ASTOUNDING!: The Power of a Federal Fraud Prosecution,
Northeast
Ohio Health Information Managers, June 6, 2008 Holiday Inn
Rockside, Independence, Ohio
The
Disruptive Provider: Dealing with Nightmares and Landmines,
Marion General Hospital, May 28, 2008
IMPAIRED
PRACTITIONERS: Due Process, Treatment and Patient Safety,
Firelands Regional Medical Center, May 22, 2008
Challenges
of Securing Health Care Data,
The Greater Cleveland Chapter of the American Academy of
Professional Coders, April 22, 2008
Sexual
Trangressions, Workplace Harassment and New Medical Board Rules,
Grand Rounds, Lakewood Hospital, February 27, 2008
Usual
and Customary or Health Care Fraud,
Intensive Course in Medical Ethics, Boundaries and
Professionalism,
Case
Western Reserve University School of Medicine,
February
22, 2008
EMR
and Speech Recognition: Practical Solutions to Legal Problems;
Intensive Course in Medical Recordkeeping,
Case
Western Reserve University School of Medicine
November 9, 2007
Life
after medical malpractice tort reform: Who's after me now?
Ashtabula County Medical Center;
October 15, 2007
Ohio
DNR CC Law Analysis and Implementation,
International
Brotherhood of Electric Workers local 38 retirees, October 9,
2007
Do Not
Resuscitate Orders and Advanced Directives,
Med-Central Health
System, September 25, 2007.
Usual
and Customary or Health Care Fraud and Case Discussions;
Intensive Course in Medical Ethics, Boundaries and
Professionalism, Case Western Reserve University School of
Medicine, George S. Dively Building, September 6-7, 2007.
A
Knock on the Door: Current Criminal Health Care Law Enforcement;
Northeast Ohio Medical Group Management Association,
June 20, 2007
The
Privacy Laws: Protecting Yourself from HIPAA: Computer privacy
information systems, insurance and penalties,
Northeast Ohio Health Information Managers, June 1, 2007 Holiday
Inn Rockside.
Hot Topics
in Malpractice, Avoiding the Worst,
Flower Hospital, May 30, 2007
A Knock
on the Door: Federal Criminal Health-care Enforcement,
MedCentral, May 22, 2007
Medical Grand Rounds - What Every
Practicing Physician Should Know About The Legal System,
St. Vincent Charity Hospital, May 16, 2007
A
Knock at The Door,
Genesis-Good Samaritan Hospital, May 2, 2007
Mandatory
Reporting, Ohio Association Medical Staff Services,
April 20, 2007, Columbus Hilton Easton, 3900 Chagrin Dr,
Columbus, OH 43219-7100
Pay
For Performance, Christ
Hospital, April 12, 2007
Usual and
Customary or Fraud and Abuse?
Ohio Health Information Management
Association, 2007 Annual Meeting, March 28, 2007
Dealing
with the Impaired Practitioner,
Holzer Medical Center, March 23, 2007
Ohio
DNR Comfort Care Law: Analysis And Implementation,
Community Hospitals And Wellness Centers, Bryan, Ohio March 12,
2007
Elder
Law: A Representation of the health care profession.
Tri-C Campus, 4250 Richmond Road, Highland Hills 44122 Room
2105, February 23, 2007
A
Knock on The Door, Mary
Rutan Hospital, February 5, 2007
Pay
For Performance, What’s Coming Next,
The Toledo Clinic, January 10, 2007
The
Legalities of The Standard of Care,
Fireland’s Regional Medical Center, December 15, 2006
A Knock on the
Door: Federal Criminal Health-care Enforcement,
Licking Memorial Hospital, November
27, 2006
Usual and Customary
or Fraud and Abuse?
MedCentral Health System, November
7, 2006
Do Not
Resuscitate Orders and Advanced Directives,
Euclid Hospital, November 2, 2006
Facing the Pharmacy
Board: Parens Patriae or Pure Punishment?
