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

By  Dennis S. Diaz, Anna C. Watterson, David A. Lawson, and Jeffrey B. Coopersmith
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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