January 28, 2022

Orlando Regional Healthcare Compliance Conference

Orlando, Florida, United States

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Handouts

Overall Survey | CEU Application | Conference Brochure

Government Enforcement Panel

Moderator:
Gabriel Imperato Managing Partner, Nelson Mullins Broad and Cassel, SCCE & HCCA Board Member
Jeremy Bloor, Assistant U.S. Attorney, USAO
Felicia Heimer, Senior Counsel, Office of Counsel to the Inspector General, U.S.
David Bundy, Deputy Director Criminal Enforcement, Medicaid Fraud Control Unit, Office of the Attorney General
Ashley Moody
Rachel K. Jones, Assistant United States Attorney, MDFL, Economic Crimes Section

• Review criminal, civil and administrative enforcement actions from 2021
• Differentiate between criminal investigations, False Claims Act cases, and agency-driven matters
• Understand government agency priorities in healthcare enforcement

Presentation
Evaluation

Compliance Professionals and the FCA

Jeremy Bloor, Assistant U.S. Attorney, USAO
Gabriel Imperato Managing Partner Nelson Mullins Broad and Cassel SCCE & HCCA Board Member

• Understand DOJ’s Cooperation Credit Guidelines
• Use specific aspects of False Claims Act cases to direct compliance training and program effectiveness.
• Utilize compliance program to identify and stop fraudulent or negligent actions
• Managing compliance risk, internal investigations and self-disclosure

Presentation
Evaluation

Effective Compliance Due Diligence

Zach Simpson, Attorney, Florida Healthcare Law Firm
Susan St. John, Attorney, Florida Healthcare Firm
Kristen Lilly-Davidson, Senior Manager, PYA

• Explore the foundation of a comprehensive compliance-centered due diligence process
• Explore how transaction structures affect the scope and approach of due diligence,
• Review the minimum compliance due diligence that should occur, and learn best practices for monitoring post-transaction compliance and mitigation of identified risks
• Examine case studies, lessons learned, practice tips, risks, and common pitfalls of conducting due diligence

Presentation
Evaluation

May I or Must I - The 21st Century Cures Act and HIPAA-Information Blocking and What You Should Know

Blaine Kerr, Sr. Director of Security and Privacy Compliance, Ensemble Health Partners
Diana Salinas, Compliance and Privacy Officer, Leon Medical Centers

• Recognize the distinctions of healthcare data sets and what data must be available for the patient:
– Legal Record Set
– HIPAA Designated Record Set
– The United States Core Data for Interoperability (“USCDI”) Set
• Identify who are actors and understand their roles and responsibilities
• Learn what practices may constitute information blocking

Presentation
Evaluation

Value based arrangements and recent changes to, stark, antikickback and beneficiary inducement laws

Robert Wade, Partner, Barnes & Thornburgh LLP

• Determine how fair market value applies to value-based arrangements
• What are the operational challenges in implementing value-based arrangements
• What value-based purposes can apply to valuebased arrangements to remain in compliance
• How are target patient populations determined under value-based arrangements

Presentation
Evaluation

Compliance Scenarios and Resolutions

Judy Ringholz VP of Compliance and Ethics & Chief Compliance Officer, Jackson Health System SCCE & HCCA Board Member
Gabriel Imperato Managing Partner Nelson Mullins Broad and Cassel SCCE & HCCA Board Member

• Appropriate response to reports of noncompliant activity- internal investigations
• Organizational governance and internal investigations; authority and practical considerations
• Methodology for internal investigations; establishment, resources, probable cause and preponderance of evidence, privilege and findings of fact
• Management of Risk; Resolution, remedial action and self-disclosure
• Tips for compliance professionals and best practices

Presentation
Handouts
Evaluation