2017 nehia conference - resourcenter.net nehia conference information that will allow us to continue...

R E G I S T E R O N L I N E A T W W W . A H I A . O R G

D E C E M B E R 6 - D E C E M B E R 8 , 2 0 1 7

To better serve this mission, in 2015, NEHIA entered into a collaboration agreement with the Association of Healthcare Internal Auditors (AHIA). By doing this, NEHIA expanded its ability to offer more education and resources to internal auditors and healthcare professionals of New England. AHIA is proud to partner with NEHIA for its 2017 Annual Conference.

Annually in December, NEHIA hosts its primary educational conference bringing expert presenters from healthcare compliance, privacy, security, and of course, internal auditing to one conference. Each presentation is an opportunity for presenters to share their knowledge with all levels of conference attendees and for conference attendees to listen and learn best practices from some of the industry’s best. In addition to providing low cost, high quality educational sessions, NEHIA works diligently to connect conference members with each other to create a strong community of healthcare professionals in New England.

CPE CER TIFICATE:NASBA: Attendees must sign in on the provided sign-in sheets to receive CPE credits and specify the amount of CPE credits earned on the appropriate form (A separate form may be provided). Signing out of sessions is required for individual unscheduled breaks. Attendees must return completed forms to NEHIA Staff. AHIA will provide attendees a CPE certificate upon verification of registration and attendance.CCB: The Compliance Certification Board (CCB)® has approved this event for up to 20.0 CCB CEUs. Continuing Education Units are awarded based on individual attendance records. Granting of prior approval in no way constitutes endorsement by CCB of this event content or of the event sponsor.

CONFERENCE E VALUATION SUR VEY:Upon verification of you attendance and paid applicable fees, you will receive an email with a link to the online conference evaluation. Your feedback is very important to us and may be required for CPE verification support should you get audited. Please take a moment to complete the brief online survey. Your answers provide vital information that will allow us to continue to deliver high quality and relevant educational offerings.

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3:20 - 5:00 pm - Organizational Risk AlignmentMarc Schulman, Principal, Ernst & Young; Dave Dreher, Partner, Ernst & Young

Many healthcare organizations have multiple risk monitoring processes operating in silos that reduce the overall value of risk management and impact business performance. The alignment of risk and compliance functions can significantly enhance efficiency, reduce spend and minimize the burden of monitoring at the business unit and process level. Risk alignment is a process and framework that includes:

•Infrastructure (i.e., governance structure, tools, technology, etc.)•Process (i.e., Identify, assess, prioritize, mitigate, monitor, report)•Integration and coordination (i.e., strategy, financial planning, other risk functions)•Change Management (communications, training, performance)

In this session we will talk about the risk agenda and methods to enhance risk strategy and governance.

Field of Study: Auditing CPE: 2 Level: All

Maximum CPE Total for Wednesday Only: 6.5 CPEs

Conference Location

Mystic Marriott625 North Road (Route 117)

Groton, CT 06340(860) 446-2600

Nightly Contracted Rate: $91 per night

9:00 am Breakfast / Registration

10:00 - 11:00 am - Telehealth and TelepsychiatryPatti Ariel, Sr. Vice President, Compliance and Audit, Westchester Medical Center

The use of telepsychiatry and telemedicine has increased not only access to mental health services but has improved outcomes for patients and their families. Both of these services are the latest tools in the healthcare industry in clinical settings with the help of interactive audio and video equipment. This presentation will define them, talk about how they are integrated in the inpatient and outpatient settings, discuss clinical advantages to patients and how access to patients has improved tremendously.

Field of Study: Specialized Knowledge CPE: 1 Level: All 11:00 am - 12:00 pm - SNF Compliance Program and Compliance Risk Areas June Crawford, RN, BSOM, CHC, CHPC, RAC-CT, Principal, The Bonadio Group

Overview of compliance program expectations for SNFs and more importantly, what are the key clinical documentation and billing risks that should be evaluated at a time when SNF are being scrutinized more than ever.