Ohio Northern University School of Pharmacy, October 25, 2006
Dealing
with the Ohio Medical Board, Responding to Investigations and
Complaints, Genesis/Bethesda
Hospital, September 26, 2006
Dealing
with the Ohio Medical Board, Avoiding A Very, Very Big Hammer,
The Lake County Medical Society, September 26, 2006
Electronic
Medical Records: A Practical Guide for Physicians,
Holzer Medical Center, September 21,
2006
Usual
and Customary or Fraud and Abuse?
Lakewood Hospital, September 20,
2006
Dealing
with Lawyers and the Legal System: Release of Information,
Serving as Witnesses and Other Entanglements,
Flower Hospital, September 12, 2006
Usual
and Customary or Fraud and Abuse?
Case Western Reserve University
School of Medicine, September 8, 2006
Usual and Customary
or Fraud and Abuse?
Euclid Hospital, September 7, 2006
Pay
for Performance-The Medicare Initiative,
Lake County Medical Society, August
30, 2006
Fundamentals of Risk
Management,
Firelands Regional Medical Center,
August 16, 2006
Legal Perspectives in Becoming a Primary Stroke Center,
Firelands Regional Medical Center,
August 16, 2006
“IMPAIRED PRACTITIONERS: Due
Process, Treatment and Patient Safety,”
MedCentral Health System, August 1,
2006.
Impairment,
whether the result of drug, alcohol, psychiatric or other
medical issues constitutes the number one most frequent form of
disciplinary action against physicians in Ohio.
Many physicians are unaware of both their rights and
their risks when dealing with impairment issues.
Few physicians, for example, realize that a citation for
driving under the influence, while having often little
consequences for lay people aside from a modest fine or often,
at worst, an automobile license suspension, can frequently cost
a physician several hundred thousand dollars in lost income as
the result of a prolonged medical license suspension and
subsequent probation.
This presentation addresses many aspects of impairment
from recognition, intervention, investigation, prosecution and
the cascade of consequences that follows.
Learning Objectives
1. Recognizing the problem, incidence and
prevalence, tell-tell signs, precipitating events, dealing with
denial.
2. Proper medical legal management of the
impaired professional; protecting patients, colleagues and the
public while assisting the impaired professional's recovery.
3. Avoiding undue legal consequences, dealing
with the Medical Board productively, managing the cascade of ill
effects.
"Electronic Medical Records: Practical
Solutions for Legal Problems"
2006 Ohio Hospital Association Annual Meeting, presented June
12, 2006
Advancing technology has now made it
possible for the practicing physician to generate and store
digital electronic medical records with a speed, accuracy and
completeness not possible even two or three years ago.
Aggressive medical legal risk management advocates the
use of these inexpensive, readily available, consumer friendly
electronic medical record solutions.
"Supplemental Compliance Program
Guidance for Hospitals," 2006
Ohio Hospital Association Annual Meeting, presented June 12,
2006
Following an understandable lull in federal
criminal enforcement of health care fraud, abuse and compliance
violations after 9/11 as resources were directed elsewhere, a
recent upturn in prosecutions highlights the need pay close
attention to the OIG's program statements.
This presentation describes recent activity in Ohio and
summarizes the key features of the Inspector General's
supplemental compliance program statement for hospitals.
“Current Legal Issues Confronting
Pharmacists: Fraud and Abuse”
Ohio Pharmacist Rehabilitation Organization, Annual Conference,
Columbus, Ohio, presented April 30, 2006
Recent civil and criminal enforcement
activities with particular reference to professional licensing
of pharmacists are reviewed.
“Usual and Customary or Health Care
Fraud?”,
Intensive Course in Medical Ethics
and Professionalism, Case Western Reserve University School of
Medicine, Cleveland, Ohio, last presented March 3, 2006. (Given
twice a year at CWRU.)
Multiple
case studies of boundary violations in the context of health
care fraud and abuse are examined for teaching purposes,
including billing and coding issues, the mechanism of repayment
audits, kickbacks and Stark Law violations.
Learning Objectives:
At the conclusion of this
presentation, participants should be able to respond
appropriately to the following concerns:
1.
Describe some of the hallmark legal
boundaries surrounding current day medical practice, including
fraud and abuse, kickbacks and billing and coding rules.
2.
Describe current enforcement activities
with specific examples of prosecutions for violations of these
boundaries.
