Presenters: Nancy J. Beckley, MS, MBA, CHC and Wade Meyer, PT, DPT, MJ
This webinar will be recorded live on March 18, 2020, 2:00 – 3:30 pm EDT. Exclusive to PPS! Insider's secrets to the physical therapy audit and investigation landscape. Federal regulatory and investigative authorities know that any review of a physical therapy private practice will likely guarantee an error rate. Error rates under $10,000 are extrapolated in some instance to over $1 million. Whistleblowers are reporting double booking/dovetailing patients and practice billing Medicare for 1:1 therapy. Known overpayments are not refunded as required in 60 days, and PTs pending credentialing "borrow" Medicare numbers from someone in the practice. Worse yet, the OIG has refused to accept CMS manual guidance in audits, despite CMS rules for delayed certification and POC requirements. Even if you survive an audit or investigation you do not go unscathed; the cost of defending your practice could bankrupt your practice, and worse, as being a practice owner could lead to your exclusion from Medicare for actions of your staff in violation of one of the five healthcare laws on fraud and abuse. Get the "True Hollywood Story" and walk away with a risk assessment tool to profile your practice and mitigate compliance risk.
Upon completion of this course, participants should be able to:
- Describe the difference between an audit and an investigation and how they are different from medical review.
- Outline the interpretation of the OIG in not accepting CMS manual guidance on therapy documentation rules despite expert attestation from the drafter of CMS policy and input from APTA.
- Learn how to conduct a practice risk assessment based upon regulations and guidance used by the OIG, Department of Justice and other regulators.
About the speakers:
Nancy Beckley is President of Nancy Beckley & Associates LLC providing compliance consulting services to therapy providers and programs. As an outsourced compliance officer Nancy has overseen internal investigations involving a variety of allegations including patient abuse, documentation falsification, insurance fraud allegations, program exclusion and licensee sanctions. She has conducted external investigations and audits under attorney-client privilege for providers under DOJ or OIG investigation. She currently works with providers that are under OIG Corporate Integrity Agreements and Medicaid Consent Agreements in developing mandated compliance programs, mandated compliance training & education and monitoring & auditing of performance. Nancy has conducted over 80 compliance program effectiveness reviews for merger & acquisition due diligence and is considered a top expert in this area. She is a subject matter expert in rehab agency and CORF Conditions of Participation and required policies and procedures. Nancy is certified in Healthcare Compliance by the Healthcare Compliance Certification Board. Nancy serves as a Compliance Columnist for IMPACT, the journal of the APTA Private Practice Section. She is on the editorial board of Compliance Today, where she serves as the “Connectivity” social media columnist.
Wade Meyer, PT, DPT, is a 2000 graduate of Creighton University with a Doctorate of Physical Therapy degree. He is Certified in Healthcare Compliance, a member of the Editorial Advisory Board for the Official Disability Guidelines, holds a Masters' of Jurisprudence in Health Law from Loyola University and has been a member of the American Physical Therapy Association since 1998. He currently functions as the Chief Compliance Officer for ATI Physical Therapy. Within this role he is responsible for the implementation and follow through of the elements of an effective compliance program. Additionally, he functions as the chair of the Quality Committee.
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Course expires March 18, 2023
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