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2018 IDC Hospice Compliance Certificate Program

This Session is sold out

Description

Successful programs today need to know the basics of healthcare compliance, including developing a compliance program, compliance risk assessment, compliance policies and procedures, and anonymous reporting.  The importance of the Stark law, the Yates memo, anti-kickback statutes, and inducements for referrals and incentives for marketing will also be covered.   It is critical to also look at hospice-specific topics to apply back home, including a detailed review of the federal hospice regulations including Conditions of Payment, conducting an internal audit, looking at organizational ethics related to compliance, and audit scrutiny.  In order to receive the certificate for the program, participants must complete a test based on program content. The two-day course promises to be just what those interested in hospice compliance are looking for – hospice specific compliance content, up to the minute compliance updates, and application back home.

Breakfast and lunch and are included both days.

Learning Objectives

  • Identify the 27 risk areas for hospices identified by the OIG, along with tools to evaluate a hospice's compliance
  • Review components of organizational ethics related to compliance risk
  • List components and structure of an internal compliance audit, complete with topics and identified staff
  • Identify strategies for external auditors, including attorney-client privilege and how to prepare to respond 
  • List risks for inducement for referrals and incentives for marketing
  • Identify strategies for attorney-client privilege and how to use it in investigations and audits

Compliance Certificate Test

  • Each participant must complete the online program exam with a passing score of 70% to receive a certificate. Participants will receive a link to the online test at the conclusion of the program’s second day.
  • Participants have two weeks from the program conclusion date to complete the exam online.
  • Program exam contains 78 questions, six per each session component.

Continuing Education for the Hospice Compliance Certificate Program

  • 14.5 hours of continuing education credit will be available for compliance officers, nurses, physicians and social workers who attend both full days of the program. Successful completion of the post-seminar test is not required to claim available continuing education.

Hospice Compliance Certificate Program Agenda

See two pages below for the full program agenda and content areas.

Day 1: Saturday, November 3, 2018 8:30 am to 5 pm
1 Introduction to Hospice Compliance
2
7 Components of Compliance, 27 Risk Areas, Compliance Risk Assessment
  • 7 components of a compliance plan
  • 27 risk areas for hospice
  • Compliance risk assessment to include risks in any of the 27 risk areas, as well as risks identified in the OIG annual work plan
Break – 10:30 to 10:45
3
Compliance Policy and Procedures, Internal Controls, Anonymous Reporting
  • Develop policies and procedures
  • Implement internal controls and anonymous reporting for compliance
  • Hospice compliance committee set up and duties
4a
Hospice Regulations, Conditions of Participation (CoPs) and Conditions of Payment
  • Subpart B
  • Subpart C
Lunch – 12:15 to 1:00
4b
CoPs and Conditions of Payment
  • Subpart D
  • Conditions of Payment
5
Surveys – state surveyors and deemed status
  • Condition vs standard
  • Plan of correction
  • Disputes in plan of correction
  • Surveyor management
Break – 3:00 to 3:15
6
Organizational Ethics (including Case Studies)
  • QAPI and Compliance Overlap
  • Partnering and distinctions
7
Billing for the Compliance Professional
  • Knowledge of modifiers
  • What to look for on claims for compliance
  • Sharing information on changes with billers
Day 2: Sunday, November 4, 2018 8:30 am to 5 pm
8
Role of the Healthcare Board of Directors
  • Expectations for Board oversight
  • Board evaluation of the Compliance Program
  • Who and what should be reported to the Board
9
HIPAA Compliance
  • Some basics of Privacy and Security
  • Identifying risks through a gap analysis
  • Case studies from the Office of Civil Rights
Break – 10:30 – 10:45
10
Conducting an internal investigation
  • What prompted the internal investigation?
  • Using in‐house counsel or engaging counsel
  • Attorney client privilege
  • Engaging clinical consultants
11a
Understanding and Applying Hospice Fraud and Abuse Laws
  • Stark
  • Anti‐Kick Back, including marketing incentives
  • Beneficiary Inducements
Lunch – 12:15 to 1:00
11b
Understanding and Applying Hospice Fraud and Abuse Laws
  • False Claims
  • Whistle Blowers and Qui Tam
12
Who are the Auditors and How Should My Hospice Respond?
  • Auditors – Medicare and Medicaid
  • OIG
    • Annual Work Plan
    • Audits and Investigations
  • Department of Justice
  • Examples of Hospice Audit Findings
  • Audit Reports and Response
Break – 3:30 to 3:45
13
What to do with the Audit Findings?
  • Overpayments, returns and claims adjustments
  • 60 day repayment rule
  • Corporate Integrity Agreements (CIA)
14 Next Steps

Faculty

Jean Acevedo, LHRM, CPC, CHC, CENTC, AAPC Fellow, Acevedo Consulting, Delray Beach, FL
Jason Bring, JD, Arnall Golden Gregory LLP, Atlanta, GA
Hallie DeCapp, BSN, Harbor Light Hospice, Glen Ellyn, IL
Maureen Kelleher, RN, MBA, CHPCA, Aviant Hospice, Mesa, AZ
Jennifer Kennedy, EdD, MA, CHC, NHPCO, Alexandria, VA
Elizabeth Kopochis, BSN, MS, CHC, Seasons Healthcare Management Inc, Rosemont, IL
Judi Lund Person, MPH, CHC, NHPCO, Alexandria, VA
Meg Pekarske, JD, Reinhart Boerner Van Deuren S.C., Madison, WI
Karla Pinkerton, JD, Reinhart Boerner Van Deuren S.C., Madison, WI
Kimberly Skehan, RN, MSN, Simione Healthcare Consultants, LLC, Hamden, Connecticut
Sylvia Singleton, RN, CHC, Caris Healthcare, Columbia, SC
Lynn Stange, RN, BSN, MA, CHC, Weatherbee Resources, Inc, Hyannis, MA
Holly Swiger, PhD, MPH, RN, CHC, The Elizabeth Hospice, Escondido, CA