3.
Explain how physicians should respond to
these enforcement activities, both prospectively and in the
event of a real or threatened prosecution.
“Mandatory Reporting”
Ohio Hospital Association, February 22, 2006
Although many administrators and
managers are aware of their reporting obligations regarding
physicians under the Databank rules, dozens of other health-care
professionals are licensed under statutes and rules which
require reporting of various infractions and violations.
This presentation reviews the broad scope of such
mandatory reporting requirements in Ohio.
"DNR & Advance Directives in Ohio"
Fremont Memorial Hospital,
January 26, 2006.
Federal
and state laws are becoming increasingly complex surrounding
end-of-life issues.
Living wills, advance directives, do not resuscitate orders,
comfort care requirements and similar rules impose multiple
obligations on physicians and require a clear understanding of
those obligations.
“Sexual Boundaries and Medical
Professionals” The Cleveland
Clinic Foundation Grand Rounds, Department of Psychiatry and
Psychology, January 12, 2006.
Boundary violations are a primary
enforcement area for professional licensing boards.
Different professional licensing boards often have very
different definitions of boundary violations, the transgression
of which frequently results in prolonged license suspension
followed by lengthy terms of probation. Health-care
professionals must be aware of the ethical and legal boundaries
defining their relationships with their patients.
“Supplemental Compliance Program
Guidance for Hospitals,” Ohio
Hospital Association Annual Meeting, presented June 20, 2005
“IMPAIRED
PRACTITIONERS:
Due Process, Treatment and Patient
Safety,”
Fremont
Memorial Hospital, presented March 7, 2005
Impairment, whether the result of drug, alcohol, psychiatric or
other medical issues constitutes the number one most frequent
form of disciplinary action against physicians in Ohio.
Many physicians are unaware of both their rights and
their risks when dealing with impairment issues.
Few physicians, for example, realize that a citation for
driving under the influence, while having often little
consequences for lay people aside from a modest fine or often,
at worst, an automobile license suspension, can frequently cost
a physician several hundred thousand dollars in lost income as
the result of a prolonged medical license suspension and
subsequent probation.
This presentation addresses many aspects of impairment
from recognition, intervention, investigation, prosecution and
the cascade of consequences that follows.
“Do Not Resuscitate Orders and Advance
Directives in Ohio”,
MedCentral Health Systems,
Mansfield, Ohio, presented September 28, 2004.
“Dealing with the Ohio Medical Board,
Responding to Investigations and Complaints”,
North Central Academy Ohio Podiatric
Medical Association, presented January 30, 2004.
Professional licensing Board investigations
often commence with a visit from a Board Investigator, "Just to
ask a few questions." These highly skilled investigators do not
appear in a physician's office for a social visit.
Instead, these are significant and potentially
catastrophic events that must be dealt with in a very careful
fashion. Martha
Stewart would have avoided prison if she had dealt with her
investigation properly.
This presentation describes the methodology of and the
proper response to professional licensure investigations and
complaints.
“Current
Status of Medicare Fraud and Abuse Enforcement”,
North Central Academy Ohio Podiatric
Medical Association, presented January 30, 2004.
“Contracts
and Negotiation Techniques”, North
Central Academy Ohio Podiatric Medical Association, presented
January 30, 2004.
“A
Knock at the Door,” Mt. Carmel West,
Columbus, Ohio, presented January 7, 2004.
This presentation highlights recent
developments in the enforcement of civil and criminal
health-care fraud and abuse violations. Billing and coding
prosecutions, kickbacks schemes (which often would not
intuitively appear to be improper) and related topics are
examined. Enforcement methods from the execution of a search
warrant, witness interrogation and the best responses to such
matters are discussed.
“The
Ohio State Medical Board: Avoiding a Very Big Hammer”,
Elyria Memorial Hospital Medical Staff, Elyria, Ohio, presented
December 4, 2003.
“Teaching Hospital Requirements-What
you need to know”,
Mt. Carmel Health System, Columbus,
Ohio, presented November 3, 2003.
Documentation requirements applicable to
teaching physicians may seem onerous and impracticable, however
a clear understanding of the rules will assist hospitals and
physicians to avoid repayment claims or worse.
