Alabama Audit Summit Pelham Civic Center April 23, 2014

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1 Alabama Audit Summit Pelham Civic Center April 23, 2014

2 Agenda 8:00 Registration 8:30 Welcome Ingram Haley, Craig Tolbert and Richard Byerly 8:30-9:00 National Audit Update Ingram Haley 9:00-10:00 OIG Audits and Work Plan Update John W. Weiss, Esq. and Gregg B. Everett, Esq. 10:00-10:15 Break 10:15-11:45 Hospital Panel Discussion on Audit Best Practices Heather Bennett, Claire Owens, Esq. and Shannon Pavel 11:45-12:00 Lunch 12:00-2:00 Update on CMS Rules & Regulations: Two Midnight Rule, Denial Management and the Benefit of Self-Audit Initiatives Dr. Gregory Palega and Joan C. Ragsdale, Esq. 2:00-2:15 Break 2:15-3:15 How to Appeal and Win a Medicare Audit Howard E. Bogard, Esq. 3:15-3:30 Wrap up

3 Session Objectives and Speaker Bios 8:30 9:00 National RAC Update Objective: To provide an update on national government audit policy. Ingram Haley, CFO, Alabama Hospital Association Ingram Haley is Senior Vice President and CFO of the Alabama Hospital Association. He oversees financial-related state and federal health care issues as well as serving as the financial officer of the Association. Previously he worked for the Virginia Hospital & Healthcare Association where he was Director of Financial Policy managing Medicare, Medicaid and Commercial reimbursement issues for six years. Prior to hospital association work he worked as a senior budget analyst in the state budget office in Virginia as well as a quality control manager for Hooker Furniture Corporation in Martinsville, Virginia. He holds a BA in History from James Madison University, a Master s of Public Administration from Virginia Commonwealth University, and a Master s of Health Administration from the Medical College of Virginia. 9:00 10:00 OIG Audits and Work Plan Update Objectives: To provide a review of current significant Office of Inspector General (OIG) and Department of Justice (DOJ) cases and settlements; to review OIG Work Plans; and to provide a better idea of what to expect as far as OIG efforts as it affects healthcare providers, in particular hospitals. John Ward Weiss, Esq., Gilpin Givhan, PC, Montgomery Mr. Weiss is a shareholder in the firm of Gilpin Givhan, PC and practices in the areas of health care, taxation, and business organizations. With over thirty years experience in health law, he represents hospitals and other health care providers in various arrangements while blending an operational understanding of the health care industry with the technical elements of health law practice. John regularly advises clients with regard to business organizations and structures, contractual arrangements, health care and tax compliance matters, joint ventures, recruiting, acquisitions and operations, and is a frequent lecturer on various compliance matters. He earned his undergraduate degree from Presbyterian College, law degree from the University of Alabama and Master of Laws in Taxation from New York University. He is a member of the Health Law and Taxation Sections of the American Bar Association, the American Health Lawyers Association, the National Association of Bond Lawyers, and the Taxation and Health Law Sections of the Alabama Bar Association. Gregg Brantley Everett, Esq., Gilpin Givhan, PC, Montgomery Gregg Brantley Everett is of counsel to the firm and a member of the Health Care practice group. He served as General Counsel and Senior Vice President for the Alabama Hospital Association (AlaHA) Through Gregg s years at AlaHA, he worked extensively on Medicare and Medicaid matters, health insurance issues, Joint Commission compliance, quality assurance, physician recruitment and retention, and risk management issues. In addition he dealt with regulatory compliance matters under EMTALA, and the Stark law, and other issues affecting both non-profit and for-profit healthcare entities. Gregg also dealt with legislative issues for hospitals across the state. For

