obesity-summit-diabetes-conference-laser-2018-tracks

2 / 25

N o v e m b e r 0 5 - 0 6 , 2 0 1 8 | P h i l a d e l p h i a , U S A
Note:
Page 22
Obesity Summit 2018 & Diabetes Conference 2018 & Laser Photonics Conference 2018 Biomedical Research | ISSN: 0976-1683| Volume 29
3rd INTERNATIONAL OBESITY SUMMIT AND EXPO
&
&
DIABETES, NUTRITION, METABOLISM & MEDICARE
2nd International Conference on
Joint Event on
OF EXCELLENCE
IN INTERNATIONAL
MEETINGS
YEARS
LASER, OPTICS AND PHOTONICS
World Conference on
Robert W Liles, Biomed Res 2018, Volume 29 | DOI: 10.4066/biomedicalresearch-C7-019
THE BUSINESS OF MEDICINE: THE
TOP 10 REGULATORY RISKS FACED
BY ENDOCRINOLOGISTS AND THEIR
PRACTICES
T he business practices of Endocrinologists are under the regulatory micro-
scope. Medicare, Medicaid and private payors are actively conducting au-
dits of endocrinology claims for reimbursement. In this session, we will discuss
a number of existing risk areas and what Endocrinologists and their practices
should expect in 2019. Specific topics to be covered include:
1. The US Department of Justice’s (DOJ’s) current focus on “individual
culpability,” that has resulted in a renewed emphasis on individual,
rather than merely corporate prosecutions in health care fraud cases.
How should you respond if contacted by law enforcement?
2. The risks associated with the failure to collect copayments and de-
ductibles and result in wide range of administrative, civil and / or crim-
inal sanctions. Similarly, extending a “Professional Courtesy” discount
or billing a patient “Insurance Only” may be a violation of the Federal
Anti-Kickback Statute. How are supposed to handle copayments, de-
ductibles and discounts?
3. How to respond if your practice is audited by a Medicare program in-
tegrity contractor such as UPIC or ZPIC.
4. The impact of hiring an individual who has been “excluded from partic-
ipation” in medicare or medicaid.
5. The penalties associated with an improper breach of protected health
information can be enormous. Is your practice compliant with applica-
ble HIPAA / HITECH regulatory requirements?
6. Private payor “Special Investigative Units” are actively auditing endo-
crinology practices. How should you respond if your claims are audit-
ed by one or more private payor insurance companies?
7. Federal and state mandates require your practice to have developed
and implemented an effective compliance program. Is your practice
currently in compliance with federal and state law?
8. State licensure boards are focusing on a number of specific concerns.
We will briefly cover several of these.
9. Steps you can take to reduce the likelihood of healthcare workplace
violence.
Biography
Robert W Liles background is somewhat unique.
In addition to a law degree, he holds both an MBA
and an MS in health care administration. He is also
a certified professional coder. Robert has worked
on the provider side, as a federal prosecutor and
now represents physician practices and other
health care providers around the country in con-
nection with medicare / medicaid / private payor
audits, state board of licensure actions, and false
claims act cases. He also currently serves as an iro
on corporate integrity agreements for the office of
inspector general. While working as a federal pros-
ecutor, Robert was asked to serve as the country’s
first “National Health Care Fraud Coordinator” for
DOJ’s Executive Office for US. Attorneys. In this
capacity, he advised federal prosecutors around
the country regarding health care fraud statutes,
schemes, investigative tools, privacy concerns, and
compliance issues. Since entering private practice,
Robert has continued to build on his health care
background and experience. He currently serves as
compliance counsel for the American Association
of clinical endocrinology.
Robert W Liles
Liles Parker PLLC, USA