3 Highlights from HCCA Compliance Institute That You Don't Want to Miss

I recently attended the 20th annual HCCA Compliance Institute conference. I attend every year, and look forward to it. As a compliance expert, I go for the people, the networking, but more than anything I go for the information. I am never disappointed. I always leave the conference with a head full of compliance knowledge delivered from the most interesting and intelligent professionals in the field. Here were some of my key takeaways from the 2016 conference:

1. Keynote speaker, HHS Inspector General (IG), Daniel Levinson, gave much praise to the compliance profession but emphasized examples of “When Compliance Fails.” He spoke of Dr. Fata, the oncologist in Michigan who was recently sentenced to 45 years in prison for treating patients for cancer when they did not have cancer. Including, to our horror, the administration of chemotherapy.

Levinson’s other examples included his concern over significant charges for general inpatient care for hospice patients, and prescription drug abuse, specifically opioids and additional drugs to enhance the high of opioids, including HIV drugs and Antipsychotics. Levinson referenced a two-minute online video from the OIG series “Eye on Oversight,” entitled "Dangerous Drug—Opioids":

2. Keynote speaker, Leslie Caldwell, Assistant Attorney General, oversees the Criminal Division of the DOJ. She described her division’s strike force against Medicare fraud with an amazing 92% conviction rate. Caldwell described how last June its efforts resulted in the largest nationwide strike force operation that brought charges against 243 individuals, including 46 doctors, nurses and other licensed medical professionals, for their participation in Medicare fraud schemes involving approximately $712 million in false billings.  Caldwell said “it will by no means be the last.”

She attributed much of their success to their model program in 21st century data-driven policing and highlighted the conviction of a hospital president, among other employees including a physician psychiatrist, who were all engaged in a $158 million scheme in false claims to Medicare for partial hospitalization programs such as outpatient programs for mental illness. Caldwell suggested that the compliance profession is a vital part of stopping fraud and explained how her team reviews the effectiveness of compliance programs, “We look at whether compliance programs are simply “paper programs,” or whether the institution and its culture actually support compliance. 

We look at pre-existing programs, as well as what remedial measures your organization took after discovering misconduct—or whether a blind eye was turned to red flags….These are all important issues and I encourage all of you to regularly review the effectiveness of your compliance programs.  Do not let them get stale. ” The entire speech can be read here:

3. Keynote speaker, Jocelyn Samuels, Director U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), provided crucial insight regarding Phase Two of the OCR HIPAA audits that have begun. She explained that any covered entity or business associate could be audited. The OCR will include a cross section of different kinds of covered entities and providers, not just doctors and hospitals. But, she detailed, they will not be auditing organizations who are currently being reviewed for compliance or currently under investigation.

Samuels laid out the steps for the audits: The OCR will first notify entities, then will perform desk audits, and eventually will perform onsite audits. Learn more about OCR’s Phase 2 Audits here.

Did you attend the HCCA Compliance Institute conference this year? Who were your favorite speakers? What were your main takeaways and why?

*Photo courtesy of HCCA