Webinar Pack

Pack of FOUR Courses: Includes Anti-Kickback Statute and Regulations, Medical Necessity, Negligent Credentialing and Federal False Claims Act

webinarpacks

Product Id: 20055PACK


Modules:
  1.   Health Insurance Portability and Accountability Act (HIPAA) Audits
  2.   Medical Necessity: Clinical Medical Necessity vs Billing Medical Necessity
  3.   Negligent Credentialing: Strategies to Protect Your Health Care Entity
  4.   The Federal False Claims Act: Becoming a Whistleblower
Webinar Pack Price
Offer Price: US$445.00
You Save: US$455.00 (50%)*
Regular Price: US$900.00

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Instructor : Phil Larson
Product Id : 20055PACK

Overview: Learn more about Health Insurance Portability and Accountability Act (HIPAA) Audits. In 2012, HHS rolled out a new audit program targeting covered entities, including group health plans for HIPAA compliance audits.

The second round of audits is about to begin in the fall of 2013.  These audits focus on the national standards for the privacy of protected health information, the security of electronic protected health information, and breach notification requirements to consumers under the Health Information Technology for Economic and Clinical Health Act (HITECH).  This session will describe what you can expect if your health plan is selected for an HHS audit, and what you can learn from the audits, whether or not your program is ever selected.  It will include real-world stories from a group health plan that has actually been through a HIPAA audit.   

Areas Covered in the Session:
  • An understanding of the Office of Civil Rights (OCR) audit program for HIPAA privacy, security and the Health information Technology for Economic and Clinical Health (HITECH) Act
  • Key terms, enforcement authority, and procedures under the new audit program
  • Who can be audited, the stages of an audit, and the audit protocols
  • "Lessons Learned" from a real life audit

Who Will Benefit:
  • HIPAA Business Associates
  • Chief Information Officer
  • Health Information Manager
  • Office Manager
  • CEO
  • CFO
  • Healthcare Council
Phil Larson practices as a health, welfare and fringe benefits attorney in Minneapolis, Minnesota. As a recognized expert on health care and employee wellness topics, Phil is a sought-after speaker for organizations and a frequent presenter at the Advanced Employee Benefits Seminar for the State Bar Association.

Phil served as a senior in-house attorney for a major international corporation for more than 17 years before forming his own law firm Kinney and Larson LLP. He has also been an adjunct professor at the University of Minnesota Law School. Mr. Larson practices exclusively in benefits law including the Affordable Care Act (ACA), HIPAA privacy and security, wellness, consumer health programs, and general plan compliance. He has experience with regulatory and contract issues ranging from a million dollars up to a billion dollars. His firm works with employers, health plans, providers, government organizations, third party administrators, financial institutions and entrepreneurs.
Product Id : 20055PACK

Overview: The session will provide an overview of medical necessity, particularly for the point of view of billing medical necessity as opposed to clinical medical necessity. We will address what providers and hospitals can do to try to stem this enforcement effort and how compliance programs should be adapted to address this risk area. We will address how historic fraud and abuse detection efforts are changing and review what the future holds for fraud detection and enforcement.

We will discuss how companies/hospitals should self assess medical necessity activity. We will address who is accountable for the medical decisions of physicians and what should be done to fulfill that responsibility. We will provide insight into measurement tools that allow hospitals to evaluate and/or challenge the medical decisions of the medical staff. We will also discuss how hospitals can self assess medical necessity activity. The roll of peer review and due diligence reviews will be reviewed.Finally, the webinar will review some of the high-profile cases and how the government is approaching its enforcement activities.

Why should you attend: This session is designed for health care executives, physicians and other health care providers who participate in and receive remuneration from Medicare, Medicaid, and other federal health care programs such as TriCare. Several recent actions bring home the realization that medical necessity is an enforcement target and compliance focus should be a priority.

As a health care executive, physician or other health care provider, you should be very concerned about the potential for the government to use medical necessity as a basis to pursue a federal False Claims Act action to stem the tide of overutilization of Medicare, Medicaid, TriCare and other government healthcare services. Three cases in particular, involving spinal surgery, have occurred in the past year. In at least one of those cases, the surgeon has apparently left the country for his native Pakistan. Attend this webinar and learn how to protect yourself and your organization.

Areas Covered in the Session:
  • Medical necessity: clinical vs billing necessity
  • How compliance programs can be adapted to address this risk area
  • Enforcement activities involving medical necessity
  • Self assessment
  • Accountability for medical decisions
  • Measurement tools
  • The roll of peer review
  • High-profile cases

Who Will Benefit:
  • CEOs
  • COOs
  • CNOs
  • CMOs
  • Medical Staff Officers
  • Physicians
  • Physicians who serve on peer review committees
  • Medical Staff
  • Support Staff
  • Attorneys representing Medical Staffs
William Mack Copeland MS, JD, PhD, LFACHE, practices health care law in Cincinnati at the firm of Copeland Law, LLC. He is also president of Executive & Managerial Development Group, a consulting entity providing compliance and other fraud and abuse related services. A graduate of Northern Kentucky University Salmon P. Chase College of Law, Bill is a frequent author and speaker on health law topics.

