PYA thought leaders once again joined Foley & Lardner for the “Let’s ‘Virtually’ Talk Compliance” event January 19-20, 2022. The panel of presenters included healthcare attorneys, certified public accountants and valuators, and healthcare advisors. Each day featured two sessions covering topics such as fraud and abuse, compensation valuation, and the No Surprises and False Claims Acts.
The complimentary sessions took place from 10 a.m. to 12:30 p.m. Eastern each day, as follows:
- Opening Comments: 10:00 a.m. – 10:05 a.m.
- Session 1: 10:05 a.m. – 11:05 a.m.
- Break: 11:05 a.m. – 11:15 a.m.
- Session 2: 11:15 a.m. – 12:15 p.m.
- Closing Comments: 12:15 p.m.
Participants who attended the duration of a full session were able to choose either CPE, CLE, or CHC credits. For a summary of the January 2022 event, read Foley & Lardner’s blog here, and see information for each session below.
Day One | January 19, 2022
Session 1 – “Fraud & Abuse: Recent Cases Settled Summary”
Olivia King, Associate at Foley & Lardner
Shannon Sumner, PYA Chief Compliance Officer and Principal
The speakers discussed recent healthcare fraud and abuse cases, settlements, and Department of Justice (DOJ), Office of the Inspector General (OIG), and Health and Human Services (HHS) enforcement activity and provided participants with key takeaways for corporate compliance programs. The session covered:
- Overview of recent healthcare fraud and abuse case law, settlements, and DOJ, OIG, and Centers for Medicare & Medicaid Services (CMS) enforcement activity.
- Key takeaways for compliance programs.
- Expectations for enforcement trends in the coming year.
Session 2 – “Compliance Considerations Related to Provider Compensation”
Judy Waltz, Partner at Foley & Lardner
Kyle Faget, Partner at Foley & Lardner
Angie Caldwell, PYA Principal
Carol Carden, PYA Managing Principal of Valuation Services
This discussion included best practices (and not so best practices!) for compliance surrounding key opinion leader compensation, open payments database reporting, telemedicine compensation, the use of value-based exceptions, advanced practice provider supervision and work attribution, and more. Key learning objectives of this session included:
- Best practices for compliance surrounding key opinion leader compensation and open payments database reporting.
- Key approaches for valuing telemedicine compensation, and the compliance impacts of not using valuation best practices.
- Considerations for using the value-based exceptions in the Stark Law and Anti-Kickback Statute.
- Best practices for compliance surrounding advanced practice provider supervision compensation, including the use of stipends, work attribution methodologies, the impact of the 2022 Medicare Physician Fee Schedule, and more.
Day Two | January 20, 2022
Session 3 – “Keeping Your House Clean: Data Analytics in Health Care Enforcement and Compliance”
Matt Krueger, Partner at Foley & Lardner
Valerie Rock, PYA Principal
DOJ, HHS, and OIG, and other agencies increasingly rely on sophisticated data analytics to guide enforcement efforts against health care fraud, waste, and abuse, which increases the need for compliance programs to use data analytics. This presentation covered:
- DOJ and HHS OIG’s expectations for compliance programs, including effective use of data.
- Practical steps to take to improve use of data in compliance activities, including risk assessments, audits, and investigations.
- Challenges to using data effectively, including data availability, technical limitations, and the need to prioritize efforts.
Session 4 – “No (More) Surprises Act – Whoops Here’s One!”
Jana Kolarik, Partner at Foley & Lardner
Kathy Reep, PYA Senior Manager
On January 1, 2022, the federal No Surprises Act became effective. The new law prohibits surprise billing for emergency services and non-emergency services furnished by an out-of-network provider in an in-network facility. It also establishes a specific process to determine the amounts owed by patients and payers. This session covered:
- A brief overview of the No Surprises Act.
- Discussion of the requirements related to the good faith estimates for uninsured and self-pay patients.
- Legal updates and compliance concerns.
If you would like assistance with any matter involving compliance, valuation, or strategy and integration, one of our executive contacts would be happy to assist. You may email them below, or call (800) 270-9629.
Educational Credits Available:
The Compliance Certification Board (CCB)® has approved this event for up to 4.8 live CCB CEUs based on a 50-minute hour. Continuing Education Units are awarded based on individual attendance records. Granting of prior approval in no way constitutes endorsement by CCB of this event content or of the event sponsor.
Participants can earn 4 CPE credits in Specialized Knowledge.
Program Level: Intermediate. Delivery Method: Group Live. Advanced Preparation: None.
Prerequisites: None. No fee. PYA, P.C. is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website: www.NASBARegistry.org.
Foley & Lardner LLP will apply for CLE credit after the program, wherever applicable, and CLE credits will be applied for in all applicable states. Foley & Lardner LLP certifies that this activity has been approved for California MCLE credits by the State Bar of California. Foley & Lardner LLP is a State Bar of California MCLE approved provider. Please note that participants must be in attendance on the date of the event; credit may not be obtained by viewing and/or listening to a program recording after the event. Certificates of attendance will be distributed to eligible participants approximately eight weeks after the program via email. Important information for New York attorneys: This program is appropriate for experienced attorneys only.