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"2015 Health Care Regulatory and Compliance Update," J.W. Marriott at LA Live, Los Angeles

By   Brad Fisher, Terri D. Keville, Kathleen H. Drummy, Adam D. Romney, Jane Eckels, Robert G. Homchick, and Jason A. Farber
02.19.15
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This seminar discussed current developments in health care regulation and compliance for hospitals.

This year's topics included:

Managing New Risks in Hospital - Physician Transactions
Presented by: Dennis Diaz

  • Hidden risks and reducing exposure under Stark; voluntary disclosures under the SRDP and the Kane vs. Healthfirst, Inc., case
  • Physicians think they have no compliance exposure: do they?
  • Dealing with physician-owned distributorships (PODs)
  • The changing landscape of fair market value
  • Case studies and practical tips limiting fraud and abuse exposure

Peer Review, EMTALA and Ebola
Presented by: Terri Keville

  • Fraud and abuse and compliance issues arising from peer review – or lack of it
  • EMTALA compliance issues involving physicians and inappropriate transfers or discharges
  • Regulatory issues arising from recent Ebola cases, including EMTALA issues

Bracing for Increased HIPAA Enforcement; Privacy and Security Update
Presented by: Anna Watterson

  • HIPAA enforcement trends: OCR and state AG settlements
  • What to expect, and how to prepare, for HIPAA audits
  • HIPAA breaches: top trends for covered entity and business associate breaches
  • New challenges for HIPAA compliance

Carrots and Sticks: Regulatory Requirements and Influencing Patient and Provider Behavior -- Reconciling Regulations with Reality
Presented by: Robert Homchick

  • Influencing Beneficiary Behavior
  • Overview of anti-kickback and civil money penalty (CMP) law on beneficiary inducements
  • ACO waivers, proposed CMP regulations and behavioral economics
  • Influencing Providers
  • Overview of Stark, anti-kickback and civil money penalty law on gainsharing and quality payments
  • ACO waivers and new developments

Reimbursement Update: Old Friends and New Foes
Presented by: Kathleen Drummy and Adam Romney

  • Audit program update and expansion: RAC (Medicare and Medicaid), ZPIC, and beyond
  • The OIG work plan and Medicare PPS
  • Integration of mental health coverage into payment plans and coverage
  • The "60 Day Payment Rule" in the context of reimbursement and coordination of benefits

Hospital Sales and Acquisitions: What A Compliance Officer Needs to Know
Presented by: Jason Farber, Sarah Fallows and David Lawson

  • How compliance issues can impact or derail a merger and acquisition (M&A) deal
  • Role of the compliance officer in a healthcare M&A deal
  • What should a compliance officer be looking for? Issues and new resources
  • Due diligence tips regarding important compliance issues - tax exemption and IRC 501(r), Stark, voluntary disclosures

Preparing and Responding to an "Unscheduled" Government Meeting
Presented by: Jeffrey Coopersmith

  • What should you do if agents arrive with a search warrant?
  • What should you do if agents arrive with a subpoena?
  • What should you do if agents arrive and ask to speak with one or more employees?
  • What investigation should you do after the search warrant or subpoena arrives?
  • What should alert you that a subpoena or search warrant may be coming?

Rolling Out EHR at the Hospital: EHR Donation and Meaningful Use
Presented by: Jane Eckels

  • Meaningful use attestation and audit
  • Security risk assessments - when your EHR is their EHR
  • Demonstrating use of Certified EHR Technology
  • Best practices for preparation

Hospital Litigation Update
Presented by: Brad Fisher

  • Litigation under the Affordable Care Act - another year and new challenges
  • Trends in reimbursement and payment litigation
  • New challenges to patient arbitration provisions

This year also featured a special panel discussion among California Hospital Compliance Officers.

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