NYSARC News Blog » Corporate Compliance

2012 Compliance Challenges Conference: Registration Now Open

nysarcadmin — Thu, 15 Mar 2012 18:14:13 +0000

CP of NYS & NYSARC, Inc.

present the
5th Annual Compliance Conference for
Providers Serving Individuals with Disabilities

Download the 2012 Registration Brochure (.pdf)

May 8, 2012
Albany Marriott Hotel
189 Wolf Road, Albany, NY
8:45 a.m. to 4:00 p.m.

What they said about it last year…

“Excellent presentations”

“I always leave this conference well informed & highly motivated”

“Excellent conference, great location”

“Information very helpful to a new compliance officer”

“Presenters were knowledgable & provided”

2012 Compliance Challenges Conference

nysarcadmin — Tue, 10 Jan 2012 19:09:02 +0000

Cerebral Palsy Associations of New York State & NYSARC, Inc. are proud to present the 5th Annual Conference for providers serving individuals with disabilities:

Compliance Challenges 2012
May 8, 2012

- Albany Marriott Hotel -
189 Wolf Road, Albany, NY 12205

8:30am to 4:00 pm

Topics being presented by speakers include the OMIG, board responsibilities and interactions, whistle-blowers, and labor issues.

Registration information will be available soon. This conference is recommended for Corporate Compliance Officers, Corporate Compliance Committee Members, Board Members, and Executive Leadership.

Download the Save-the-Date

BHL Presents a FREE Educational Seminar on OSHA Compliance

nysarcadmin — Wed, 21 Sep 2011 15:00:46 +0000

Bailey, Haskell & LaLonde
along with the
United States Department of Labor, Occupational Safety and Health Administration

Presents a FREE Important Educational Seminar on OSHA Compliance For:

Nursing Homes and Assisted Living
Hospitals
Social Services Residential Care

Learn About and Have Your Questions Answered on:

Recordkeeping
Is my facility on the list targeted for inspection?
How do I prepare for an OSHA inspection?
How much are fines and can I contest them?
What help can I get from OSHA to correct hazards?
What resources are available from OSHA?
How to find your answers on the OSHA website
There will be a live internet demonstration conducted by a US OSHA Compliance Assistance Specialist on OSHA e-Tools specific to your industry to help you find and correct hazards
There will be a CD takeaway with resources, links and electronic tools

PLUS, there will be a Q&A session with the OSHA representative – get your answers from the real source! You are also invited to submit your questions to be answered at the seminar via email to BHL – send them to Christina Warner at cwarner@bhlinsurance.com two weeks before your seminar date.

Newburgh, NY – October 25, 2011 at Courtyard by Marriott, Newburgh Stewart Airport, 4 Governor Drive, Newburgh, NY

Long Island, NY – October 28, 2011 at Nassau County AHRC, 189 Wheatley Road, Brookville, New York

Albany, NY – November 2, 2011 at Travelers Insurance, 900 Watervliet-Shaker Road, Albany

Syracuse, NY – November 4, 2011 at BHL Insurance, 5232 Witz Drive, North Syracuse, NY

Agenda

8:00 -8:30 am – registration and continental breakfast

8:30-11:30 am – presentation and Q&A session

Reserve your space now! – email Christina Warner at cwarner@bhlinsurance.com or call her at 315-413-4418. Seating is limited.

Medicaid Recovery Audit Contractor Update

nysarcadmin — Mon, 15 Aug 2011 14:58:46 +0000

In the March 2011 edition of “Compliance News” basic information was provided on Medicaid Recovery Audit Contractors (RACs). In June 2011, it was announced that Health Management Systems (HMS) would be the designated RAC for the state of New York. HMS is not a new player in the NY Medicaid system – HMS has had a contract with the OMIG since 2001 and already assists in identifying third party insurance coverage and recovering claims that were paid in error.

As a RAC, HMS will conduct 2 types of claim reviews:

Automated Reviews (e-Reviews) – these consist of overpayments that can be identified with extremely high accuracy through available data (i.e. data mining). For example, provision of services to deceased recipients or residential billings where the individual is hospitalized at the time of service;
Complex Reviews – these consist of potential overpayments where additional information is required to make a clear determination. In these cases the provider would be required to submit the necessary documentation to HMS for review and a determination.

Under its RAC contract, HMS will likely begin by conducting automated reviews and move to the more time consuming complex reviews only after the obvious data mining related recoveries have been largely exhausted. According to HMS’ timetable, payment integrity reviews will begin in October 2011, and while there are no guarantees, it is reasonable to hope that such reviews will initially target other areas of the health care industry.

Tania Seaburg
Associate Executive Director for Corporate Compliance, NYSARC, Inc.

Compliance Risk Assessments

nysarcadmin — Mon, 15 Aug 2011 14:41:39 +0000

One of the most dreaded tasks for a compliance officer is the completion of a risk assessment. This is because some risk assessment tools take the form of complex spreadsheets that require a working knowledge of statistics and color coded risk levels. While risk assessments are not optional – NY State compliance regulations require “a system for routine identification of compliance risk”[1] – the process does not have to be quite so intimidating. In addition to tracking the work plans of outside audit agencies such as the OMIG and the federal department of Health & Human Services, compliance officers should spend some time with program directors to identify pressing issues. Perhaps even more importantly, compliance officers should determine what has changed over the past year (e.g. regulations, program requirements, audit initiatives) and make sure that their agency has kept pace with the changes. For example:

The MSC program recently underwent a complete re-design. Have additional checks and balances been implemented to ensure that employees have made all necessary changes?
At Home Residential Habilitation was converted to Community Habilitation. Were all ISPs and Hab Plans updated to reflect “Community Habilitation” by July 31, 2011? Is staff aware of Community Habilitation limitations – for example, services can only be provided in a non-certified setting?
Level of Care Eligibility Determination (LCED) forms have been revised. Has the new form been implemented properly?
The Department of Health (DOH) has conducted OT/PT service reviews. Is the agency familiar with the applicable guidelines and the results of the DOH reviews?
Health Management Systems, under contract with the OMIG, implemented an initiative to collect Medicaid dollars where the claim(s) at issue should have been billed to a third party insurance carrier. Has the agency reviewed its process for identifying other sources of reimbursement and ensuring that Medicaid is the payer of last resort?
After potentially facing false claims act charges, a human service provider in NY entered into a large settlement with the Attorney General’s office. One of the major issues in the case related to improper consolidated fiscal report (CFR) entries. Has the agency read the settlement document and reviewed its own CFR practices to ensure that accurate reporting is a priority.

Adopting a risk assessment policy, such as this Sample Policy, can be a way to get your agency on the right track.

[1] 18 NYCRR 521.3(c)(6)