Compliance Track Day 1 – Thursday, Sept. 30, 2004

7:00 a.m. – 8:00 a.m. – Registration and Continental Breakfast

9:30 a.m. – 10:45 a.m.
What to Expect from OIG in the Next 12 Months
James Kopf, former OIG Director of Program Investigations; President, Health Care Oversight, New York, N.Y.

Find out direct from the person who used to be in charge of OIG’s investigations just what kinds of physician practice activities the agency will scrutinize in the months ahead. Last year physician/pharmaceutical company relationships and physician practice arrangements with DME suppliers were high on the list, as well as physician practice charges that OIG saw as excessive. The next 12 months will see a continuation of these targets, but also the addition of new ones. Kopf will let you know what to prepare for, so your physician practice isn’t caught unawares.

11:00 a.m. – 12:15 p.m.
Is Your Specialty a Government Target?
Frank Cohen, Senior Analyst, Medical Information Technologies, Clearwater, Fla.

CMS is targeting internists, physical therapists, general practitioners, urologists and other specialties for audits, based on a study the agency recently did of improper payments. Find out from statistics research expert Frank Cohen just how CMS put these figures together, whether they’re reliable, and what you should expect from the agency, as well as what you should do to prevent your practice from becoming the target of a CMS audit.

1:30 p.m. – 2:45 p.m.
Patient Inducements and Discounts – What You Can Do…and What You Can’t
Allison Shuren, health care attorney, Arent Fox, Washington, D.C.

OIG and CMS want to be absolutely certain that physician practices are not in any way paying patients to get unnecessary services billed to Medicare. OIG’s suspicions are having a chilling effect on waivers and discounts, leading many practices to drop such offers entirely. Any benefits offered to patients need to be made according to strict fraud prevention protocols, says Allison Shuren, who will walk you through how Medicare wants to be billed for such items and how you can verify patient need to pass OIG/CMS muster.

3:00 p.m. – 4:15 p.m.
25 Compliance Tools You Can Take Home and Use
Marie Auguste, MBA, RN, ABQAUR, National Director of Quality and Compliance, VITAS Healthcorp & Managing Partner, Comprehensive Health Solutions. Inc.,
Miami, Fla.

Bring your briefcase for this one. You’re going to leave with at least 25 hands-on physician practice compliance tools you can take back to your office and use right away. Marie Auguste, who has worked with 75 physician practices to help them stay on the right side of fraud and abuse, as well as HIPAA, laws and regulations, shares with you – and tells you how to use – such practical tools as a coding/billing sample audit tool and a HIPAA flow of information chart.
BONUS: They’ll all be on your Tools CD-ROM so you can use them immediately upon your return to your office.

Mix & Match! Customize your conference by attending the sessions that suit your needs. Don’t forget to review the agendas for the Coding Track and Billing Track.

Compliance Track Day 2 – Friday, Oct. 1, 2004

7:30 a.m. Continental Breakfast

9:30 a.m. – 10:45 a.m.
How Private Payers Investigate Physician Prac tices
…and What You Need to Do
Greg Anderson, Vice President of Corporate and Financial Investigations, BlueCross/BlueShield of Michigan, Southfield, Mich.

OIG and the Justice Dept. aren’t the only investigative bodies you need to worry about. More and more private payers, through their Special Investigation Units and fraud investigation departments, go after what they see as fraud in the claims submitted to them. And they often share that information with the government. Anderson, who leads one of the most aggressive private payers in the country, heads a team of 17 investigators that has so far led to the arrest of 1,929 individuals and 1,586 convictions. Find out from him just what red flags in physician practice private payers looks for, how private payer investigations differ from government investigations…and what you can do to make sure your practice stays out of the private payer spotlight.

11:00 a.m. – 12:15 p.m.
How the Government Decides Who, What and How to Crack Down
Mark Nagle, Chief – Civil Division, U.S. Attorney’s Office, Washington, D.C.

The Justice Dept., OIG and CMS perpetually have their antenna up for possible fraud. When they get a lead, they investigate, then decide whether to prosecute. Just how they make that decision is something Mark Nagle shares with you. He should know. As the chief of the civil division at one of the most aggressive U.S. Attorney’s offices in the country for 6 years, he daily sifts through mountains of reports and data and decides who, what and how to crack down. Listen as he tells you what government prosecutors look for when deciding whether to prosecute a physician practice…and then make sure your practice won’t draw government attention.

1:30 p.m. – 2:45 p.m.
What Physician Practices Should Do When the Government Knocks
Kimberly Dunne, health care attorney, Sidley Austin Brown & Wood, Los Angeles, Calif.

The federal government collected $4.21 billion in fines, settlements and other payments from health care investigations in the past three years – more than the $3.29 billion it collected in the previous 10 years combined. It’s not enough to know who the government targets are. Your practice needs to know what to do and how to act if OIG or Justice Dept. investigators unexpectedly show up at your doorstep. Kimberly Dunne, a former Assistant U.S. Attorney, has worked both sides of the aisle. Find out from her how to prepare yourself for that unexpected phone call or letter from the government.

3:00 p.m. – 4:15 p.m.
Get Ready for the Coming HIPAA Security Rule Deadline
John Parmigiani, former Chairman, HIPAA Administrative Simplification Security and Electronic Signature Implementation Team, Baltimore, Md.

The next HIPAA deadline is fast approaching: the Security Rule, with which you have only a few months to comply, contains 18 different compliance standards and 42 implementation specifications for administrative, physical and technical safeguards. That’s a lot to digest in a short time. Fortunately, one of the original HIPAA architects is here to help you. John Parmigiani, who led the government team that wrote the proposed rule, cuts through the details with a plain-English explanation of what it all means, what the government really wants, and what you should do to comply.

Mix & Match! Customize your conference by attending the sessions that suit your needs. Don’t forget to review the agendas for the Coding Track and Billing Track.

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