“Legal
Perspectives in Becoming a Primary Stroke Center”,
2nd
Annual Northern Ohio Stroke Seminar, American Stroke
Association, Canton, Ohio, Presented September 17, 2003.
“Assisting
the Impaired Physician”, 2003 OHA
Annual Meeting, Columbus, Ohio, Presented June 10, 2003.
“Dealing with Licensing Boards:
Safety Retaining Affected Professionals in the
Workplace”,
2003
OHA Annual Meeting, Columbus, Ohio, Presented June 10, 2003.
“A
Knock on the Door”, 2003 OHA Annual
Meeting, Columbus, Ohio, Presented June 9, 2003.
“Impaired Practitioners”, Cure for the Disease,
Ohio Hospital Association, Columbus, Ohio,
Presented October 17, 2002.
“Physician
Compliance Plans”, Robinson Memorial
Hospital, Ravenna, Ohio, Presented June 12, 2002
Following the publication of the
OIG's guidance program for physician groups, no practicing
physician should be without a comprehensive, well designed and
continuously implemented compliance program.
Such a program greatly reduces the risk of both civil,
and more importantly, criminal prosecutions for health care law
violations. The
essential elements of a comprehensive physician compliance
program including prospective (and emphatically not
retrospective) audits, recordkeeping, use of documentation
templates and related matters are covered in this presentation.
“Compliance
Plans”, Medical Executive Leadership
2002, University Hospitals of Cleveland CME Program, Cleveland,
Ohio, Presented February 2, 2002.
“Building
a Fortress Against the Fraud and Abuse Police”,
A Physician Compliance Program, Massillon
Community Hospital, Canton, Ohio, Presented November 8, 2001.
“Physician
Compliance Plans”, Preventative
Medicine for Fraud and Abuse Violation, Association of Indian
Physicians of Northern Ohio, Cleveland, Ohio, Presented October
27, 2001.
"Provider
Compliance: Building a Fortress against the Fraud and Abuse
Police", University Hospitals Health
System, Cleveland, Ohio, Presented August 1, 2001
"Physician
Compliance, a New Era of Risk Management",
30th Annual Convention, Association of Philippine Physicians in
America, Cleveland Ohio, Presented July 28, 2001
“Current
State for Local Federal Enforcement Activities”,
Cuyahoga Physician Network, Cleveland,
Ohio. Presented June
26, 2001.
“Navigating
the Perioperative Minefields”, The
Greater Cleveland Peri Anesthesia Nurses Association, Mentor,
Ohio. Presented
February 24, 2001.
“A
Knock at the Door”, Ohio Hospital
Association, Columbus, Ohio.
Presented June 19, 2001.
“Assisting
the Impaired Physician”,
Ohio Hospital Association, Columbus, Ohio.
Presented June 19, 2001.
“Dealing
with Licensing Boards: Safety, Retaining Affected Professionals
in the Workplace”, Ohio Hospital
Association, Columbus, Ohio.
Presented June 18, 2001.
“Complying
with Federal Mandates”,
Premiere Physicians, Westlake, Ohio.
Presented May 23, 2001.
“Exploring Hospital/Physician Relationships in Ohio, The Bad
Guys are Coming”, Lorman Education
Services, Cleveland, Ohio.
Presented April 25, 2001.
“Physician
Compliance Plans:
The Reality of Violations”,
MetroHealth
Medical Center, Medical Grand Rounds, Cleveland, Ohio.
Presented March 22, 2001.
“Physician
Compliance Plans: Dealing with the Fraud and Abuse Police” ,
Bedford Medical Center, Bedford,
Ohio. Presented
“Provider
Compliance”, St. Michael Hospital,
Cleveland, Ohio.
Presented February 15, 2001.
“Compliance
Program”, Eye Care Associates, Inc.,
Youngstown, Ohio.
Presented February 8, 2001.
“Healthcare
Compliance for Physician Practices”,
The Academy of
Medicine of Cleveland/Northern Ohio Medical Association
(AMC/NOMA)Cleveland, Ohio.
Presented February 7, 2001.