4 eleven years before joining the Alabama Hospital Association, Gregg was the General Counsel for a large hospital where he participated in forging positive relationships between hospitals and physicians as well as developing successful partnerships with administrators and the medical staff. Gregg is a frequent lecturer (locally, statewide, and nationally) on a wide array of health care issues. Before joining a health service organization, Gregg was law clerk to Senior Associate Justice Hugh Maddox of the Alabama Supreme Court. He is an Adjunct Professor in the Graduate School at Auburn University Montgomery and has served as special counsel to the Alabama Legislature. He is on the Boards of the Gift of Life Foundation and the Alabama Board of Specialization of the Alabama State Bar. He was selected as one of the top lawyers in Alabama in 2009, 2010 and :15 11:45 Hospital Panel Discussion on Audit Best Practices Objective: To provide specific examples of successful provider audit review strategies. Heather Bennett, Director of Case Management, Coosa Valley Medical Center Heather Bennett is a Registered Nurse and Certified Professional in Health Care Management with 20 years of experience in a rural acute care facility. She is a BSN graduate of Auburn University School of Nursing. She is employed by Coosa Valley Medical Center (CVMC) in Sylacauga, Alabama where she serves as the Director of Case Management, Infection Control and Education. Her Case Management role in the facility includes being the clinical liaison for appeals and denials. CVMC currently is contracted with Executive Health Resources where she also serves as the clinical liaison for appeals and denials. She is a member of the Alabama Hospital Association (AlaHA) Alabama Quality Task Force and the AlaHa RIC/RAC group. Claire Owens, Esq., JD, CPHRM, CHC, Director, Fiscal Integrity, Baptist Health System Claire Owens is an experienced healthcare executive who currently serves as the Director of Fiscal Integrity at Baptist Heath System in Birmingham Alabama. Claire s focus areas include: regulatory compliance; government audits RAC/MAC and Medicaid; Medicare Advantage audits; clinical and coding compliance. Prior to moving to the Baptist corporate office, Claire spent nine years at Shelby Baptist Medical Center in Alabaster, Alabama. Her last role was as the Executive Director of Risk, Compliance & Shared Services where she led efforts related to: clinical risk management, patient safety, root cause analysis leadership, facility level claims referrals, HIPAA compliance, CMS Conditions of Participation and other regulatory compliance, physical safety and security, and disaster preparedness, Environment of Care management. She has a degree in Quantitative Analysis with an emphasis on Operations Management from Louisiana State University, and a Juris Doctorate from Birmingham School of Law. Claire is past president of the Alabama Society of Healthcare Risk Management and past contributor/editor staff to the American Society of Healthcare Risk Management s Patient Safety

5 Network Newsletter. She is active in her community and has held various board positions with the local Arts Council and Library. She is a 2010 graduate of the Leadership Shelby County Program. Claire currently serves on the Board of Directors for the Chilton and Shelby County Mental Health Centers. Shannon Pavel, RN, CPHM, Manager of Clinical Appeals and Denials, Infirmary Health System Shannon Pavel is a Registered Nurse and Certified Professional in Health Care Management with 18 years of experience in an acute care hospital and expertise in the fields of Case Management and Utilization Review. She is employed by The Infirmary Health System, one of the largest health systems in the state of Alabama, and has served as the Clinical Appeals and Denials Coordinator since 2009 managing all aspects and types of governmental post payment and prepayment clinical audits including RAC, MAC prepayment denials, Medicare Advantage audits, and CERT audits. Shannon is a member of the Cahaba GBA Provider Outreach and Education Advisory Board and serves on the Alabama Hospital Association RIC/RAC steering committee as an advocate for improvements and greater transparency in all clinical governmental audit programs. She was recently honored with the opportunity to speak at the 7 th National RAC summit in Washington D.C. among a panel of distinguished presenters and attendees. 12:00 2:00 Update on CMS Rules & Regulations: Two Midnight Rule, Denial Management and the Benefit of Self-Audit Initiatives Objectives: Participants will be able to understand current health care law as well as CMS rules, regulations and guidance relative to 2014 Hospital IPPS for Acute Care Hospitals; be clear about the implications and medical necessity requirements of the Two-Midnight rule; identify the impact of the Probe & Educate program and how to respond; learn how to leverage effective self-audit initiatives to identify and correct process deficiencies that can result in denials. Joan C. Ragsdale, Esq., JD, Chief Executive Officer, MedManagement, LLC Ms. Ragsdale serves as the Chief Executive Officer for MedManagement, LLC, a company she cofounded in She is a Phi Beta Kappa graduate of the University of Alabama where she received her Bachelor of Arts degree, magna cum laude. She received her law degree from the University of Alabama where she was an editor of the Alabama Law Review and was on the National Moot Court team. Prior to joining MedManagement, Joan practiced law in Birmingham. She was a partner with Sirote & Permutt and later, Bradley, Arant, Rose & White where she served as Chair of the Healthcare Group. She is a past-president of the Health Law Section of the Alabama Bar, was previously selected for inclusion in the Best Lawyers in America, was chosen as one of the Birmingham Business Journal s Top Ten Business Women in Birmingham and was identified as a Birmingham Health Care Hero. She is a frequent speaker and author on current health care regulatory and compliance issues. She is a board

