Conference Materials (Password Required)
Attendees will gain valuable insight into the various audits and investigations that are conducted in the government and commercial healthcare fraud, waste and abuse (FWA) space. The focus will be on government audits and investigations and the appropriate responses to such audits. Attendees will also gain an understanding of the different types of subpoenas that are available to law enforcement, and how understanding the subpoenas can help to shape an understanding of the issues presented.
Attendees will also learn about some of the most common proactive compliance measures available, and how to easily implement some of the Office of Inspector General’s recommended 7 points of a provider compliance program. Understanding the methodologies employed by the government to identify outlier claims can assist a healthcare provider in knowing where there may be lapses in compliance.
Learning Objectives:
- Learn about the various types of audits and investigations conducted by the government – CMS, MAC, UPIC, OIG, commercial payors
- Understand the value in knowing how subpoenas are issued, the types of subpoenas and the limitations of a subpoena
- Gain insight into knowing provider data from the inside as a proactive compliance measure
- Learn how to employ simple proactive measures to facilitate a culture of compliance and meet suggested compliance protocols as outlined by the OIG
Areas Covered in the Session:
- Audits vs. Investigations
- UPIC/MAC/RAC/SIU
- CERT/PERM
- Difference between Audits and Investigation
-
- Payment Integrity Purposes Check
- Proper Enforcement of Payment Policies NCD/LCD
- MUE/NCCI Circumventions
- Error Rate Testing
- Payment Error Rate Measurement (PERM)
- Comprehensive Error Rate Testing (CERT)
- Waste and Abuse
- Empirical Study and Analysis
- Office of Evaluation and Inspections (OEI)
- Office of Audit Services (OAS)
- Internal Purposes (Proactive for Compliance)Reasons for Audits
- PERM
- CERT
- Why are PERM and CERT Important
- Investigational Audits
- Subpoenas
- Criminal Subpoenas-Grand Jury
- Criminal-HIPAA
- Civil-CID
- Administrative-CMPL/OIG Subpoena
- Proactive Compliance is Key
- OIG Checklists as Guidance
- Report Overpayments and Determine Scope of Problem
- OIG Model Compliance Guidance
Related Webinars You May Like
Suggested Attendees:
- Healthcare CEOs, CFOs, COOs
- Directors of Compliance
- Billing Managers
- Practice Managers
- Providers
- Compliance Professionals
- Compliance Attorneys
- Billers, Coders and Auditors
- C-Suite
- Physicians
- Practice Managers
- In House Counsel
- Billing Companies
- Clinic Owners
- Chief Quality Officers
- Senior Internal Auditors
- Regulatory/Risk Officers
- Government Employees
- General Counsel
Presenter Biography:
Eric Rubenstein, MSCJ, CFE, is a seasoned retired federal law enforcement officer (25 years), specializing in white-collar crime investigations as a Special Agent for HHS-OIG. Wide-ranging experience involving federal healthcare programs, with an emphasis on crimes involving the Medicare and Medicaid programs by healthcare providers, including physicians, pharmacies and healthcare entities. Demonstrated success in complex criminal investigative management and planning. Over $500 million in restitution, forfeiture, damages, penalties and fines to government programs and over 150 convictions and civil settlements involving healthcare fraud matters. Broad trial experience, including three criminal trials in fourteen months (9 trials in all, including the first Civil False Claims Act trial in the District of New Jersey involving a violation of Stark). 20 years of presentation and training facilitation experience and a feature presenter/ trainer at local, regional and national training academies, conferences (such as the National Healthcare Fraud Association and the American Association of Professional Coders) and subject matter case analysis. Extensive mentoring and training of new agents. A conduit of information on internal and external policies and procedures for criminal, civil and administrative investigative matters.
A previous member of the IBM UCM project, providing Subject Matter Expertise on FWA matters as part of the Optimization Team servicing all UCM user groups (including UPICS, MEDIC and the greater UCM user community-law enforcement). A former Partner Liaison of the Trusted-Third Party for the Healthcare Fraud Prevention Partnership (HFPP) serving the membership of the HFPP and providing SME in the areas of FWA and investigative efforts to combat FWA in healthcare.
