Moving the HME Industry Forward

Billing/Reimbursement

Compliance, Audits, and More – The van Halem Group Has it Covered at Medtrade Spring, March 27-29 at the Mandalay Bay Convention Center

March 18, 2018

LAS VEGAS – Compliance for reimbursement and HIPAA will be a hot topic at Medtrade Spring, and several sessions will have it covered. Representatives from The van Halem Group – A Division of VGM Group Inc, will be sharing the stage with other experts in an effort to navigate the troubled documentation waters.

“In my experience, most providers have a compliance program, but it is not always sufficient should the DOJ or OIG review it,” says Kelly Grahovac, senior consultant, The van Halem Group. “Even more shocking, is the lack of HIPAA compliance requirements being met. Attending this presentation (What You Don’t Know Can Hurt You – Are You Doing What CMS Thinks You Are? – See Details Below) will provide attendees with the tools they need to assess their own compliance programs to determine where deficiencies are. More importantly, it will provide solutions.”

Grahovac will also be presenting on the change in CMS’ contractors, specifically DME MACs going from widespread probe reviews to targeted reviews. “This is a relatively new strategy for DME MACs, and this presentation will provide more information on the audit process and what to expect should suppliers find themselves chosen for this type of audit,” explains Grahovac. “This presentation (Migrating from Widespread to Provider Specific Reviews: Discussing this new CMS Strategy) will explain the process and provide a step-by-step approach on how to work through it, if selected.

“Go to Medtrade Spring for this top-notch education and excellent networking opportunities, including the Audit Happy Hour, which we are co-sponsoring,” continues Grahovac. “Being successful in this industry involves doing more than just business. Staying on top of what affects you – changes in legislature, audits, cash flow opportunities- keeps you ahead of the game.”

Tuesday, March 27, 2018

  • Migrating from Widespread to Provider Specific Reviews: Discussing this new CMS Strategy
  • Time: 1:00 p.m. – 2:00 p.m.
  • Room: Islander E

The Medicare Audit Strategy is changing from widespread prepayment review to Targeted Provide Education (TPE). Depending on how a supplier performs, this could be very positive for a supplier. However, if a supplier does not perform well, it could have a significant impact on a supplier including increased audits, overpayment, and even revocations. This presentation will provide examples of what suppliers are seeing in the new TPE audit environment and what we would expect to occur as this new strategy begins to develop. The presenters will provide information on how supplier are chosen for audits and share best practices as well as recommendations on how suppliers can prepare and respond to these audits. It will also discuss common issues, codes, and provide a practical “”to-do”” list to be best prepared.

  • Kelly Grahovac, senior consultant, The van Halem Group
  • Wayne van Halem (pictured), president, The van Halem Group

Tuesday, March 27, 2018: 10:15 AM – 11:45 AM

Trending Topics in Compliance

  • Room: Islander E
  • Time: 10:15 a.m. – 11:45 a.m.

A panel discussion of industry compliance experts who have seen it all. This discussion includes topics such as entering into Corporate Integrity Agreements, hiring an Independent Review Organization, compliance program implementation and oversight, and common compliance issues. The panel includes a compliance consultant, attorney, and Compliance Officer that has managed through a Corporate Integrity Agreement.

  • Britney Lefkovits, senior compliance manager, Orthofix
  • Josh Skora, attorney, K&L Gates
  • Wayne van Halem, president, The van Halem Group

Wednesday, March 28, 2018

What You Don’t Know Can Hurt You – Are You Doing What CMS Thinks You Are?

• Room: Islander E

• Time: 2:45 PM – 4:15 PM

In 2017, within just weeks of each other, the Department of Justice, as well as the Office of Inspector General released publicly for the first time, guidance on metrics they would use to evaluate a company’s compliance program. This includes over 400 unique metrics that these agencies will be evaluating to determine if a company has implemented a comprehensive compliance program. We’ve also seen in the news where the Office of Civil Rights has begun auditing providers and identifying significant fines and penalties for companies who do not have the appropriate controls in place. This panel, conducted by well-known reimbursement and HIPAA compliance experts, will discuss what the government expects every Medicare provider to be doing already when it comes to an internal compliance program, that covers both reimbursement and HIPAA. It will also provide potential penalties for non-compliance while including practical solutions that will reduce your company’s risk.

Tom Meadows, founder, HIPAAwise

Wayne van Halem, president, The van Halem Group

Kelly Grahovac, senior consultant, The van Halem Group

Tuesday, March 27

The Audit “Happy” Hour
• Room: Tradewinds E/F

• Time: 5:00 pm – 6:15 pm
• Sponsored by: Mediware Information Systems, Pride Mobility, and The van Halem Group
There’s not much happiness when it comes to audits – unless you’re figuring out how to navigate them. We’re making it fun by giving you that opportunity, and a chance to meet with experts at a relaxed networking reception. Grab a glass of wine or beer (audits do drive us to drink, right?!), and meet with audit experts at this Q&A and networking opportunity.

Click Here for pricing and registration.