Schedule at a Glance Wednesday, Sept. 8 10 a.m.-noon
From Hotline Call to Qui Tam Complaint - Strategies for Mitigating the Risk of Qui Tam Complaints at the Compliance Investigation Stage Tracy Field, JD, Partner Robert Brennan, JD, Partner Parker Hudson Rainer & Dobbs
3-5 p.m.
Auditing for the OIG Work Plan Allison Luke, JD, CHC, Executive Consultant Lori Carlin, Director, Professional Coding Services Arlene Baril, Director, Facility Coding Services Jodi Nayoski, Director, Professional Consulting Services Pinnacle Enterprise Risk Consulting Services
Thursday, Sept. 9 10 a.m.-noon
New Compliance Trends for the Compliance Officers Lori Foley, Managing Principal of Compliance Services Tynan Kugler, Principal PYA
3-5 p.m.
From Ransomware to Regulation: What’s Up in Privacy and Data Security?! Gina Greenwood, JD, CIPP/US Partner, Co-Lead of Data Protection, Privacy and Security Practice Nelson Mullins
Friday, Sept. 10 10 a.m.-noon
Fraud and Enforcement Trends and Priorities Scott Grubman, JD, Partner Chilivis Grubman Dalbey & Warner
3-5 p.m.
COVID-19 Liabilities and Government Enforcement Ross Burris, III, JD, Shareholder Ross Sallade, JD, Shareholder Polsinelli
5-6 p.m.
Happy Hour
Continuing Education Credits The Georgia Hospital Association is approved by the Compliance Certi cation Board (CCB) to offer Continuing Education Units (CEUs). The CEUs are awarded based on individual attendance. Participants may earn up to 14 CEUs. By attending the 2021 Compliance Officers Virtual Conference offered by GHA participants can earn Continuing Legal Education hours (CLE) from the State Bar of Georgia. Participants may earn up to 12 CLE hours.
Thank You to the 2021 Planning Committee and Our Sponsors! It is through your dedication, hard work and planning that we can produce an event like this!
Planning Committee Darcelle Skeete Burgess, JD, MHA Emory Healthcare Regina H. Davidson, MBA, CHC, CCEP Tanner Health System Allison Luke, JD, CHC Pinnacle Enterprise Risk Consulting Service Nakesha Rolle, MBA Miller County Hospital
Sponsors Chilivis Grubman Dalbey & Warner, LLP Nelson Mullins Parker Hudson Pinnacle Enterprise Risk Consulting Services Polsinelli PYA
3-5 p.m. Auditing for the OIG Work Plan Allison Luke, JD, CHC, Executive Consultant with Lori Carlin, Director, Professional Coding Services, Arlene Baril, Director, Facility Coding Services and Jodi Nayoski, Director, Professional Consulting Services Pinnacle Enterprise Risk Consulting Services Allison Luke has over 27 years of experience in health law and regulatory compliance. She has served as a corporate compliance officer, legal counsel, privacy officer and consultant for hospitals, health care systems, home health agencies, DME, dental practices, mental health organizations, physician practices and others. She has extensive experience in health care law and compliance, and her responsibilities have included risk assessments, corporate compliance program development, compliance investigations and resolutions, HIPAA Privacy and Security Rules policy development and organizational implementation, privacy violation and security breach investigations, compliance audit program development, and compliance training. Her strengths and experience include compliance policy review and development, training, compliance research and reports, external compliance investigations, privacy and security process review, and compliance audit program development. She is a national and regional speaker on health care law and compliance issues including fraud and abuse, risk assessments, HIPAA and HITECH Act, the False Claims Act, the Anti-Kickback Statute, EMTALA, Home Health and DME, among others. Lori Carlin brings over 20 years of health care experience to the Pinnacle team including a wide variety of expertise/services including revenue cycle management, coding and auditing, quality assurance, training, operations, and litigation support. She specializes in coding and compliance with responsibility for large scale coding and audits, oversight and training for providers and staff, as well as reimbursement consulting Arlene Baril brings more than 35 years of operational, consulting, and technical experience to Pinnacle. Specializing in revenue cycle management and HIM operations, she has acquired a unique skillset that encompasses systems analysis and design, staff training and development, and software product development. Her expertise is extensive and includes HIM outsourcing, RAC assessments, charge description master reviews, inpatient MS-DRG, outpatient OPPS coding assessments, third party payor reviews, clinical documentation improvement and physician practice coding. Jodi Good Nayoski has more than 15 years of coding, auditing, education and consulting experience in hospitals, physician groups, and payors. She is an experienced health care consultant with proven abilities in project management, physician audits, curriculum development, and training. Her specialties include ICD-10 physician and coder training, evaluation and management training, CMS compliance, clinical documentation improvement, and professional coding audits.
3-5 p.m. From Ransomware to Regulation: What’s Up in Privacy and Data Security?! Gina Greenwood, JD, CIPP/US Partner, Co-Lead of Data Protection, Privacy and Security Practice Nelson Mullins Gina Greenwood is the current co-chair of the Nelson Mullins Data Breach Response and Investigation Team. She has a 20-year career in data privacy and health care law, practicing her entire career at three different AmLaw 100 law rms. Prior to transitioning to Nelson Mullins, she developed and chaired the Breach Team at another AmLaw 100 law rm for over eight years. She is a recognized authority in Emergency Medical Treatment and Labor Act (EMTALA) compliance, investigations, hearings, and survey responses; fraud and abuse compliance plans, Joint Commission, and licensure compliance; reimbursement issues; contract drafting and general business advice; and many other regulatory and compliance matters pertinent to large and small businesses, device/pharmaceutical manufacturers, and health care entities.