Field of Study: Specialized Knowledge CPE: 1 Level: All

12:00 pm - 1:00 pm LUNCH

1:00 - 2:00 pm - Healthcare Fraud UpdateLauren Mack, Partner, Moses & Singer

Healthcare Fraud update to include an overview of recent healthcare settlements, audit trends by government contractors, and new and emerging audit risk areas as documented in Medicare and OIG publications.

Field of Study: Busines Law CPE: 1 Level: All

2:00 - 3:00 pm - Health Plan Compliance and Monitoring & Auditing According to CMS Regulatory GuidanceNancy Waltermire, Associate Director, Navigant Consulting

This presentation will focus on Medicare Advantage Sponsors’ Compliance programs, auditing and monitoring, and industry best practices. Nancy will provide general insight on the new 2017 CMS CPE Audit Protocols around the three audit elements. In this section Nancy will also share compliance program benchmarking and best practices. The Compliance Auditing and Monitoring section will provide an in-depth explanation of the difference between auditing and monitoring, as well as high risk areas and best practices. In addition to the above, the presentation will also provide a compilation of industry best practices through Navigant’s work with Sponsors during Independent Validation Audits and “Mock”


3:00 - 3:20 pm BREAK

Wednesday, December 6, 2017

Thursday, December 7, 2017

Schedule of Events7:30 - 8:30 am Breakfast / Registration

8:30 - 9:30 am - Vendor Security RiskCliff Baker, Managing Partner, CORL Technologies

Most Healthcare organization have hundreds to thousands of vendors that have access to PHI and other sensitive data. If you are exploring practical approaches to understand your risk and meet regulatory and compliance obligations – this is the session for you.


9:30 - 9:45 am BREAK 9:45 - 10:45 am - IT Incident Response PlanningMichael Kanarellis, IT Assurance Sr. Manager, Wolf and Company

The regulatory landscape in healthcare continues to evolve and become more complex, while the punitive damages for HIPAA noncompliance also continue to grow. One of the core tenets of the HIPAA Security Rule and Meaningful Use is that a risk assessment be performed to properly gauge key risk factors and to assess that security controls surround the administrative, technical, and physical safeguards of both paper and electronic health records. Also essential is an appropriate and thorough IT incident response plan that is tested regularly and updated as the environment changes and new risks evolve.


10:45 - 11:00 am BREAK

11:00 - 12:00 pm - The Roles of Medicare Administrative Contractors and CMS Review Contractors New Targeted Probe and Educate ProgramKathy Dunphy, Director, Congressional Affairs National Government Services

In addition Medicare Administration Contractors, there are a number of other agencies involved in the medical review processes tasked with oversight of the Medicare program.The presentation will review the roles of each contractor. This will also include a review of the new probe and educate process for Medicare which will expand education and reduce provider burden.

Field of Study: Auditing Governmental CPE: 1 Level: All

12:00 - 1:00 pm LUNCH

1:00 - 2:00 pm - The Emerging World of Value-Based Payments: Implications for Compliance Professionals Brian Ellsworth, Director, Payment Transformation, Health Dimensions

Medicare, Medicaid and commercial insurers are moving towards value-based payment, which can rapidly transform a market from rewarding volume to value, especially when providers face downside risk. These “Alternative Payment Models” such as Accountable Care Organizations and bundling are creating new expectations for providers to lower cost and improve quality. This session will cover: the emerging payment environment and address essential concepts like shared savings, episode payment, and care redesign, and conclude with implications for compliance professionals.


2:00 - 3:00 pm - EMTALA: Good Intentions Gone WrongPaul Cushing, Office of General Counsel, Partners HealthCare System

Mr. Cushing will present a case experience involving alleged EMTALA violations at two affiliated community hospitals with adult and pediatric emergency departments. The matter involved alleged failures to complete the required initial medical screening examination on a pediatric patient. The presentation will focus on EMTALA triggers, transfer issues within a system and self-disclosure issues. The presentation also will address agency audits and enforcement and the new penalty regime. Attendees will learn about the corrective action taken to reinforce EMTALA compliance and will have an opportunity ask questions.


