Traininng.com LLC, Online
2019-03-25
OverviewSection 6401 of the Affordable Care Act provides that a "provider of medical or other items or services or supplier within a particular industry sector or category" shall establish a compliance program as a condition of enrollment in Medicare, Medicaid, or the Children's Health Insurance Program (CHIP). And even before the Affordable Care Act was passed, most healthcare organizations implemented compliance programs to help prevent fraud, waste and abuse of federal health care programs. Needless to say, if you provide services to Medicare or Medicaid patients and you either don’t have a compliance program or you need to strengthen your healthcare compliance program, this webinar is for you. Why should you Attend We will perform a review and application of the 7 elements of an effective compliance program as outlined in the U.S. Sentencing Guidelines as well as explained the U.S. Health and Human Services Office of Inspector General. The current enforcement environment against hospitals, doctors and other provider types demonstrates financial penalties, fines, settlements and even jail time are on the rise. A compliance program is one way to prevent non-compliance and can also be to your organization’s benefit if something does go wrong and you are investigated by enforcement agencies. Areas Covered in the Session - Published guidance documents from the U.S. Health and Human Services Office of Inspector General
- Enforcement trends and government authority under the U.S. False Claims Act
- Developing Policies and Procedures (Element 1)
- Oversight of the compliance program (Element 2)
- Compliance Training and Education (Element 3)
- Reporting/Communication (Element 4)
- Response/Disciplinary action (Element 5)
- Auditing/Monitoring (Element 6)
- Investigation, remediation (Element 7)
Learning Objectives- Comprehend the current regulatory enforcement environment in the health care industry
- Review recent settlement cases due to a lack of compliance
- Analyze and apply the 7 elements of an effective compliance program as defined by the U.S. Sentencing Guidelines
- Understand the Role of the U.S. Health and Human Services Office of Inspector General in regards to Compliance Programs
- Review principles of and effective compliance program
- Summarize skills and roles of a Chief Compliance Officer
Who Will Benefit The Affordable Care Act made it law for any provider participating in in Federal Healthcare Programs (such as Medicare, Medicaid, etc.) to have a Compliance Program so any of the following leaders in a healthcare provider types such as physician practice, hospital, skilled nursing facility, etc.: - Director
- Manager
- Billing
- Coding
- Auditor
- HIPAA Officers
- Compliance Officers
- Physician Practice Partner
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Invited Speakers:
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C.J. Wolf, MD, M.Ed. has been involved in healthcare for over 20 years beginning with his years in medical school. Early in his career, Dr. Wolf made a change to healthcare administration, reimbursement and compliance. He has worked in various coding, reimbursement or Chief Compliance Officer roles for Intermountain Healthcare, the University of Texas MD Anderson Cancer Center, the University of Texas System and Merit Medical Systems. He currently is Sr. Compliance Executive at Healthicity.
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