Bringing Compliance to the Business

Lorie A. Davis, Manager, Medicaid Government Compliance, Gateway Health
John Dumnich, Manager of Medicare Compliance, Gateway Health

• Understand the advantages of taking a proactive approach to compliance with the operational areas in your organization
• Recognize key considerations for establishing effective business relationships with operational team members
• Design regularly scheduled workgroups and touchpoint meetings to promote effective lines of communication and compliance knowledge within your organization

Presentation
Evaluation

The Federal and State Health Policy Landscape in the Biden Administration

Tracey Lawless, Government Affairs Advisor, K&L Gates LLP
Victoria Hamscho, Associate, K&L Gates LLP

• Review the Biden administration’s health policy priorities and actions taken to date
• Learn about health policy priorities and relief being considered in Congress and by the Pennsylvania General Assembly
• Discuss how these issues will play out among policymakers and their impact to compliance regulations and providers

Presentation
Evaluation

Program Integrity and COVID-19 Fraud, Waste, and Abuse Schemes

Dr. Melissa Berdell, Director, Fraud, Waste, and Abuse, Gateway Health

• Participants will be able to identify the program integrity framework and elements needed to prevent and detect FWA
• Participants will be able to understand the collaboration of MCOs with oversight agencies and law enforcements to address FWA • Participants will be able to classify FWA schemes specific to the COVID pandemic
• Participants will be able to develop strategies to prevent and mitigate FWA concerns and schemes specific to the COVID pandemic

Presentation
Evaluation

The Risks in Assessing Risk

Adam Turteltaub, CCEP CHC Chief Engagement & Strategy Officer Society of Corporate Compliance and Ethics Health Care Compliance Association
• Learn how the brain understands and misunderstands risks
• Identify traps that can derail a risk assessment
• Come away with a better understanding of how to have a more reliable understanding of your organization’s risks

Presentation
Evaluation

Trends in Healthcare Enforcement

Karen Gal-Or, Assistant U.S. Attorney - Civil Division, Western District of Pennsylvania
Adam Fischer,Assistant United States Attorney, Civil Divisio - U.S. Attorney’s Office, Western District of Pennsylvania

• Recent developments in False Claims Act litigation in Western Pennsylvania
• Recent Western Pennsylvania Opioid Fraud and Abuse Detection Unit (OFADU) cases
• COVID-19 Fraud • Other health care fraud initiatives, including telemedicine and durable medical equipment fraud, sober home fraud, and genetic testing

Presentation
Handout
Evaluation

Criminal Antitrust Compliance and Risks in Healthcare

Eyitayo “Tee” St. Matthew-Daniel, Assistant Chief, Antitrust Division, United States Department of Justice

• Understand criminal antitrust risks and vulnerabilities in healthcare
• Evaluate corporate compliance programs in light of the US DOJ Antitrust Division’s guidance
• Apply this knowledge to manage the risks of non-compliance with criminal antitrust laws

Presentation
Handout
Evaluation