The Disruptive Physician Practitioner: A Danger to the Hospital’s Operation
Most disciplinary policies are progressive. A progressive policy applies increasingly more severe sanctions to additional incidents of bad behavior. It is very important that the organized medical staff have a disruptive practitioner policy. This webinar will discuss the development of such a policy, including what it should include, and how it should be implemented. It is also important to understand what ..
Healthcare Data Analytics: Methods of Matching Scarce Resources with Uncertain Patient Demand, Optimized Budgeted Nursing Staffing with Random Patient Demand
Because of the inevitable variability of the patient census (uncertainty), the planned (budgeted) staffing is usually: (i) either not enough to deliver proper quality of care or (ii) is excessive, resulting in idle time for some employees and/or pay under contractual obligation for the idle time.This webinar is providing a methodology called the ‘newsvendor’ framework ..
Marketing to Medicare or Medicaid Beneficiaries - What You Can and Cannot Do
This program will discuss the Federal Anti-Kickback Statute, what it prohibits, its penalties, its scope and its exceptions. It will also discuss how the Medicare and Medicaid Patient and Program Protection Act of 1987 changed the Act and how it is administered. It will also discuss how the 1987 Act added protections for entities covered by the AKS. The program will also review guidance from the Department ..
Healthcare Data Analytics: Methods of Matching Scarce Resources with Uncertain Patient Demand, Data Envelopment Analysis: Comparing Productivity and Performance of Units with Multiple Inputs and Outputs
Data envelopment analysis (DEA) is a technique that was developed to measure the multiple dimensions of performance (efficiency) of producing units. DEA allows the use of multiple inputs and outputs to develop a single efficiency score to measure comparative efficiency (performance) of hospital units, physicians or group practices. The procedure of comparing the units’ efficiency can be formulated as a line..
Paying for Referrals: A Danger to Your Freedom
The session will provide an overview of the Anti-Kickback Statute (AKS) and review what it prohibits, as well as review the Statute’s available safe harbors. It will also show how violation of the AKS can raise FCA concerns, and it will provide an assessment of enforcement activities, showing how participants may be at risk. In addition, the session will review recent cases and show how they potentially imp..
Healthcare Data Analytics: Methods of Matching Scarce Resources with Uncertain Patient Demand, Integer Linear optimization for Staffing and Scheduling
Integer Linear Optimization is a very powerful and resourceful methodology for developing rather complex optimized staffing and schedules schemes. In contrast to general LO, the Integer LO produces the optimal solution for staffing that is strictly constrained to integer numbers rather than real fractional ones and, thus, should not be rounded off to the nearest integers. The latter usually results in a sub..
Access Point Case Management: Managing Your Routes of Entry While Maintaining Compliance with the 2-Midnight Rule
In this webinar we will explore the unique roles of the ED and admitting office and transfer center case managers and social workers and how an initial assessment and clinical review can better ensure that patient are placed in the correct setting right from the get-go. We will review the 2-midnight rule and the part that case management plays in managing it. This can better ensure a reduction in use of Con..
Anti-Kickback, Fraud, Stark, and Marketing - Where are the Landmines?
This webinar will provide an in-depth understanding of the Federal False Claims Act, Federal Anti-Kickback and Stark laws, and discuss how marketing activities can trigger either or both. It will also provide the basic building blocks you will need to develop and maintain your company’s precious commodity, your reputation and eliminate exposure to fraud charges based on marketing practices. It will also cov..
Care of the LGBTQ Patient and Their Families: Policies, Procedures, Practices and Laws
Whether your employer is a clinic, a hospital, home health, or long term care; whether you are an MD, RN, an occupational therapist, a receptionist, or in the C-Suite, approximately 5% - 10% of your patients may be gay, lesbian, or bisexual. Additional patients may be transgender, intersex, or questioning their gender identity or sexual orientation. The healthcare needs of LGBT patients may appear to be the..
Compliance and the Role of the RN and Social Work Case Manager in the Acute Care Setting
This program will review the compliance issues that most greatly impact your practice such as the 2-midnight Rule, the NOTICE Act, HINNs, the important message and others. The joint commission is now monitoring these issues when they have deemed status from medicare, so your compliance is critical to a good joint commission survey outcome.This program will help you to identify where you may have compliance ..
Discharge Planning: Best Practices Including a Review of the Conditions of Participation
We will begin with a review of the prior rules and from there we will discuss the most recent changes from the Medicare program and how they will impact the roles of the RN case manager and the social worker. Learn how to be sure that your processes address the complexities of the new healthcare environment and that your role as a case manager or social worker is designed and staffed to meet the changes ahe..
Physician Employment Agreements: Problem Areas that can be Landmines
We will review the elements of the physician employment agreement that can cause the greatest problems, focusing on the pitfalls and the complications that can develop when the parties do not fully understand what is being agreed to. Such items as corporate practice, term and termination, termination for cause, duties of the physician, call, non-compete clauses, and compensation are all items that should be..
The Anti-Kickback Statute: 2023 - Year in Review
This webinar will focus on cases and enforcement actions taken by the HHS OIG and its law enforcement partners in 2023. We will also briefly review the Anti-Kickback Statute (“AKS”), discuss safe harbors, particularly the new proposed safe harbor for coordinated care and associated value-based arrangements, and OIG Advisory Opinions that have been issued in 2023, as well as pertinent cases involving the AKS..
The Federal False Claims Act: Enforcement and Recent Updates
The session will provide an overview of the Federal Civil False Claims Act (FCA) and how it works. It will also provide an assessment of enforcement activities, showing how healthcare providers may be at risk. In addition, the session will review recent cases and show how they potentially impact healthcare providers.We will start with a review of the Federal False Claims Act and discuss how it works and how..
Utilization Management: Rules, Regulations, and How To’s
The Centers for Medicare and Medicaid Services (CMS) provides us with two conditions of Participation that apply to the work of case management professionals. These include the Conditions of Participation for Discharge Planning and the Conditions of Participation for Utilization Review. This webinar will focus on these rules as they apply to the role of utilization review. In order for case management depar..