Survive a RAC Audit (Audio Conference)

AUDIOCONFERENCE ON CD OR AUDIO ON-DEMAND

Sponsored by Healthcare Compliance Professional's Guide to the False Claims Act

presented on June 18, 2008

Since 2005, CMS collected nearly $440 million in improper Medicare payments thanks to its 3-year Recovery Audit Contractors (RACs) demonstration program. With a congressional mandate, the agency plans to rollout a permanent RAC program nationwide by 2010.

With thousands of dollars and possible False Claims Act litigation at stake, you need to be prepared. Is your facility ready for a RAC audit?

Take a proactive approach to prepare for a RAC audit

Make sure your facility is ready for this new government scrutiny. Listen to HCPro's 90-minute audioconference Survive a RAC audit: 12 Tips to be Ready and FCA Compliant. Healthcare compliance experts from Executive Health Resource, Robert Corrato, MD, MBA, president and CEO, and Michael Taylor, MD, senior medical director and government appeals director, present effective tips to help you prepare for RAC reviews and protect your facility from False Claims Act scrutiny. Listeners will gain an in-depth understanding of the rules for RACs, the RAC review process, the RAC demand letter, and RAC payment dispute levels.

The speakers also detail a step-by-step approach to implementing consistent and compliant records analysis to ensure regulatory compliance and establish revenue integrity.

At the end of this audioconference, your staff will be able to:

• Develop a system for internal reporting of RAC activity
• Track medical necessity and coding errors
• Identify how and why Quality Integrity Organizations (QIO) target short stays and observation status
• Construct a consistent operational process to ensure compliance in the event of a one-day stay review from the QIO
• Review the risk that highly reimbursed procedures (such as ICD’s, Pacemakers, and PCI) present to your institution
• Use the Hospital Payment Monitoring Program and Payment Error Prevention Program Report (PEPPER) data to conduct proactive analysis
• Unite clinical and financial interests to develop a Medicare Admissions Review Program that meets CMS regulations
• Evaluate your current compliance program and revenue risks

AGENDA

• Era of regulatory scrutiny
• RAC initiative
• Rules for the RACs
• RAC review process
• Audits and auditors
• Medical Necessity
• Claims certification
• Inpatient vs. outpatient (1-day stays)
• Proactive RAC programs for hospital compliance
• How to prepare for an audit
• Operational processes
• How to benefit from your utilization review (UR) committee
• Principals of law
• Applicable Code of Federal Regulations
• Manual Guidance
• Levels of Appeal
• RAC payment disputes
• Administrative Law Judge appeal process
• A case study:  Medicare Admission Review: Interventional Cardiac Procedures
• Question & Answer session

MEET THE SPEAKERS

Robert Corrato, MD, MBA, president and CEO of Executive Health Resource. Executive Health Resources (EHR) is a Philadelphia-based organization that provides expert Physician Advisor teams concentrating on managing Medicare and Medicaid regulatory compliance, minimizing medical necessity denials and achieving appropriate lengths of stay in acute care hospitals and health systems. Prior to founding EHR, Dr. Corrato held the post of deputy director of the Office of Health Policy and Clinical Outcomes at Thomas Jefferson University in Philadelphia.

Mike Taylor, MD, senior medical director, government appeals director, Executive Health Resource. Dr. Taylor is board certified by the American Academy of Family Physicians, and has extensive inpatient and outpatient experience in urban, rural, academic and community settings. At Executive Health Resource, he is responsible for overseeing the management of all governmental retrospective appeals and the Physician Advisor team that supports these efforts.

WHO SHOULD LISTEN?

Professionals with the following titles:

• Compliance officer
• Healthcare administrator
• CEO, CFO, Chief Medical Officer
• Managed care director
• Director of regulatory affairs
• Director of risk management
• Hospital legal/regulatory counsel
• Finance director
• Director of case management
• VP/Director of revenue cycle
• Director of patient financial services

PROGRAM MATERIALS:

Program materials are provided with PDF links.

AUDIO ON-DEMAND

In addition to the regular purchase option for HCPro audioconferences, CD, we are pleased to offer another option, an audio on-demand. Audio on-demand allows you to download the program and play it back at your convenience through your computer or MP3 player. Purchase a CD or audio on-demand of the program and listen when you can. It's also a perfect training tool for new staff or as a refresher for veteran staff.

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