American Health Lawyers Association (AHLA) Institute of Medicare and Medicaid Payment Issues
Foley attorneys Daniel Reinberg, Robert Slavkin, and Judith Waltz are speaking at the American Health Lawyers Association (AHLA) Institute of Medicare and Medicaid Payment Issues, April 9 -11, 2008 in Baltimore, Maryland.
Ms. Waltz is speaking on April 10, 2008 from 1:45 p.m. – 2:45 p.m. with Rodney A. Johnson, Subsidiary General Counsel, Palmetto GBA LLC and again on April 11, 2008 from 1:25 p.m. – 2:25 p.m. Their session is titled “Administrative Enforcement Options: Payments, Penalties, and Participation.” Topics to be covered include:
- Overpayments and recoupment: Recovery of cost report, claims-based, extrapolated, and RAC-identified overpayments
- Payment suspension regulations, procedures, and case law
- OIG CMPs and exclusions: Authorities, procedures and case law
- CMS decertification actions and quality of care CMPs
- Administrative appeal procedures, federal court challenges and judicial review
Mr. Reinberg is speaking on April 10, 2008 from 1:45 p.m. – 2:45 p.m. with Tamar V. Terzian, Office of the Inspector General, US Department of Health and Human Services and again on April 11, 2008 from 11:00 a.m. – 12:00 p.m. Their session is titled “Quality – A Payment Issue and an Emerging Compliance Issue.” Topics to be covered include:
- Components of the OIG Self Disclosure Protocol
- Benefits and risks to making a voluntary disclosure
- Types of issues to consider voluntarily disclosing
- Voluntary disclosure of Stark violations
- Lessons learned – appropriate use of outside counsel and/or independent consultants
Mr. Slavkin is speaking on April 11, 2008 from 9:45 a.m. – 10:45 a.m. with Anne Hance, McDermott Will & Emery LLP. Their session is titled “Medicare Part D: Effect on Providers – Year Two’s Influence on Year Three. Topics to be covered include:
- Common payment issues, including Plan payments (and potential differentials) to PBMs and pharmacies; billing and payment for vaccines; and billing and payment for Part B vs Part D drugs
- Contracting issues for providers contracting with Medicare Advantage-Prescription Drug plans, such as data collection and provider marketing
- Contracting requirements for physicians, pharmacies and other providers delivering Medicare prescription drug benefits
- Preventing and addressing potential compliance issues in the Medicare Part D Program as part of an overall Medicare Compliance Program
