Catalog Number : ncd1220
Title : OIG Supplemental Compliance Program For Hospitals - Part 2
Speaker : Sue Dill

Webplay Recording Date : 6-16-2005
Webplay Price : $ 225 for two weeks viewing

Teleconference/Webinar Presenter: Sue Dill Calloway, RN, Esq., AD, BA, BSN, MSN, JD

Teleconference/Webinar Title: OIG - Part 2

Teleconference/Webinar Level: Intermediate

Teleconference/Webinar Objectives:

• Explain that the 2005 OIG (Office of Inspector General of the Department of Health and Human Services) compliance guidance program (CGP) for hospitals supplements, rather than replaces, the OIG’s 1998 CPG for hospitals.
• Recall that the OIG compliance program for hospitals addressed the fundamentals of an effective compliance program.

Teleconference/Webinar Outline for Both Parts 1, 2 & 3:

• Introduction
• 2005 OIG Compliance guidance program (CGP)
• Supplements 1998 CGP
• Fundamentals for effective compliance program
• Benefits of a compliance program
• Application of compliance program guidance
• Same day rule
• Abuse of partial hospitalization payments
• Same day discharges and readmissions
• Violation of Medicare’s post-acute care transfer policy
• Supplemental payment considerations
• Reporting of costs of pass through items
• DRG outlier payments
• Claims for incorrectly designated provider based entities
• Claims for clinical trials
• Claims for organ acquisition costs
• Cardiac rehab services
• Costs related to educational activities
• Use of information technology
• Referral statutes; physician self referral law (Stark Law) and federal anti-kick back law
• Physician self referral
• Safe harbors
• Joint ventures
• Compensation arrangements with physicians
• Relationship with other health care entities
• Recruitment arrangements
• Discounts
• Medical staff credentialing
• Malpractice insurance subsidies
• Gain sharing arrangements
• EMTALA
• Substandard care
• Relationship with federal health care beneficiaries
• Gifts and gratuities
• Cost sharing waivers
• Free transportation
• HIPAA Privacy and Security rules
• Billing Medicare and Medicaid substantially in excess of usual charges
• Preventive care services
• Professional courtesy
• Hospital compliance program effectiveness
• Code of conduct
• Compliance officer
• Compliance committee
• Review of compliance program effectiveness
• Development of compliance policies and procedures
• Standards of conduct
• Open lines of communication
• Training and education
• Internal monitoring and auditing
• Response to detect deficiencies
• Enforcement of disciplinary standards
• Self reporting
• Conclusion

Prerequisities: This is an intermediate series of Webinars/Teleconferences. While there are no specific prerequisites, attendees should have training, education and associated experience in general coding, billing and reimbursement areas to best assimilate the information, concepts and processes that will be presented.

Target Audience: Compliance officer, risk manager, hospital legal counsel, compliance team members, CEO, COO, CFO, Board members, Nurse managers, physician recruiters, Medical staff leadership, director of nursing, utilization review nurse, business officer manager, director of health information management, audit committee members, coding manager, outpatient department manager, director of cardiac rehab, manager responsible for charge master and anyone else involved with compliance activities.

Nursing Contact Hours: This course has been approved for 2.4 Iowa Nursing Contact Hours. There is usually a reciprocal agreement between state associations to allow these to count for each state. If you have any questions, please ask your state association.

Full tuition is refunded immediately on request if the participant has not been sent the program materials and instructions. Once the instructions (including access codes) have been sent, a full refund will be issued only after the program runs and it is verified that the participant did not access the program.