3:00 - 3:50 pm BREAK

3:50 - 5:30 pm - Enterprise Risk Management RoundtableKate Connelly, Corporate Director, Enterprise Risk Management, Partners HealthCare; Lauri Douglas, Manager, Internal Controls, Yale New Haven Health System; Kelly Sauders, Partner, Deloitte Consulting

A panel discussion on Enterprise Risk Management (“ERM”) programs facilitated by an industry expert and including questions and answers with the ERM leaders from three health care systems at various stages of program development. Topics covered include some basics, such as “what is an enterprise risk management program” and many specific operational and industry specific questions, such as how each provider established their programs, what benefits their programs have provided and some challenges they have encountered in running the ERM program. Learn that ERM is a dynamic process that can be successfully implemented in various forms and in a manner that works best with the institutional culture of the health system. The session is intended to be interactive, with the panel taking and responding to attendee’s questions during and after the facilitated discussion.


5:30 - 6:30 pm NETWORKiNG RECEPTION

Maximum CPE Total for Thursday Only: 8 CPEs

Friday, December 8, 2017

Schedule of Events7:00 - 8:30 am Breakfast / Registration

8:30 - 9:30 am - Cultivating ResiliencySusan Greanleaf, Chief Learning Officer, Director, Patient ExperienceYale New Haven Health – Lawrence and Memorial Healthcare

In this presentation we will highlight societal pressures/expectations and how they impact resiliency. We will explore the science behind thoughts and emotions (heart/brain coherence) and increase our awareness of the choices that are within our control. We will separate facts from the stories we spin. I will provide a brief a self-assessment for resiliency as well as energy management. A model of change and transition will be presented to help us better understand our adaptation to change.


9:30 - 10:30 am - Social Media: Compliance and Privacy RisksJennifer Cox, Partner, Cox & Osowiecki, LLC

The current healthcare environment necessitates the use of social media for a variety of processes at healthcare institutions and other medical settings, both for consumer-facing platforms and internal processes used by workforce. Providers must assess specific challenges, including privacy and security concerns, specific workforce-related risks, and the need for policies and procedures on use and monitoring of social media. The presentation will outline the major legal and compliance issues that should be considered when interacting with, or deploying, social media in the healthcare setting. The presentation will include an overview of relevant government enforcement activity and important case law that help to inform social media policies, with detailed focus on compliance risks and privacy issues.


10:30 - 10:45 am BREAK

10:45 - 11:45 am - Using Data to Monitor your hospital’s handling of Medicare observation and inpatient short staysStephen Gillis, Director, Billing Compliance, Partners HealthCare System

Since 2013 and the go-live of the Medicare 2 Midnight rule, hospitals have had to increase their internal controls related to Medicare short stays. This discussion will focus on leveraging data as an efficient method to monitor hospital Medicare short stays as both inpatients and observation patients.


11:45 - 12:00 pm BREAK

12:00 - 1:00 pm - Risky Business: The World of Physician AuditingPam D’Apuzzo, President, RR Health Strategies

Overview of physician audit approaches, corporate compliance programs, risk areas and corrective action plans. Physician education topics and methods. Prospective vs retrospective reviews. Risk areas and how best to monitor and avoid. Industry changes and how to prepare.


CONFERENCE CONTINUING EDUCATIONAL CREDITS

AHIA is registered with the National Association of State Boards of Accountancy as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credits.

Complaints regarding registered sponsors may be addressed to the National Registry of CPE Sponsors, 150 Fourth Avenue North, Suite 700, Nashville TN, 37219-2417; 615.880.4200; http://www.nasba.org. In accordance with the standards of the National Registry of CPE Sponsors, CPOE credits have been granted based on a 50-minute hour. National Registry of CPE Sponsors ID Number 103386

A maximum of 19.5 CPE credits will be granted for those attending the entire conference.

CPEs For Individual Day Registrations and Attendance:

Maximum CPE Total for Thursday Only: 6.5 CPEsMaximum CPE Total for Thursday Only: 8 CPEsMaximum CPE Total for Friday Only: 4.5 CPEs

The Compliance Certification Board (CCB)® has approved this event for up to 20.0 CCB CEUs. Continuing Education Units are awarded based on individual attendance records. Granting of prior approval in no way constitutes endorsement by CCB of this event content or of the event sponsor.