Copeland is a member of the American Health Lawyers Association, American, Ohio and Cincinnati Bar Associations and is a life fellow in the American College of Healthcare Executives. He was awarded the American College of Health Care Executives Senior-Level Healthcare Executive Regent’s Award in 2007.
Product Id : 20055PACK

Overview: Hospitals, as corporate entities, have the ultimate responsibility for the quality of medical care provided in its facilities. This statement can be misleading, however, if one concludes that the hospital is liable for all acts of negligence or malpractice by a physician who practices at the hospital. In truth, the hospital must take reasonable steps:

  • To select a competent medical staff
  • To ensure that the individual physician on it staff performs only procedures for which he or she is qualified
  • To implement certain quality control measures to verify that only qualified practitioners remain on the staff and that quality care is provided in the institution
We will review the historical relationship between the physician and the hospital and, to see this relationship in the proper context, the roles each plays under the "corporate responsibility doctrine." We will also review the development of negligent credentialing and examine what actions should be taken to preclude liability for failure to properly credential practitioners.

Why should you attend: In a medical malpractice action, the plaintiff is looking for the defendant with deepest pocket for recovery. There is little question that hospitals have the deepest pocket. You should attend this program to learn how negligent credentialing develops and learn strategies to defend against it.

Areas Covered in the Session:
  • A brief history of peer review in hospitals
  • How the doctrine of corporate responsibility developed
  • Responsibility of the hospital for monitoring the care provided by physicians
  • What negligent credentialing is and how it developed
  • A brief review of state lawsuits involving negligent credentialing
  • Strategies that should be taken to preclude liability

Who Will Benefit:
  • Hospital Executives
  • Medical Staff Officers
  • Physicians who serve on peer review committees
  • Medical Staff
  • Support Staff
  • Attorneys representing Medical Staffs
William Mack Copeland MS, JD, PhD, LFACHE, practices health care law in Cincinnati at the firm of Copeland Law, LLC. He is also president of Executive & Managerial Development Group, a consulting entity providing compliance and other fraud and abuse related services. A graduate of Northern Kentucky University Salmon P. Chase College of Law, Bill is a frequent author and speaker on health law topics.

Copeland is a member of the American Health Lawyers Association, American, Ohio and Cincinnati Bar Associations and is a life fellow in the American College of Healthcare Executives. He was awarded the American College of Health Care Executives Senior-Level Healthcare Executive Regent’s Award in 2007.
Product Id : 20055PACK

Overview: The program will provide an overview of the Federal Civil False Claims Act (FCA), including how to determine if you have a viable whistleblower suit. We will discuss what type of evidence you need to have to proceed with the suit.

The program will take the FCA and show step by step how an action is filed, how the government responds and how the courts interpret various elements of the FCA. We will discuss proof, damages under the FCA and how a whistleblower is rewarded for bringing a successful case. Retaliation will be discussed, along with and how the whistleblower is protected from retaliation under the FCA.

We will discuss the theories of false certification and show how violation of the anti-kickback statute and/or physician referral laws (Stark II) can constitute false claims. Since the government relies on compliance with these laws for payment, violations serve as the basis of a FCA suit.

Why should you attend: Several recent cases involving healthcare providers have resulted in huge settlements. If you believe that you have a potential whistleblower lawsuit that can be filed under the False Claims Act, you should attend this webinar to explore your alternatives. You may be setting on a gold mine and you should examine how viable you potential case is. This webinar will provide you with the tools to evaluate your case with a view to discussing it with an attorney who practices in the False Claim Act arena.

Areas Covered in the Session:
  • The Federal False Claims Act and how the Act works
  • Rewards to whistleblowers
  • Proof
  • Damages
  • Risks of filing a whistleblower suit
  • False claims, Stark and Anti-kickback
  • How the case proceeds
  • Why prosecuting a whistleblower case can be difficult
  • Legal representation
  • Awards
  • Downsides

Who Will Benefit:
  • Hospital Employees
  • Executives and Department Managers
  • Nursing Home Employees and Executives
  • Physicians
  • Physician Practice Managers
William Mack Copeland MS, JD, PhD, LFACHE, practices health care law in Cincinnati at the firm of Copeland Law, LLC. He is also president of Executive & Managerial Development Group, a consulting entity providing compliance and other fraud and abuse related services. A graduate of Northern Kentucky University Salmon P. Chase College of Law, Bill is a frequent author and speaker on health law topics.

Copeland is a member of the American Health Lawyers Association, American, Ohio and Cincinnati Bar Associations and is a life fellow in the American College of Healthcare Executives. He was awarded the American College of Health Care Executives Senior-Level Healthcare Executive Regent’s Award in 2007.