Medical Offices continue to face the ever-growing compliance requirements of government laws, regulations, rules, and guidelines. To be prepared and properly trained in compliance, medical practices need staff who can develop, organize, manage, and direct the roles and responsibilities of a compliance department.
The Patient Protection and Affordable Care Act (PPACA) of 2010 indicated compliance programs will become mandatory as a condition of enrollment in the Federal healthcare programs. A basic compliance program should address areas of prevention and detection of criminal conduct, and how-to enforcement government rules and regulations. In addition, train staff on how to report areas of concern, without fear of retaliation.
“Best practices” can ensure they are in compliance and up to date on all of them is by implementing a compliance program. It is much more expensive to “not” have a compliance program in place than to have one. The top reasons to join this session are:
- Opportunity to take a look at where your medical office is regarding compliance and starting planning to reach your new goals.
- Learn about the different areas of compliance that practices need to provide training for their employees.
- There is increased scrutiny on Medicare/Medicaid fraud and abuse, the impending requirement for mandatory physician practice compliance programs.
- On January 2, 2018, the U.S. Department of Labor announced an increase in the maximum penalty amounts for violations for Occupational Safety and Health Administration (OSHA) standards and regulations.
- Civil penalties for violating the Anti-Kickback Statute may include penalties of up to $74,792 (in 2017) per kickback plus three times the amount of the kickback.
- Penalties for physicians who violate the Stark Law may include fines, up to $24,253 (in 2017) exclusion from all Federal health care programs.
- Office of Inspector General (OIG) has the authority to waive an individual’s or entity’s exclusion participation in the Federal health care programs.
- Receive valuable resources on “top compliance” concerns for training in your organization
Areas Covered In The Session:
- Responsibilities/job description of the compliance officer and/or committee
- Who in your medical office is responsible for adhering to compliance.
- Penalties a physician or practice could face if it is not in compliance with regulations.
- Major compliance concerns for the medical practice, along with information to help avoid penalties and potential penalty amounts.
- Your medical practice role with training on potential social media violations
- HIPAA and guidance for doctors responding to opioid crisis patients
- Statistics on potential areas for data breeches in your organization
- Coding and Documentation Accuracy areas of concern
- How to engage your providers and staff in effective monitoring of your compliance plan.
- How to structure your organization to be a “Culture of Compliance”
- Learn what areas of non-compliance can be of risk to your medical office
- Review the roles/responsibilities of a Compliance Officer
- Receive information on Setting up Compliance Plan for your size medical practice
- Discuss key healthcare fraud and abuse laws including the False Claims Act, Stark Laws, and Anti-kickback Statute, including the associated penalties
- Other laws and regulations including HIPAA and OSHA
- How to effectively communicate to physicians and patients regarding co-pays and patient discounts to maintain compliance
- Gain more information on effectively managing social media in your practice that may cause penalties for your practice
- How to start an audit process to ensure correct coding and documentation efforts
- Importance of effective monitoring of your compliance plan
- Healthcare Execurtives
- Compliance Officers
- Practice Managers
- Revenue Cycle Managers
- Medical Staff Office Personnel
About The Presenter:
Pam Joslin, MM, CMC, CMIS, CMOM, CMCO, CEMA, CMCA-E/M currently serves as a Compliance Program Manager within the Audit and Compliance Services team of HonorHealth in Scottsdale, AZ. Anne previously worked with Presence Health, an 11-hospital system in the greater Chicago area where she served as a Regional Compliance Officer overseeing the implementation of the system’s compliance program at two Lakeshore hospitals. Prior to her work at Presence Health, Ms. Brummell served as Regulatory Compliance Analyst at Sutter Health in Northern California where she implemented numerous programmatic and operational processes to increase the effectiveness of compliance activities across the 30-hospital system. She also served as a Regional Physician Contract Coordinator for Sutter Health’s Sacramento Region. Anne has also served as Senior Paralegal and Administrative Manager at an investment management firm in the Bay Area.
You will receive an email with login information and handouts (presentation slides) that you can print and share to all participants at your location.
Operating System: Windows any version preferably above Windows Vista & Mac any version above OS X 10.6
Internet Speed: Preferably above 1 MBPS
Headset: Any decent headset and microphone which can be used to talk and hear clearly
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