Conference LocationMystic Marriott

625 North Road (Route 117)Groton, CT 06340

(860) 446-2600

Nightly Contracted Rate: $91 per night

Contuniuing Educational Credits

AHIA is registered with the National Association of State Boards of Accountancy as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credits.

Complaints regarding registered sponsors may be addressed to the National Registry of CPE Sponsors, 150 Fourth Avenue North, Suite 700, Nashville TN, 37219-2417; 615.880.4200; http://www.nasba.org. In accordance with the standards of the National Registry of CPE Sponsors, CPOE credits have been granted based on a 50-minute hour. National Registry of CPE Sponsors ID Number 103386

A maximum of 19.5 CPE credits will be granted for those attending the entire conference.

CPEs For Individual Day Registrations and Attendance:

Maximum CPE Total for Thursday Only: 6.5 CPEsMaximum CPE Total for Thursday Only: 8 CPEsMaximum CPE Total for Friday Only: 4.5 CPEs

The Compliance Certification Board (CCB)® has approved this event for up to 20.0 CCB CEUs. Continuing Education Units are awarded based on individual attendance records. Granting of prior approval in no way constitutes endorsement by CCB of this event content or of the event sponsor.

One registration form per attendee. Copy this form as needed.

Name: _______________________________________________________________________________

Name of Organization: _________________________________________________________________

Title: ________________________________________________________________________________

Mailing Address: ______________________________________________________________________

City: ____________________________________ State: _________ Zip: ________________________

Phone: __________________________________ Fax: _______________________________________

Email: _______________________________________________________________________________

Vegetarian Meals? Yes No

Special Assistance Required: _____________________________________________________________

Full Conference: Early-Bird Price $350 After Nov. 24, 2017 $375

One-Day Passes:

Wednesday Only $175 Thursday Only $200 Friday Only $175

Payment Information:

Total Amount Enclosed: $ ____________

Check MasterCard Visa American Express Discover

Card Number: ________________________________________________________________________

Expiration Date: _______________________________________ 3-Digit CVV Code: _______________

Name of Cardholder: __________________________________________________________________

Signature: ___________________________________________________________________________

Cancellations & SubstitutionsNo refunds will be given for “no shows. ” Cancellations received in writing by November 27, 2017 will be issued a refund less a $50 cancellation fee. NO REFUNDS FOR CANCELLATIONS AFTER November 27, 2017. AHIA/NEHIA reserves the right to cancel any event due to insufficient registration or any unforeseen circumstances. In the unlikely event of cancellation, AHIA/NEHIA are not responsible for any costs, damages, or other expenses of any kind, including, without limitation, transportation and/or hotel costs incurred by registrant. Speakers are subject to change without notice. You may send a substitute; please call AHIA at 888-275-2442.

Regional Seminar Fees

Return this form with payment to: 10200 West 44th Avenue, Suite 304

Wheat Ridge, CO 80033Phone: 888.275.2442 l Fax: 720.881.6101

Register Online at www.ahia.org

G R O T O N , C O N N E C T I C U T • D E C E M B E R 6 - D E C E M B E R 8 , 2 0 1 7

Registration Form

and CEO of two successful companies that provide information protection services to healthcare organizations including many of the nation’s leading provider, payer and business associate organizations. Cliff also led the creation the HITRUST framework, which is the most broadly adopted healthcare security and privacy framework in the industry. Cliff started his career with PricewaterhouseCoopers where he established and lead the firm’s first dedicated healthcare care security practice. He is published author on database security and various whitepapers and is a frequent speaker at compliance related conferences.

Michael Kanarellis’s experience consists of over 20 years of properly scoping security/compliance/audit initiatives for organizations across all verticals with particular expertise in healthcare and managing those efforts. Michael has been involved in the managing of projects which include; IT risk management & assessments, vendor management reviews, social engineering, wireless network security, web applications, firewalls, general information security & controls, IT governance, business continuity planning, vulnerability/penetration testing, and various application security reviews. Michael has also been involved with Office of Civil Rights (OCR) corrective action plan (CAP) audits. In addition to technical audits noted above, Michael has performed work in various compliance areas including Health Insurance Portability and Accountability Act,(HIPAA), NIST 800-53, 800-30, 800-66, The HITECH ACT, Meaningful Use risk assessments, ISO 27001, PCI-DSS 3.2, and other state privacy laws.

