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Compliance updates after PHE – How to be Compliant in 2023 and Beyond

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Some may take the position that the rest of the country already returned to a new “normal” following the COVID-19 pandemic. But healthcare providers continue to have to navigate complicated compliance requirements at both the federal and state levels. It is important for healthcare providers to understand how the compliance landscape has changed in 2023 with the ending of the Public Health Emergency (“PHE”) and moving into a new future. Providers are facing audits, fines, and unexpected scrutiny based on practices that they got used to under PHE guidelines. Even though a provider may not mean to violate reinstated or new laws, violations can still result in significant fines and even criminal charges.

This webinar will touch on various healthcare compliance topics including telehealth, HIPAA compliance, Medicaid, licensure concerns, payment for COVID testing, and the latest fraud and abuse trends and cases. These topics are varied but all had some significant changes due to COVID so it is important for providers to understand what requirements apply now.

Telehealth, for example, has grown exponentially in popularity as a method to provide clinical services and many states have implemented updated telehealth laws. In this webinar we will discuss what providers need to consider when providing telehealth across state lines and tele-prescribing. In addition, the coverage of COVID vaccines and testing by all payors has changed significantly since the PHE ended. Providers must ensure that they are billing for these tests and vaccines properly or they could face significant repercussions under federal fraud and abuse laws. The webinar will also educate attendees on changes in HIPAA flexibilities following the end of the PHE as well as how providers should handle the fallout from the disenrollment of many Medicaid beneficiaries.

While these topics may seem unrelated, many practices will have to deal with all of them at some point and the webinar will have useful information for everyone.

Learning Objectives:
  • Educate attendees on which flexibilities under COVID still exist and which are gone
  • Help attendees understand when telehealth is appropriate and what state laws apply
  • Educate attendees about what to do with newly uninsured patients that were dropped from Medicaid
  • Understand when tele-prescribing is allowed, especially for controlled substances
  • Understand which HIPAA flexibilities have been rescinded
  • Learn how to properly bill for COVID vaccines and tests
  • Learn how to avoid fraud and abuse violations and about the latest cases
Areas Covered in the Session:
  • Why think about compliance in terms of pre- and post-PHE?
  • Brief trip down Covid memory lane + Covid compliance context
  • Telehealth
    • Telehealth Pre- and Post-PHE
    • Enforcement Discretion
    • Temporary Medicare Changes Through December 31, 2023
    • Permanent Medicare Changes
    • Medicare Reimbursement Parity for Telehealth Services
    • Changes to Telehealth Billing Codes
    • Common Telehealth Medicare Billing Mistakes
    • Documentation Requirements & Tips
    • Documentation: Medical Necessity
    • General Consent Guidelines
    • Key Changes: DEA Rules
    • Telehealth Services by Payor After the PHE
      • Medicare
      • Medicare Advantage
      • Medicaid and CHIP
      • Private Payor
  • Medicaid
    • Medicaid Overview
    • Continuous Coverage Ending & Routine Operations Begin
    • Overview of Redetermination Process
    • CAA and FMAP
    • Expected Issues
  • No Surprises Act
    • Overview of No Surprise Act
    • Part I
    • Part II
    • Good Faith Estimates
    • Content of the Good Faith Estimate
    • Timeframe for Good Faith Estimates
    • How to Provide the Good Faith Estimate
  • Licensure
    • Overview of Licensure
    • PHE and Licensure
    • Multi-State Licensing Compacts
    • Supervision Waivers
  • Billing (vaccines and other flexibilities)
    • Medicare
    • Medicaid and CHIP
    • Private Insurance
    • Current State of Things
    • Fraud and Abuse Law
Suggested Attendees:
  • Healthcare Executives
  • Physician Practices
  • Individual Providers
  • Hospitals
  • FQHCs
  • Billers
  • Coder
  • Revenue cycle team
  • Physician, PAs and NPPs
  • Compliance Officer and Personnel
  • Privacy and Security Officer
  • Healthcare Attorney and Legal Staff
  • Medical Officers
  • Practice Managers
  • Medical Providers
  • Registered Nurses
  • Administrative Staff
  • Risk Managers
  • Other Healthcare Provider Executives
Presenter Biography:

Ashley Watson Esq. : Ashley is a healthcare attorney in BMD’s Columbus office. She works with nonprofit and for-profit healthcare providers, healthcare trade associations, individuals and businesses. Ashley is experienced in healthcare public policy and regulatory compliance, legislative and government affairs, grant administration, and healthcare program operations.

Ashley helps clients find creative, public policy-based strategies to ensure they can best serve their community. As an attorney with a regulatory healthcare background, Ashley connects clients with business opportunities through government relations and strategic consulting. She also advises on regulatory and compliance matters, board governance, grant compliance, and public policy development.

Daphne Kackloudis Esq. : Daphne L. Kackloudis is a Member of the firm, she heads BMD Columbus’ health care practice, and she was the co-founder and initial chair of BMD’s Empowerment and Opportunity (DE&I) Committee. Daphne’s success – and that of her clients – is rooted in the nexus between traditional health care legal services and health care public policy. She has broad and deep experience in health care operations, service delivery, payment systems, and compliance, as well as Medicaid, public policy, and government affairs. Daphne advises health care trade associations and health care providers as outside counsel and in-house as a member of her clients’ senior leadership teams.

Daphne’s clients include Federally Qualified Health Centers, hospitals, community behavioral health providers, providers of services to people with intellectual and developmental disabilities, child welfare agencies, pharmacies, individually licensed health care providers, health care trade associations, and social service agencies.


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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