On January 18-19, PYA and Foley & Lardner LLP presented the sixth annual Let’s Talk Compliance virtual conference. The event was moderated by Foley Health Care Partner Jana Kolarik and PYA Consulting Principal Angie Caldwell. Panelists included members from Foley’s Health Care & Life Sciences Sector as well as PYA’s healthcare consulting, compliance, and cybersecurity experts. Each day featured two sessions that covered relevant and trending topics in healthcare and life sciences compliance.
Day 1: Thursday, January 18, 2024
Session 1: Refreshing Compliance Programs to Respond to OIG’s New Health Care Compliance Guidance and Recent Enforcement Actions
Presenters: Shannon Sumner, Judy Waltz
In this session, attendees learned about the following:
- A general overview of the November 2023 release of the OIG’s General Compliance Program Guidance (GCPG) including key risk areas.
- The most notable updates, changes, and emphasis by the OIG since the original release of Compliance Program Guidance in the Federal Register.
- A summary of recent enforcement actions for consideration by compliance officers when developing their 2024 compliance work plan.
SLIDES | ON-DEMAND RECORDING | KEY TAKEAWAYS
Session 2: Privacy, Security, and Artificial Intelligence: Patient Rights, Tracking Technologies, and Cybersecurity
Presenters: Barry Mathis, Jennifer Hennessy
In this session, attendees learned about the following:
- Challenges and trends regarding the use of AI in the healthcare space.
- Considerations on the use of tracking technologies in the healthcare space.
- Recent trends in healthcare cybersecurity, including a discussion of healthcare-related dark web activity.
- A refresher on HIPAA’s right for patients to access their own information, in light of HHS settling at least 44 investigations under its HIPAA Right of Access Initiative.
- Other trends in recent HHS investigation settlements.
SLIDES | ON-DEMAND RECORDING | KEY TAKEAWAYS
Day 2: Friday, January 19, 2024
Session 3: Medicare Advantage: Compliance Issues and Enforcement
Presenters: Valerie Rock, Mike Tuteur
In this session, attendees will learned about the following:
- How has the landscape changed over the last few years related to government scrutiny of Medicare Advantage plans and payments?
- How do the reimbursement differences between traditional (or fee-for-service) Medicare and Medicare Advantage affect the analysis of compliance – e.g., application or not of local coverage decisions/national coverage decisions; diagnosis codes; who is paid?
- What are the current areas of focus of the HHS Office of Inspector General in the Medicare Advantage space?
- Concerning recent government activity, what should the compliance focus of plans and providers be?
- Increasing interest/visibility of Medicare Advantage in Congress, OIG, and CMS (including new rulemaking)
SLIDES | ON-DEMAND RECORDING | KEY TAKEAWAYS
Session 4: Panel Discussion on Compliance Hot Topics
Presenters: Angie Caldwell, Jana Kolarik, Valerie Cloud, Matthew Vogelien
This session was a panel discussion addressing various emerging issues in healthcare compliance, and provided attendees an understanding of the following:
- The general state of the healthcare policy landscape surrounding artificial intelligence (AI), various risk considerations, and provider organization perspective on AI governance, controls, and implementation.
- Practical recommendations for incorporation of the OIG General Compliance Program Guidance (GCPD) in your compliance program effectiveness plan.
- Compliance considerations surrounding advanced practice provider and physician collaboration, including split-shared visits guidance, best practices surrounding provider education, risk assessment, audit strategies, and examples of provider compensation impacts.
- Identifying and solving physician compensation challenges related to the assessment of physician productivity, financial assistance arrangements, and call pay.
SLIDES | ON-DEMAND RECORDING | KEY TAKEAWAYS
Speakers
- Angie Caldwell, Consulting Principal, PYA
- Jana Kolarik, Partner, Foley & Lardner LLP
- Valerie Cloud, Chief Compliance Officer, Summa Health
- Jennifer Hennessy, Partner, Foley & Lardner LLP
- Barry Mathis, Principal, PYA
- Valerie Rock, Principal, PYA
- Shannon Sumner, Consulting Principal PYA
- Michael Tuteur, Partner, Foley & Lardner LLP
- Matthew Vogelien, Division Corporate Responsibility Officer, AdventHealth
- Judith Waltz, Partner, Foley & Lardner LLP
CPE, CLE, and CHC credits were available to those who attended the live sessions and met the polling and/or affirmation requirements. This educational activity was offered free of charge.
Learn more about the PYA and Foley & Lardner compliance initiatives.
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.
About Educational Credits
CHC:
The Compliance Certification Board (CCB)® has approved this event for up to 4.8 Live CCB CEUs based on a 50-minute hour, each. 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.
CPE:
Participants can earn up to 4 CPE credits in Specialized Knowledge. Program Level: Intermediate. Delivery Method: Group Internet Based. 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.
CLE: Applications for accreditation will be submitted to CO, FL, NY, and WI for up to 1.0 credit hours (50-minute hour) and CA, IL, TX, UT, and VA for up to 2.0 credits hours (60-minute hour). Uniform Certificates of Attendance will be provided to attendees seeking credit in other jurisdictions.
Foley & Lardner LLP is an approved MCLE provider in California, Colorado, Illinois, New York, Texas, and Utah.
For purposes of New York CLE credit, this program is appropriate both newly admitted and experienced attorneys. Certificates of attendance will be distributed to eligible participants approximately eight weeks after the program via email.