Katherine Dunphy is responsible for external relations and Congressional affairs in Jurisdiction K ( New England and New York) in which National Government Services serves as the Medicare Administrative Contractor for the Center for Medicare & Medicaid Services.

•30 years of management experience in Medicare administration in all aspects of the program.

•Holds graduate degree in Health Care Administration

•Fellow Hunter College, Brookdale Center of Aging

•Recipient of Center for Medicare and Medicaid (HCFA) Certificate of Merit.

•Medicare Certificate, Cornell University

•HHS Inspector General’s Integrity Award

Brian Ellsworth, MA, Director, Payment Transformation, Health Dimensions Group, leads efforts to develop value-based payment approaches, including analysis of bundling opportunities and value-based strategic positioning. Mr. Ellsworth has more than 30 years of experience in health care financing, delivery, and policy from both payor and provider perspectives. He has worked at Optum (UnitedHealth Group) and as a policymaker in New York’s Medicaid program, and has extensive provider experience, including the American Hospital Association, president and CEO of the Connecticut Association for Home Care & Hospice, and a senior policy leadership role at LeadingAge New York. Mr. Ellsworth has served on numerous advisory committees for federal and state governments, including payment and quality reform efforts.

Paul Cushing leads the Litigation and Compliance Section of the Office of General Counsel for Partners HealthCare System in Boston. He also serves as the Secretary and Managing Counsel for North Shore Medical Center and North Shore Physicians Group within the Partners system. He previously served in that role for Partners Continuing Care and the Spaulding Rehabilitation Network. Paul focuses his practice on resolving complex disputes in intellectual property, licensing, real estate, regulatory and general commercial matters. In his Managing Counsel role he advises the board, senior management and mid-level management on general contract, governance, regulatory and patient care related matters.

Paul is a graduate of Boston College and Boston College Law School. He worked in finance at the General Electric Co. before going to law school and graduated from the company’s Financial Management Program. He is a board member and past president of the Northeast Chapter of the Association of Corporate Counsel. He also has served on the Council and Executive Committee of the Boston Bar Association and currently serves as a member of the Board of Trustees and Executive Committee of the Boston Bar Foundation. Paul has been an adjunct professor at New England School of Law and is a frequent panelist on various topics of interest to in-house counsel.

June Crawford is a Principal in the Compliance Solutions Division at The Bonadio Group. She is a Registered Professional Nurse with more than 25 years of supervisory experience. She has held the positions of Director of Nursing Services, Director of Residential Services, Director of Continuous Improvement, Corporate Compliance Officer and HIPAA Privacy Officer.

June is certified in Healthcare Compliance, Healthcare Privacy Compliance, and MDS/RAC and has extensive experience in organizational management including regulatory and corporate compliance, administrative investigations, quality improvement, HIPAA implementation, and policy development. Her expertise in the health and human service sectors has provided her with the ability to transfer that knowledge and experience to assist a broad array of provider types including hospitals, nursing homes, human service agencies, physician practices, clinics, hospice, and home health care

Lauren Mack is a partner at Moses & Singer in the firm’s White Collar Criminal Defense, Government Investigations and Healthcare Litigation practice groups. She has a broad range of skills in criminal investigations, litigation, healthcare fraud and abuse, and extensive trial experience.

A culture of compliance is a healthcare organization’s first line of defense in any oversight action. Lauren works with healthcare organizations and medical practices that require guidance in establishing and maintaining up to date compliance programs. She assesses existing ones, analyzes needs, makes recommendations and aids in the development of a compliance manual.

Nancy Waltermire is a seasoned professional with proven ability to manage multi-functional areas of operations and maintain compliance with Federal & State Regulations. Successful in the implementation and administration of government contracts, Ms. Waltermire provides consulting and expert services relating to regulatory compliance and operations in the commercial and government-sponsored programs space. Her experience includes working with payers (commercial, Medicare Advantage and Part D, SNP MOC, Medicaid, & Affordable Care Act), providers (ancillary providers and pharmacies) and pharmaceutical manufacturers. Ms. Waltermire has performed numerous risk assessments, compliance and delegation oversight program implementations and effectiveness measurement assessments, including four Independent Validation Audits for Part C ODAG, CPE & SNP MOC.

