This presentation will cover the reasons for the need for a compliance program, the elements of a compliance program that will pass muster with state or federal investigators, the purpose of each of those elements, suggestions for implementing each of them with limited resources, challenges faced and suggestions for addressing those challenges.
Why should you Attend:
The lack of an effective compliance program increases the potential for illegal or unethical conduct which, in turn, exposes the organization to legal liability as well as significant financial penalties.
Putting a compliance program together that mitigates the likelihood of fraudulent Medicare or Medicaid billing or violations of HIPAA or 42 CFR Part 2, the federal Anti-trust Statute or Stark laws, for example, can be done without a significant increase in overhead and a program that meets national standards can be easily implemented.
Areas Covered in the Session:
- Background - Why do we need a program
- Program content - What do we need to include in the program
- Discussion of each of the program elements - How do we implement each of the program elements
- Right-sizing your program - What you don't need to do
- Implementation challenges - How to make the program work for you
Mr Tim Timmons,
Financial Manager and Administrator ,
Tim Timmons Following 25 years as a hospital financial manager and administrator, Tim has spent the past eighteen years assisting behavioural health organizations, hospitals, physician practices and home health agencies with the implementation of ethics and compliance programs. The initial emphasis of these programs was Medicare and Medicaid fraud and abuse, but they have since been expanded to address the implementation of CCO and other contractual obligations, NCQA standards, the HIPAA Privacy and Security standards, confidentiality requirements associated with substance abuse treatment, and many other statutes and regulations.
He has presented on compliance-related topics at national conferences sponsored by the National Council for Behavioral Health, the Health Care Compliance Association, the Healthcare Financial Management Association, the HIPAA Summit and numerous other organizations. He is a Certified Compliance and Ethics Professional, a Certified HIPAA Professional, a Certified HIPAA Security Specialist and is Certified in Healthcare Privacy Compliance. He currently serves as the corporate integrity officer of GOBHI.