Medicaid Enforcement (Audio Conference)

AUDIOCONFERENCE ON CD OR AUDIO ARCHIVE

Sponsored by Healthcare Compliance Professional's Guide to Risk Assessments

presented on February 20, 2008

And you thought complying with Medicare rules was tough. Welcome to the world of Medicaid enforcement. With the Deficit Reduction Act of 2005 came a revolution in Medicaid claims compliance oversight that includes:

• $25 million annually for Medicaid OIG audits and investigations
• 100 additional CMS Medicaid Integrity Program (CMS) staff members

The regulation encouraged states to create their own False Claims Acts—nearly 20 states have already done so. Furthermore, any hospital which receives more than $5 million in Medicaid reimbursement claims must implement a compliance program to conform to CMS standards.

Do you know what will trigger an OIG investigation into your facility’s Medicaid billing practices? Are your prepared to identify the Medicaid high risk areas in your organization?

Listen to HCPro's 90-minute audioconference “Medicaid Enforcement: Prepare your compliance program for government scrutiny.” Healthcare compliance consultants David Butler and Michael F. Mangano (both of Strategic Management Systems, Inc.) and attorney Sara Kay Wheeler (Powell Goldstein LLP) will discuss steps to:

• Identify the top Medicaid compliance risk areas
• Determine top OIG Medicaid concerns
• Develop an effective compliance program to handle Medicaid risks
• Organize compliance training as required by the Deficit Reduction Act

Our team of experts offer the latest news and the best practice information to help you handle this hot-button enforcement issue. You cannot afford to pass up this presentation.

TAKE A LOOK AT THE AGENDA

• The new Medicaid compliance environment
• What has changed with the DRA
• Time to update compliance programs
• Medicaid trouble spots in 2008 and beyond
• Medicaid managed care contracts
• Medicaid fee for service providers
• Medicaid compliance in the OIG Work Plan
• Identifying and managing Medicaid risk
• The 4 step approach to a risk management program
  • Risk Identification
  • Risk Assessment
  • Risk Strategy Planning
  • Risk Remediation
• Legal considerations when constructing a risk management program
• Update on state regulatory reaction to DRA
  • Promulgation of state false claims acts and other DRA-related regulations
  • Identification of specific state laws to be included in DRA policies
  • Issuance of requests for certification with DRA employee education provisions
  • Potential consequences of non-compliance
• General compliance strategies Compliance with the DRA employee education provisions
  • Revisiting DRA employee education policies
  • Addressing contractor/agent issue
• A question and answer session follows the presentation

MEET THE SPEAKERS

David Butler, President, Strategic Management Systems, Inc. Mr. Butler oversees the strategic, financial, and overall operating plans for SM, focusing on ongoing revenue growth and profitability. He presides over the performance of the senior management team to ensure effective execution of business strategies, as well as fostering strategic business partner relationships to promote business development. Mr. Butler exercises enterprise-wide leadership for both government and privacy-sector initiatives, and ensures the direction of SM's business lines to continuously meet the ever-changing needs of the health care industry.

Michael F. Mangano, Senior Vice President, Strategic Management Systems, Inc.  Prior to his current role as consultant with SM, Mr. Mangano spent 25 years working with the OIG, including stints as Principal Deputy and Acting IG. During his distinguished Federal service, he was recognized on three occasions by the President of the United States with Distinguished and Meritorious Executive Rank Awards. At the Administration on Aging he was responsible for administration of over 1,000 grants and contracts to state and local governments annually. He performed the Chief Financial Officer, Chief Information Officer, and Chief Grants Officer functions.

Sara Kay Wheeler, Partner, Business Litigation, King & Spalding LLP. Ms. Wheeler practices exclusively in the area of health and hospital law. She has extensive experience in the creation and implementation of corporate compliance programs, including the negotiation of corporate integrity agreements (CIAs) with the United States Department of Health and Human Services, and the Office of Inspector General. Ms. Wheeler's other areas of expertise include experience in Medicare and Medicaid reimbursement arrangements, fraud and abuse concerns, internal investigations and other compliance issues, clinical research compliance, privacy matters, managed care arrangements and healthcare litigation.