic practices are facing including MIPS reporting for physical therapists as it relates to reporting the Promoting Interoperability category. There will be a centric focus on the existing Stark statute and how Stark, AKS, and CMP are implicated in value-based models. Understanding how to successfully operate in a value-based payment model when statutes like Stark and AKS make it so difficult to coordinate care. Our experts will provide you the proper guidance to return to your practice and proceed in the new world with confidence.


 

 

 

Thank you to our sponsors!

 

 

 

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