Antitrust Enforcement: Evaluating Compliance Programs

Mark Grundvig Assistant Chief, Washington Criminal II Antitrust Division, Department of Justice
Aimee Imundo International Counsel, U.S. DOJ, Antitrust

• Understanding the Antitrust Division compliance program evaluation criteria
• Lessons to learn from recent cases

No Presentation Available
Evaluation

How to Respond to ‘I Heard That is Illegal!’

David Glaser Shareholder, Fredrikson & Byron PA

• Suggestions for improving your hiring process for compliance professionals.
• Tips for explaining complicated rules and the legal hierarchy to both compliance professionals and medical professionals.
• Strategies for analyzing contradictory “expert” opinions and reducing the legal anxiety that can prompt employees to become external whistleblowers.
• Review examples of situations where compliance professionals correctly, or incorrectly, concluded something was illegal.

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Evaluation

How to Find Your CMS Outliers and Build Your Risk-Based Benchmarking Program from Scratch

Jared Krawczyk Director of Analytics, Nektar Analytics

• Explore today’s hot audit targets and the benchmarking metrics you can use to discover if you are at risk.
• Learn how to utilize multiple benchmarking techniques to create an overall risk score on a provider.
• Discuss chart selection methodologies that leverage benchmarking to be more focused and efficient within your internal audit processes

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Managing Compliance Risk: CARES Act Audit and Monitoring Strategies

Lori Laubach Partner, Health Care Consulting Group Moss Adams LLP
Sharon Hartzel Director, Health Care Consulting Group Moss Adams LLP

• Provide an Overview of CARES Act Funding for Providers
• Consider the specific compliance risks areas in regard to CARES Act funding where the compliance team can focus resources to assess the system of internal controls and/or provide monitoring and auditing assistance
• Walk through examples of internal control strengths and opportunities for improvement in identified risk areas; discuss related workplans and corrective action to drive results and mitigate risk

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Evaluation

Transform Your Policies: A (Relatively) Pain-Free Guide

Andrea Falcione Principal & Head of Advisory Services Rethink Compliance
Desiree Ramirez Chief Compliance & Integrity Officer UNT Health Science Center

• Building on momentum from its digital Code of Culture initiative, University of North Texas Health Science Center (UNTHSC) embarked upon a policy transformation journey to fundamentally change its approach to policy management.
• Learn about UNTHSC’s mandate to decrease the number of its policies from 425 to a more manageable 90 (or so!).
• Hear how UNTHSC evaluated its existing policy inventory and policy management process and then crafted and executed on a massive policy transformation plan

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Evaluation

COVID-19 Documentation, Coding and Billing Compliance Risks and Assessments

Laura Jarrett Senior Director – Compliance Childrens Health System of Texas
Bryan Beaudoin Senior Manager and Health Information Management (HIM) Solutions Lead at Protiviti
Joe O’Malley Healthcare-Revenue Integrity and EMR Optimization, Solutions Lead at Protiviti

• Review federal and state guidance regarding documentation, coding, and billing guidance for COVID and COVID-related services during the pandemic
• Learn how one compliance program has managed the evolving guidance around expanded virtual health services, COVID testing, and other COVID related services in order to mitigate risk and incorporate the changes 2020 has made to their annual workplan
• Hear about current documentation, coding and billing trends, risk areas and best practices for monitoring and auditing

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Evaluation