Assist/ consult with law firms and providers on due diligence, statistical sampling, self-disclosures, subpoena response, and OIG compliance-related issues, trial and litigation support. Subject Matter Expert (SME) in a variety of healthcare FWA issues, and previously retained as such for litigation and report preparation purposes.
This is a Live Virtual session.
A new way of immersive learning that allows you to engage live with our instructor and peers providing you with the flexibility to juggle the new work-life balance.
Purchase Order Form –Â Click Here to download PO form.
Snippet From Our Previous Session
Frequently Asked Questions:
HOW MUCH TIME DOES IT TAKE TO RECEIVE THE DVDs/ FLASH DRIVE? +
For DVDs/ FLASH DRIVE – It will take around 7 working days.
CAN I PLACE AN ORDER ON CALL? +
Yes, you can call our toll-free number 302-444-0162 and ask our representative for the enrollment. Alternatively, you can also mail us at care@skillacquire.com .
CAN I PURCHASE ANY OF YOUR TRAINING FORMATS, AT ANY TIME? +
For DVDs/ FLASH DRIVE – Yes, you can place the order at care@skillacquire.com using the order brochure or can call us at our toll-free number 302-444-0162.
DO I REQUIRE A COMPUTER FOR ATTENDING A LIVE COURSE? +
The system requirements are quite basic: OS: 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, in case of live course you can raise questions using a microphone.
HOW CAN I BECOME FACULTY AT SKILLACQUIRE? +
Please share your detailed CV with us and our team will screen the best faculty for the specific field.
HOW CAN I GET ACCESS TO THE LIVE TRAINING? +
You can access the live training using Joining Link or Dial-In Number. To get the joining link, you can click on the conference materials on the product description page, and enter your email address and password that you received in your email.
We will also send you the joining link or dial-in number to the registered email address 2-3 days prior to the live training. You can simply click the joining link to join the live training.
HOW CAN I MAKE A BULK PURCHASE? +
You can call our customer service department at 302-444-0162 and may also avail some discounts on the bulk orders.
WHAT’S THIS DIFFERENT FORMAT? +
- Live (One Attendee) – Only 1 person will be able to join the webinar
- Live (2 to 4 Attendees) – Upto 4 persons are allowed to join the webinar
- Live (5 to 10 Attendees) – Upto 10 persons are allowed to join the webinar
- On-Demand Recording (One Attendee) – Webinar recording link will be provided for a single attendee
- On-Demand Recording (Multiple Attendees) – Webinar recording link will be provided that can access by more than one person
- DVD – DVD will be shipped physically to the address provided
- Flash Drive – Flash drive will be shipped physically to the address provided
- Live + DVD – This allows you to attend live webinar plus you also get DVD shipped to the address provided
- Replay + FLASH DRIVE – Allows you to get webinar recording link plus you also get DVD shipped to the address provided
- Live + REPLAY + DVD – This allows you to attend live webinar plus you also get webinar recording to your email and DVD shipped to the address provided
WHAT CERTIFICATION DO I GET POST THE TRAINING? +
After successful completion of the training, you will be awarded the course completion certificate (on request). The certifications/ recertifications should be mentioned under the description of every course.
TESTIMONIALS
“Jim Sheldon-Dean’s insights on privacy and security were very much helpful to our team, it was great to learn from an instructor like him. Appreciate!” CHRISTINE JACOB MD, CDI SPECIALIST
“This program on HIPAA did a great job providing actionable concepts in a way that updated our team and me, I now know how I will implement the concepts because I already did it in their online seminar, it was easy to ask questions from the speaker at the end of my 60 minutes course.” MELISSA PRESTON, HEALTH INFORMATION MANAGEMENT STAFF
“The workshop was very insightful and made absolute sense in terms of the regulations and their compliance. I am thankful for having the opportunity to attend.”BARBARA CAPRIOTTY, REHABILITATION DIRECTOR
