"2014 Health Care Regulatory and Compliance Update," J.W. Marriott at LA Live, Los Angeles
This seminar discussed current developments in health care regulation and compliance for hospitals.
This year's topics included:
Health Care Litigation Trends and Developments
- Litigation under the Affordable Care Act—the new world of health care litigation
- Developments in privacy/data breach litigation—the growing exposure
- Reimbursement-related litigation
New Developments in Hospital-Physician Transactions
- Physician compensation in the era of health reform: developing legally compliant ways to incentivize quality and value
- Fair Market Value (FMV) and hospital transactions update: what's new?
- Compliance and valuation implications of "stacked arrangements;" pitfalls to avoid
- Legal issues in recruiting and retaining "superstar" physicians
- Lessons learned from Toumey and Halifax
Top Ten Hospital Health Care Billing and Payment Issues for 2014
- The two-midnight rule for inpatient admissions
- Compliance landmines introduced by innovative payment models (ACOs, bundled payments, etc.)
- Compliance challenges caused by ICD-10 implementation
- Hot topics from the OIG Work Plan, MPFS, OPPS, and IPPS Updates
AM Peer Review Is a Compliance Issue
Terri Keville and Abbie Maliniak
- Medicare CoPs, TJC standards, and Title 22 requirements
- Governing body's ultimate responsibility for care provided—and not billing for medically unnecessary services
- Need to coordinate peer review and compliance processes
- Ongoing enforcement activity; substantial payments by several hospitals
AM Protecting Tax Exempt Status under Section 501(c)(3)
LaVerne Woods and David Lawson
- IRS "stealth" audits: is your hospital undergoing one without knowing it?
- Fact and fiction of community health needs assessments (CHNAs)
- New guidance on reporting and penalties for violations of Section 501(r) requirements
- Financial assistance and emergency care policies
- Billing practices and "extraordinary collection activities"
- Lessons learned from the IRS compliance report on colleges and universities
The Rise of the Whistleblower: the Newest Headache in Health Care Compliance
Jeff Coopersmith and Dennis Diaz
- How has hospital exposure to whistleblowers increased?—recent rulings under the False Claims Act
- How to maximize your hospital's chances of avoiding a whistleblower/Qui Tam action
- How do you defend a whistleblower/Qui Tam case if one is filed?
- What if the government intervenes in the case?
- The anatomy of a real life hospital whistleblower/Qui Tam case
Emerging Accountable Care Organization (ACO) Compliance and Operational Issues
Presented by Bob Homchick
- Combining Commercial ACO and MSSP ACO operations
- Record keeping, governance and audits
- Liabilities arising out of network organizations
- Liabilities arising out of ACO providers' treatment decisions
HIPAA: Responding to Changes in Technology and Enforcement
Presented by Becky Williams and Adam Greene
- Updates on HIPAA developments
- Recent health information privacy enforcement, including settlements and the audit program
- Management of patient portals
- Increasing challenges of mobile devices
Hospital and Health Care Mergers & Acquisitions: What Does a Compliance Officer Need to Know?
Presented by Bob Schuchard
- How does a hospital deal come together?—the anatomy of a deal
- Update of the Attorney General's oversight and regulation of nonprofit deals
- How compliance issues impact—or derail—health care deals
- The emerging and important role for the compliance officer in a health care deal