6 member of the Jefferson County Medical Foundation Trust, the UAB Callahan Eye Foundation, Inc. board, and a member of the University of Alabama at Birmingham Medical Leadership Committee. Gregory Palega, MD, JD, Medical Director of Regulatory Affairs, MedManagement, LLC Dr. Palega was born in New York and attended Columbia University, where he received his BA in biology, magna cum laude. In addition, Dr. Palega was chosen for the Phi Beta Kappa honor society. Remaining in NYC, Dr. Palega graduated as one of three Valedictorians in his class at Cornell University Medical College and was elected to the Alpha Omega Alpha medical honor society in both his third year and fourth year. After medical school he accepted Duke University Hospital s offer of an internal medicine residency position. In his third year of residency, Dr. Palega was chosen to be an Assistant Chief Resident. Subsequently, he entered private practice internal medicine, where he practiced for almost 13 years. While practicing medicine, he completed a law degree and passed the California Bar exam, thus obtaining a license to practice law. Dr. Palega worked as General Counsel for New Hanover Medical Group from , where he gained experience in corporate compliance and health law regulations. He is currently board certified in Internal Medicine and licensed to practice both medicine and law. He now practices hospital medicine in North Carolina and serves as the Medical Director for Regulatory Affairs at MedManagement. 2:15 3:15 How to Appeal and Win a Medicare Audit Objective: The session will discuss the Medicare audit appeal process with an emphasis on the Administrative Law Judge (ALJ) hearing process. Attendees will learn about "best practices" to obtain a successful appeal result. Howard E. Bogard, Esq, Partner, Burr & Forman LLP Howard serves as Chair of the firm s Health Care section, which contains over 25 attorneys practicing throughout five states successfully representing clients on all matters of health care related law, including corporate, litigation and regulatory matters. His area of focus involves corporate and regulatory matters, including Stark and Anti-kickback and False Claims Act compliance, facility and professional licensure matters, HIPAA, physician practice formation, joint venture arrangements, mergers and acquisitions, certificate of need issues, Medicare and third-party audits and investigations, and contract negotiations. He is the author of Legal Strategies for Health Care Providers, published by Aspatore Books in 2005, coauthor of Legal Guide for Physicians in Alabama, published by the Medical Association of the State of Alabama in 2000, revised in 2002, and is a regular writer for the Birmingham Medical News. Howard is also a frequent speaker on various health care topics both locally and nationally. Howard has been listed in The Best Lawyers in America (Health Law) since 2005, and was chosen as the "Birmingham Alabama Best Lawyers Health Care Lawyer of the Year" for Howard has been named "Who's Who in Health Care" by The Birmingham Business Journal since 2009 and listed as an Alabama "Super Lawyer" (Health Law) since 2010.

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