Ms. Waltermire has also conducted data analyses for many large payers, providers, and PBMs by examining many different enrollment, clinical, and medical and pharmacy claims systems.

Dave Dreher is a Partner in our Risk Advisory Services practice with more than 20 years of experience with internal audit, internal controls, enterprise risk assessment and risk management. Dave is the coordinating partner on several large risk advisory engagements overseeing the delivery of internal audit and risk management services for our clients. Dave also works with other companies across the Northeast Region providing risk, information technology and performance improvement services.

Dave also serves as the Americas Internal Audit Health Industry Leader responsible for developing area training events and content for thought leadership and for facilitating the development and exchange of industry-leading businesses to clients and EY professionals.

Marc Schulman is an Executive Director in the Advisory Services practice of Ernst & Young LLP and serves as a national leader for Healthcare Risk and Compliance. Marc is responsible for the delivery of Advisory services to both providers and managed care organizations. He has over 30 years of healthcare specific experience working directly for managed care organizations, hospitals and as an industry business advisor. His experience includes managing large internal audit teaming engagements, enterprise risk management engagements, compliance and process and controls assessments within healthcare organizations including academic medical centers, managed care organizations, Medicare Advantage plans and specialty benefit companies. Marc has worked with alternative financing and risk sharing programs between insurers and providers and CMS sponsored gain sharing programs based on total cost of care.

Cliff Baker has spent over twenty years in the risk management profession in the healthcare industry. In his dedication to the industry and passion to tackle many of its most challenging risks, Cliff has created solutions that are leveraged and used by organizations across the nation. He is the founder

Speaker Biographies

As the Chief Learning Officer and Director of the Patient Experience, Susan Greenleaf’s role is to foster a culture of compassion and self-accountability that results in measureable improvements in patient satisfaction and employee engagement. She has been successful in building strong teams around sometimes-controversial issues and have a track record of providing a motivating, energetic environment. Her professional goal is to make a difference in organizations’ and in people’s lives.

Her expertise encompasses the art & science of leadership. She holds facilitator certifications in Creative Health Care Management’s “Re-igniting the Spirit of Caring”, Healthcare Performance Improvement’s “High Reliability”, Vital Smart’s “Crucial Conversations, Bridge’s “Change and Transitions”, General Electric’s “Essentials of Leadership Excellence, Six Seconds Emotional Intelligence “Emotional Intelligence”, and Integrity Healthcare System’s “Service Excellence” .

Jennifer L. Cox is a founding member of Cox & Osowiecki, LLC, a health law firm in Hartford, Connecticut. She provides advice to healthcare providers in the areas of corporate and practice compliance, regulatory guidance, contracting, and HIT issues. Her clients include hospitals, healthcare associations, physician practices, and individual professionals. She is a frequent lecturer on regulatory compliance, health information management and HIT, privacy and security, and operational aspects of healthcare facilities and medical practices for several organizations including the Connecticut Hospital Association, the Connecticut Chapter of the American Academy of Pediatrics, the Connecticut Medical Group Management Association, and various chapters of the American Academy of Professional Coders and the Health Information Management Association. She is also an adjunct professor at Sacred Heart University, in Fairfield, Connecticut, in the subject area of healthcare informatics.

Steven Gillis has over 20 years of experience in the healthcare industry, spending the last 19+ years focused on compliance program development, program assessment, training and education, monitoring and auditing and conducting and responding to investigations. Steve is currently the Director of Compliance Coding, Billing and Audit for Partners HealthCare System, which is the corporate organization founded by Massachusetts General Hospital and Brigham and Women’s Hospital and is based in Boston and includes 7 other hospitals, 4 physician organizations, home health services and multiple rehab facilities. Steve’s team is responsible for evaluating potential documentation, coding and billing risks across all of the PHS entities through data mining, medical record review and other ongoing risk assessment activities.

