7:30 a.m. Registration – Continental Breakfast
8:30 a.m. Welcome and Introductions
8:45 a.m. Department of Justice: 2015 Update
In this annual update, a distinguished panel will discuss government investigative initiatives in western New York and various other topics including recent settlements, self-disclosures, Medicare Part "C" and their latest focus on Elder law and Skilled Nursing Facilities.
Gretchen L. Wylegala, Esq.; Assistant U.S. Attorney, U.S. Department of Justice, Western District of New York
Kathleen Lynch, Esq.; Assistant U.S. Attorney, U.S. Department of Justice, Western District of New York
Peggy McFarland; U.S. Department of Justice, Western District of New York
Peggy Glynn; Special Agent, U.S. Department of Health and Human Services, Office of Inspector General, Office of Investigations
9:55 a.m. Break
10:10 a.m. How the Immortal Words of Game Show Host Richard Dawson “Survey Says”
–Means Only Increased Risk of Stark Liability under FCA Cases
In addition to Family Feud, “survey says” is a phrase heard daily in the healthcare industry as the basis for FMV of physician compensation. But are surveys the last word on whether physician compensation arrangements comply with the Stark requirements for FMV and commercial reasonableness? Recent FCA cases and settlements would appear to say otherwise. Losses on physician practices represent a major red flag for regulators, but such losses are usually ignored when survey data only is used for FMV. This session will address the compliance risks arising from physician losses and how to mitigate these risks. The session will enable the compliance professional to gain a better understanding of several legal and transactional points.
Robert Trusiak, Esq.; Principal, Compliance Experts, LLC
11:20 a.m. Break for Speaker Change
11:30 a.m. Self-Disclosure: When, How & To Whom AND Corporate Integrity Agreements:
Provisions that are actually Negotiable
Ellen Weissman and Michelle Merola will address the challenges related to self-disclosure and Corporate Integrity Agreements. The self-disclosure portion will include the pros/cons of disclosing to the various regulatory agencies including OIG, DOJ, MFCU, OMIG and NGS. The Corporate Integrity Agreements portion will include successful negotiation tips and techniques.
Ellen Weissman, Esq.; Partner at Hodgson Russ
Michelle Merola, Esq.; Partner at Hodgson Russ and former Assistant U.S. Attorney
12:40 p.m. Lunch
1:40 p.m. “If I Were You” – Advice from NGS for Compliance Professionals
Dr. Laurence Clark will share his insight into NGS investigative priorities and initiatives. He will offer his perspective on a variety of compliance issues for health care providers to focus on in the coming year, such as: short inpatient stays, denials from specific health care settings (SNF, Hospice, Hospitals), Stark, ICD-10, site of service, non-physician practitioner billing issues
Laurence J. Clark, M.D., FACP; Contractor Medical Director, National Government Services
2:50 p.m. Break
3:05 p.m. DSRIP Compliance – Challenges and Opportunities
Robert Hussar will summarize the compliance challenges and opportunities associated with the New York Delivery System Reform Incentive Payment (DSRIP) Program. He will address the evolution of the program, oversight expectations, what’s next, where does it end and lessons learned to date.
Robert Hussar, Esq., CHC; Counsel at Manatt, Phelps & Phillips, LLP
4:15 p.m. Session Summary and Adjournment
Frederick Holderle; Compliance Officer, University of Rochester Medical Center
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