The Affordable Care Act includes provisions mandating compliance programs as a condition of participation in Medicare, Medicaid, and the Child Maternal Act programs. CMS is charged with developing these new requirements and will build off the voluntary compliance standards of the DHHS Office of Inspector General (OIG). The same seven standard elements common to the US Sentencing Commission guidelines and the OIG compliance guidance will continue as the framework for more specific requirements. With executive leadership having to certify compliance with these new mandates, the entire compliance program landscape is changing and taking on new importance.

One of the critical elements of an effective compliance program relates to written compliance guidance in the form of policies and procedures. A number of them are specified in current OIG guidance and others are alluded to by reference. Now more than ever, healthcare organizations need to ensure that their written compliance polices are properly developed; accurately reflect the ever-changing regulatory and enforcement environment; understandable to those required to abide by them; and properly communicated to all affected parties through education and training programs.

Join us for this presentation with Richard Kusserow, former DHHS Inspector General and Deborah Hutchison, JD, LL.M. General Manager of the Compliance Resource Center, LLC, in which they will explore best practices in compliance policy development and management. During the 90-minute presentation, the presenter examined:

• Why policies are a critical compliance program element
• Listing of key compliance program policies and related operational documents
• Processes for compliance policy development
• Roles and responsibilities in developing compliance policies
• Recommended policy form and formats
• Proper compliance policy management and administration
• How to validate the effectiveness of policy guidance
• Ongoing policy monitoring
• Auditing standards for validating policy effectiveness

Sample policies and templates will be made available to all session attendees.

Who Should Attend:

• Healthcare Providers and Payers
• Compliance Officers, Directors and Managers
• HRM Directors
• Legal/Regulatory Counsel
• Risk Managers
• VP/Director of Regulatory Affairs
• Director of Internal Audit
• HIPAA Privacy and Security Directors

About the Presenters:

Richard Kusserow is CEO of Strategic Management (SM). He is without peer in health care compliance. He possesses special and unique expertise involving compliance program development, evaluation and enhancement, as well as fraud and abuse laws and regulations, such as the anti-kickback statute, qui tam actions. Prior to establishing Strategic Management, Mr. Kusserow served eleven years as the DHHS IG, where he was responsible for audit, evaluation, and investigative oversight over agencies representing 38% of outlays of the Federal government. He provides unparalleled knowledge and expertise on fraud and abuse, sanctions, exclusion, and debarment processes, as well as regulatory and legal issues arising from the CMS, OIG, FDA and DOJ.

Deborah Hutchison is an attorney and General Manager of the Compliance Resource Center, LLC (CRC) that houses a number of compliance program modules, including the Policy Resource Center (PRC). Ms. Hutchison is an experienced consultant specializing in conducting evaluation of compliance program effectiveness, assessments of high risk areas on behalf of healthcare entities and data analysis to ensure program integrity. She also assists clients in the research, development and implementation of compliance programs, strategic plans and audit protocols. Prior to joining Strategic Management, Ms. Hutchison worked as a health policy analyst at the Centers for Law and the Public’s Health at Georgetown and Johns Hopkins Universities.

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