Friday, Sept. 10 10 a.m.-noon Fraud and Enforcement Trends and Priorities Scott Grubman, JD, Partner Chilivis Grubman Dalbey & Warner Scott Grubman is a former Assistant United States Attorney (AUSA) and Department of Justice (DOJ) Trial Attorney who represents clients across industries. A substantial portion of his practice involves representing health care providers of all types and sizes in connection with high-stakes government investigations, both criminal and civil, by agencies such as the U.S. Department of Justice, HHS-OIG, the FBI, and state Medicaid Fraud Control Units. Scott also has extensive experience representing health care providers in connection with administrative proceedings, audits, and general health care regulatory matters, particularly those related to the False Claims Act (including qui tam whistleblower actions), Stark Law, and Anti-Kickback Statute.
Thursday, Sept. 9 10 a.m.-noon New Compliance Trends for the Compliance Officers Lori Foley, Managing Principal of Compliance Services and Tynan Kugler, Principal PYA Lori Foley leads PYA’s Compliance Advisory service line and is a member of PYA’s Compensation Valuation Physician Service teams. She combines industry experience with over two decades of consulting experience advising physicians and hospitals in the areas of compliance, compensation, strategic planning, operational and nancial improvement, and affiliation structures. Lori also works closely with attorneys to assist clients with complex compliance matters, including meeting obligations outlined in corporate integrity agreements, applying Medicare and Medicaid regulatory requirements to audit and potential overpayment situations, assisting with self-disclosure reporting including statistically valid sampling protocols and extrapolations, and providing pretransaction compliance and operational due diligence. Additionally, Lori has also procured signi cant experience in CMS-funded value-based reimbursement programs including MIPS/MACRA reporting, population health management, chronic care management, transitional care management, and remote patient monitoring structures. Tynan Kugler’s experience includes performing fair market value compensation analyses and valuations of medical practices and ancillary service lines for a variety of physician and hospital transactions. Additionally, her experience includes medical staff development plans, physician needs analyses, and market assessments. Tynan has more than two decades of health care consulting experience and, prior to re-joining PYA in 2007, spent several years assisting community hospitals/health care systems, academic medical centers, and physician groups with strategic planning related to the development of coordinated, comprehensive cancer programs. She has speci c expertise in medical, radiation, and surgical oncology and provides various related valuation and consulting services speci c to these specialties. She is credentialed as a Certi ed Valuation Analyst (CVA) by the National Association of Certi ed Valuation Analysts (NACVA) and is a frequent speaker on valuations and related topics for various health care organizations.
3-5 p.m. From Ransomware to Regulation: What’s Up in Privacy and Data Security?! Gina Greenwood, JD, CIPP/US Partner, Co-Lead of Data Protection, Privacy and Security Practice Nelson Mullins Gina Greenwood is the current co-chair of the Nelson Mullins Data Breach Response and Investigation Team. She has a 20-year career in data privacy and health care law, practicing her entire career at three different AmLaw 100 law rms. Prior to transitioning to Nelson Mullins, she developed and chaired the Breach Team at another AmLaw 100 law rm for over eight years. She is a recognized authority in Emergency Medical Treatment and Labor Act (EMTALA) compliance, investigations, hearings, and survey responses; fraud and abuse compliance plans, Joint Commission, and licensure compliance; reimbursement issues; contract drafting and general business advice; and many other regulatory and compliance matters pertinent to large and small businesses, device/pharmaceutical manufacturers, and health care entities.
Friday, Sept. 10 10 a.m.-noon Fraud and Enforcement Trends and Priorities Scott Grubman, JD, Partner Chilivis Grubman Dalbey & Warner Scott Grubman is a former Assistant United States Attorney (AUSA) and Department of Justice (DOJ) Trial Attorney who represents clients across industries. A substantial portion of his practice involves representing health care providers of all types and sizes in connection with high-stakes government investigations, both criminal and civil, by agencies such as the U.S. Department of Justice, HHS-OIG, the FBI, and state Medicaid Fraud Control Units. Scott also has extensive experience representing health care providers in connection with administrative proceedings, audits, and general health care regulatory matters, particularly those related to the False Claims Act (including qui tam whistleblower actions), Stark Law, and Anti-Kickback Statute.
3-5 p.m. COVID-19 Liabilities and Government Enforcement Ross Burris, III, JD, Shareholder and Ross Sallade, JD, Shareholder Polsinelli Ross Burris bene ts clients by applying a strong business acumen to understanding the goals and challenges clients face and by leveraging a commanding ability to counsel on intricate legal matters. His experience includes advising clients regarding the complex and ever-changing federal and state regulatory environment. Ross approaches each issue with a practical application that is unique to the client’s context, and draws on a strong background of working with numerous regional and national health care providers, including hospitals, health systems, long-term care providers, durable medical equipment suppliers, and Independent laboratories. Ross’s compliance work encompasses numerous federal and state health law requirements, including Medicare Reimbursement Audits, Medicaid issues and Commercial Payor disputes and Medicare billing guidelines. Ross Sallade works with clients to help them navigate through the myriad of state and federal health care regulatory challenges facing them. He regularly counsels clients to aid in structuring their business transactions and relationships in compliance with federal and state regulations, including change of ownership requirements as well as federal anti-kickback statute and federal physician selfreferral (or “Stark”) laws. Ross advises clients regularly on a variety of matters, including Medicare and Medicaid (and other federal and state payor programs) enrollment; State licensure; Medicare and Medicaid compliance; provider and supplier reimbursement in both the Medicare and Medicaid programs; health care operational matters; diligence support in connection with mergers and acquisitions and nance transactions; professional service and management service agreements, including “controlled professional corporations”; and fraud and abuse.