Pam D’Apuzzo has over 25 years of healthcare consulting experience spanning academic medical centers, community hospitals, faculty practice plans and large private practices. She has consulting experience in all areas of practice and is a recognized industry expert in the area of coding and compliance.

Pam conducts educational and training seminars and provides comprehensive compliance programs at New York’s leading healthcare institutions. She also has a successful record of practice management services including operational and billing reviews, practice assessments, practice start‐up assistance and EMR implementation.

Kelly Saunders is a Partner with Deloitte & Touche LLP who has over 20 years of experience in the health care industry. She specializes in providing regulatory compliance and risk services in the health care industry. Kelly has led numerous regulatory compliance program assessments, HIPAA/privacy program assessments, implementation projects and responses to government investigations. Many of these have involved documentation, coding or billing matters. This experience includes coding and billing for hospitals, physician groups, skilled nursing facilities, home health and hospice. She has also been involved in many enterprise-wide risk assessment and ERM program development projects. In these roles she works frequently with boards of directors and executive teams.

This experience has given Kelly both a broad and deep understanding of health care (e.g. academic and community hospitals, physician/clinic, SNF/HH, outpatient, etc.) and the impact of changing regulations not only on health care organizations but on large employers and companies in related industries. Kelly has also served several academic medical center and health system clients as an interim chief compliance officer and as an interim director of internal audit . She has assisted numerous clients with CIA-readiness, government investigations , OIG audits, and self-disclosures regarding documentation, coding and billing matters and has led a number of Independent Review Organization (IRO) engagements. Kelly has also served as an expert witness on a billing dispute between a medical practice

Speaker Biographies

and a hospital. She is a frequent national speaker on compliance programs, ERM, coding and billing matters, internal controls and other regulatory topics.

David T. Haig is Vice President, Office of Compliance and Integrity for Hartford Health Care. David has more than 20 years of health care experience and holds a Master of Health Care Administration degree. He has certifications in health care compliance, privacy and coding from the Health Care Compliance Association and the American Health Information Management Association. As vice president and chief compliance officer, David leads all areas related to compliance, audit and privacy and is responsible for planning and designing, implementing and maintaining system-wide corporate compliance programs, policies and procedures.

Mr. Haig served in many healthcare compliance positions prior to joining Hartford Healthcare. Most recently he held the position of Compliance and Privacy Officer for Yale-New Haven Hospital, part of the Yale-New Haven Health System (YNHHS), which he joined in 2005. During that time, David held a number of posts at YNHHS including Compliance and Privacy Officer for North East Medical Group and Compliance and Privacy Officer for Bridgeport and Greenwich Hospitals. David is a board member of the New England HealthCare Internal Auditors Association and active participant in the New England Compliance Officers Forum, American Health Information Management Association and HealthCare Compliance Association.

Lauri Douglas is the Manager of Internal Controls at Yale New Haven Health. She has been with the health system for almost eight years. In her role, she is responsible for facilitating and reporting out on the system enterprise-wide risk program. This is accomplished through working with senior and executive level personnel throughout the organization. In addition, she leads the health system’s enhanced business practice program which is responsible for identifying and monitoring internal controls over financial reporting. Lauri also works very closely with the internal audit team to ensure that the annual audit plan is carried out as planned.

Prior to joining Yale New Haven Health, Lauri worked in the global internal audit team for JLL and spent over 6 years at RSM performing external audits across a variety of industries.

Kate Connelly is Corporate Director, Enterprise Risk at Partners HealthCare System, Inc. Prior to this role, she was Vice President of Regulatory/Health Information and Chief Compliance Officer at South Shore Health System where she oversaw Compliance, Privacy, Health Information Management, Risk Management, Clinical Documentation Improvement and Internal Audit. Other previous positions included eleven years in management roles in the Partners Compliance and Internal Audit departments and five years consulting and auditing at PricewaterhouseCoopers LLP. Ms. Connelly received her bachelor’s degree in economics from Tufts University and her Master’s in Business Administration from Boston University School of Management. She also is a Certified Public Accountant.

2017 nehia conference - resourcenter.net nehia conference information that will allow us to continue...

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