Session 2...1:30 pm to 3:00 pm

Presented By: Connie Raffa & Rachel Hold-Weiss, Arent Fox LLP

Every other day a home health provider is facing an audit, investigation or survey. Whistleblowers are becoming overnight millionaires by filing complaints against their current or former employers. Technical requirements are the basis for overpayments to Medicare and Medicaid.

This session will examine specific clinical, billing, marketing, referral, inducement and cost report issues being targeted, including OIG's 31 Risk Areas, OIG Work Plans, and Fraud Alert. Finally, the presenter will discuss compliance strategies to meet the challenges of each of the issues, including how to conduct an internal review of your agency.

Biography:

Connie Raffa

Connie Raffa is a partner with thirty-two years’ experience in health care law and litigation. She is a member of the health care group and the corporate compliance and government enforcement group. Connie founded the health group practice in the New York office of Arent Fox.

Connie focuses on regulatory and reimbursement issues, audits, medical reviews, corporate compliance, fraud and abuse investigations and sanctions, Medicare survey and certification, administrative and federal litigation, transactions and Medicare and Medicaid issues. Her clients include all types of health-care providers, such as hospitals, hospital-based and free-standing palliative care programs, home health agencies, hospices, physician practices, nursing homes, institutions for the developmentally disabled, laboratories, adult homes, and other health care providers. In 2008, Chambers and Partners recognized Connie as a leading health care lawyer in New York.

Before joining Arent Fox in 1995, Connie served 15 years with the US Department of Health and Human Services as senior trial attorney and assistant regional counsel in the Office of General Counsel, and as staff attorney for the Office of the Inspector General. She represented HHS in federal district and circuit courts and administrative hearings, and was appointed special assistant US attorney in the Eastern, Southern and Northern Districts of New York and the District of Puerto Rico.

While in these positions, Connie specialized in Medicare reimbursement, survey and certification, Inspector General audits, investigations and sanctions, Medicaid state plan compliance, Medicaid disallowances and reimbursement, the Clinical Laboratory Improvement Act, Peer Review Organizations, and grant issues for Head Start and the Administration on Aging.

Rachel Hold-Weiss

Rachel Hold-Weiss is an associate in the New York office of Arent Fox, where she focuses on health care regulatory, transactional and litigation matters for a wide range of health care clients.

Rachel represents a variety of nonprofit and for-profit health care providers, includinghospices, home health agencies, skilled nursing facilities, general hospitals, long-term care hospitals, assisted living facilities, continuing care retirement communities and physician practices.

Specifically, Rachel focuses on advising clientsin certificate of need, facility and medical professional licensing, HIPAA, Medicare and Medicaid survey and reimbursement, fraud and abuse issues (including Anti-Kickback and False Claims), corporate practice of medicine, and corporate compliance. Rachel also assists clients with compliance audits, and the development and implementation of compliance programs. In addition, Rachel has represented large, national senior care companies with regulatory matters related to complex corporate transactions and acquisitions.

Handouts are Available Now

Presented By:Karen Green, VNA Care Network

Home care companies are generally viewed as downstream providers by payors, hospitals, and physicians. As the healthcare system of the future evolves, it is critical that home care be viewed and valued as a full partner. In this session, participants will hear how one VNA accomplished this transition.

The VNA Care Network in Worcester, MA, under the leadership of CEO Karen Green, has become a key player in that region's healthcare delivery system through participation in a variety of collaborative ventures. Among their partnerships are a three-way collaborative medical home model, a COPD focused study involving four partners, joint acquisition of a private duty venture, and other projects involving hospitalists and transitions of care. Ms. Green will outline innovative approaches to working with physician groups, demonstrate where home care can save hospitals from losing reimbursement, and share how they have learned to satisfy HMOs, their major payor source.

Biography:

Karen H. Green, RN, president and CEO of VNA Care Network & Hospice. As president and CEO of VNA Care Network & Hospice, Green oversees one of the largest and oldest nonprofit Visiting Nurse Associations in New England. The agency provides home health care, palliative care, and hospice services in patients' homes, nursing homes, assisted living and other facilities in more than 200 Eastern and Central Massachusetts communities. VNA Care Network & Hospice also offers hospice residences in Cambridge, Needham and Worcester; inpatient hospice in Worcester; child care center in Worcester; and a variety of wellness programs.

Handouts are Available Now

Presented By: Robert Markette, Gilliland & Markette LLP

After reviewing some of the many laws that apply to home care providers, Mr. Markette will address the twenty-five most common mistakes employers make and how to avoid them. For example, employers routinely misunderstand wage and hour issues such as the definition of work time, what is a "regular rate," what it means to be exempt and who fits that criteria. This session will also review the recent trends in EEOC, DOL and other enforcement activity. Providers who overlook or misunderstand their obligations to employees regarding non-discrimination and other laws may face tough enforcement policies, including civil lawsuits. Judgments or penalties can cost an employer not only unpaid wages, but damages, interest, and attorney fees. This is an area where an ounce of prevention is much cheaper than a pound of cure.

Biography:

Robert W. Markette, Jr., CHC is a partner in the law firm Gilliland & Markette in Indianapolis. His primary areas of practice are health law, fraud and abuse, employment law and litigation. Robert is certified in health care compliance by the Health Care Compliance Board.

Mr. Markettes's primary areas of practice are health law, fraud and abuse, employment law, and litigation. He is certifi ed in health care compliance by the Health Care Compliance Board. Mr. Markette assists clients including county health departments, home health agencies, hospices, and nursing facilities with a wide range of health care compliance and litigation issues. He has counseled clients on fraud and abuse issues ranging from joint ventures to marketing efforts. He has advised clients on HIPAA privacy and security compliance, Medicare certification, licensure, business transactions including changes of ownership and many other health law matters. Mr. Markette has also assisted clients during surveys and audits. He has guided clients through fraud and abuse investigations, including assisting with internal investigations, responding to government inquiries, and negotiation settlements.

In addition, Mr. Markette has spoken across the country on health law matters including HIPAA Compliance, Fraud and Abuse, Medicare Compliance, Home Health Advanced Beneficiary Notices, Wage and Hour compliance, and Non-Competition Agreements. He has authored numerous articles on fraud and abuse, HIPAA, and other health law topics for the Remington Report and other trade publications. He graduated from Hanover College with a degree in Computer Science and received his law degree from Indiana University School of Law. Mr. Markette is a member of the American Health Lawyers Association, the Health Care Compliance Association and the Indiana State Bar Association.

Handouts are Available Now