Compliance Plans - Internal Auditing to Reduce Risk
Diane Robben, Sandberg Phoenix
Thank you to our sponsor!
Wednesday, August 14
11:30am - 1:00pm
12031 Lackland Rd. St. Louis, MO 63146
$35 Members / $45 Non-Members / $25 Students
No refunds for cancellations after Friday, August 9.
Developing a strong internal compliance program and auditing your risks can help reduce the possibility of significant fines and penalties from the federal government. With over 2,000 employees in the field, the Office of Inspector General is committed to auditing, investigating and evaluating compliance with HHS rules to safeguard the integrity of the Medicare and Medicaid programs. Through the use of education, civil monetary penalties and oversight responsibilities, the OIG seeks to improve the overall system.
Be prepared for any potential audit by evaluating your own internal policies and practices to identify areas where you are exposed to risk. The OIG publishes a Work Plan every year that identifies the current focus areas of their investigations and the scope of the projects. This provides great insight into the hot areas where the government is looking. For instance, learn the focus of outliers within Medicare Part A and B billing by providers and where there have been concerns of over payments. Identify the key areas of billing fraud being pursued and the fines being levied, as well as Corporate Integrity Agreements. Furthermore, don’t forget about important human resources issues and privacy/security requirements under HIPAA/HITECH.
With regard to billing, auditing physician charges and billing practices may be burdensome, but will typically result in improved claims management processes, cash flow and compliance with applicable laws and regulations. Annual audits can reveal specific coding issues that may recur in similar claims submissions. Correcting these problems before submission can safeguard against errors that could result in claim denial, and prevent patterns before the auditors identify them.
About the Speaker
Diane S. Robben is a Shareholder with Sandberg Phoenix and focuses her practice in the firm’s Health Law Practice Group. Diane leads the firm’s transactional and regulatory health care practice, devoting a significant amount of time advising hospitals, physicians, nursing homes and other healthcare providers on a variety of issues to find practical solutions to complicated legal problems. Read Full Bio
Photos: Pictures and videos may be taken at an event for Greater St. Louis MGMA to use for marketing purposes. Registration, attendance and/or participation in this event constitutes an agreement that Greater St. Louis MGMA may use attendees' or registrants' image or voice in these photos and videos.