Course Description:

The OIG publishes it work Plan each year with new focus areas and revisions to prior years focus. The OIG carries out its mission to protect the integrity of HHS programs and the health and welfare of the people served by those programs. To do this they focus on aspects that are vulnerable to fraud or misuse. To do this they conduct a nationwide network of audits, investigations and evaluations conducted by the operating components with assistance from OIG counsel and management. The results or outcomes from these various activities impact the next years Plan. They also impact the other groups that the government has conducting Audits: IE your RAC/MAC/ZPIC etc….

The OIG has also begun to audit some of the Auditors. Due to these ongoing audits and the increased focus of governmental agencies in regards to compliance combined with efforts to cut waste within the HealthCare industry it is important for your organization to know what the current trends are.

In this 2 day workshop/ conference you will learn about the current work plans, revisions from previous years and the new ones for 2016. You will learn how prior work plans have contributed to the focus for current ones and how the work plans have contributed to the audits and focused reviews by other agencies. You will also learn what the process is for audits and reviews conducted by the OIG. Other areas to be covered are the financial impact of the OIG work plans ; currently recover of funds is with over $1 billion.



Learning Objectives:

Upon completion of this course participants should:

  • Know the current OIG Work Plans
  • What is new – what is revised
  • Understand the impact of these works plans upon various aspects of the healthcare industry
  • Which of these Plans will cause or support increased scrutiny for your organization
  • Which areas of the country are most impacted by the focus areas?
  • Importance of Quality Reporting Data
  • Understand the focused attention on Medicare Programs
  • Understand the focused attention on Medicaid Programs
  • Know what reports are available for review and information
  • How to determine which reports are pertinent to your organization
  • How to use this information to help you create solutions and optimize your compliance
  • Resources that are offered to facilitate compliance

Seminar Fee Includes:

Lunch
AM-PM Tea/Coffee
Seminar Material
USB with seminar presentation
Hard copy of presentation
Attendance Certificate
$100 Gift Cert for next seminar



Who Will Benefit:

This course is designed for people who are active in ensuring the compliance of their organization with Government regulations for the Healthcare industry. For those individuals who understand that knowledge of the OIG Work Plan will facilitate putting strategies and plans in place to reduce their risk or non-compliance and to support their ability to make informed and comprehensive plans. It will provide information on how the OIG works and provide information regarding how the OIG operates when conducting and assessment or audit.

  • Chief Compliance Officers
  • Regulatory Professionals
  • Compliance Professionals
  • HealthCare Providers
  • CEO’s
  • CFO’s
  • Director of Nursing
  • Director’s of Hospice Services
  • Director’s of Clinical Services for Outpatient
  • Pharmaceutical Professionals
  • Distributors of Durable Medical Equipment




Course Outline:

Day One (8:30 AM – 4:30 PM) Day Two (8:30 AM – 4:30 PM)

Registration Process: 8:30 AM – 9:00 AM
Session Start Time: 9:00 AM

  1. Introduction to OIG Work Plans and Purpose
    1. What is the Purpose of the OIG Work Plans?
    2. How this purpose impacts the focus of the work plans and the areas that are targeted.
    3. Government focus and its impact on the Work Plans
  2. What are the 2016 Work Plans?
    1. Revisions to prior years’ work Plans
    2. The changes and modifications that drive closer scrutiny and more concise review of information
    3. How this impacts your organization
    4. Focus of Work Plans
      1. Hospitals
        1. Meaningful use
        2. Re-admission rates
        3. Pharmaceuticals
      2. Skilled Nursing Facilities
        1. Overuse of therapy
        2. Meaningful use
        3. Quality Indicators
      3. Hospice
        1. Overuse of services
        2. ALF and Hospice
      4. Free standing Clinics
        1. Outpatient
        2. Dialysis
      5. Drug Plans / Pharmaceuticals
        1. Drug choices
      6. Durable medical equipment
        1. Over use
        2. Inappropriately prescribed
  3. Medicare and Medicaid Focus
    1. LEIE list
    2. Excluded and Re-instated Facilities

  1. Areas of Focus within the US
    1. Regional focus
    2. OIG Hotline
    3. Protection of Whistleblowers
  2. Impact to your Organization
    1. Increased risk of Whistle Blowers
    2. Fraud; tighter scrutiny
    3. New Regulations/ Reporting
  3. Reports within the OIG
    1. What is available
      1. select those that keep you informed
    2. What benefit do they have to you
      1. Knowledge regarding focused outcomes
      2. Information to improve your own internal audits
    3. Educational Supports
      1. supports provided to providers
      2. utilization of reports to increase your organizations awareness
  4. Compliance issues
    1. Focus of internal compliance audits based on OIG Work Plans
    2. Resources available to support compliance
    3. Create your plan of approach for compliance




Meet Your Instructor

Laura S Hargraves
MS CCC-SLP Business Owner, Bridging Documentation

Laura S Hargraves, MS CCC- SLP RAC-CT; has been working in all aspects of HealthCare Industry for the past 28 years. Ms. Hargraves has been providing compliance and oversight of documentation to meeting changing guidelines during this period. She has a background in education, which helps her maximize her ability to communicate these changes to the various professionals that she works with.She is a specialist in Documentation/Compliance/Audits and Reviews. Professional Presenter on topics related to Medicare, MDS 3.0, and documentation.





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