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FIFTH NATIONAL
MEDICARE RAC SUMMIT
Contingency RACs in Medicare and Medicaid
March 9 - 11, 2011
ONSITE
Wardman Park Hotel
Washington, DC
ONLINE
Live and Archived for 6 months
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MEDICARE RAC CERTIFICATE PROGRAM
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2010 MEDICARE RAC CO SPONSORS
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SUMMIT GRANTORS
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BRONZE GRANTORS
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ADDITIONAL GRANTOR
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FEATURED SESSIONS
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Preconference Boot Camp for Small and Critical Access Hospitals
Preconference on Advanced Coding and CDI Issues
CMS Program Integrity Update
Lessons from the Field on Revenue Cycle Management
Evaluation of Your Appeals Strategy and Outcomes
New Data from AHA RACTrac
Hospital Association Panel on Current Issues by Region
Introduction to the new Medicaid Contingency RACs
Legal Roundtable
What's Ahead for Different Provider Sectors
What's Ahead in Congress?
AHA Looks at the Road Ahead
Updated Medicare RAC Certificate Program
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RECENT GAO REPORTS
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Click here for a copy of the March 2010 GAO Report on RAC prepared by Kathleen King and her staff.
Click here for a copy of the March 2010 GAO Report on MACs prepared by Kathleen King and her staff.
Click here for a copy of the June 15, 2010 GAO Report on Medicare Fraud, Waste, and Abuse: Challenges and Strategies for Preventing Improper Payments, prepared by Kathleen King and her staff [NEW]
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CMS RELEASES DRAFT RULE ON FRAUD AND ABUSE
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As noted by Deputy Administrator Peter Budetti, MD, JD in his keynote address at the Fourth Medicare RAC Summit, CMS will be engaging in a very proactive campaign against fraud and abuse under new PPACA authorities. A draft rule was published in the Federal Register on September 23, 2010 and can be accessed here.
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AHA RELEASES 3d QUARTER 2010 RACTrac RESULTS
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On November 15, 2010 AHA has released its report on the 3d Quarter 2010 findings from the national RACTrac survey. The full set of slides for that report is here.
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MEDICARE RAC SUMMIT IS
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CMS MEDICARE LEARNING NETWORK DOCUMENTS ON RAC
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CMS has recently released a new RAC MLN Matters document on Place of Service, SE 1104. Click the document number below to access this and previous MLN documents in the series.
SE 1104: (March 2011) The Importance of Correctly Coding the Place of Service by Physicians and Their Billing Agents
SE 1037: (January 2011) Guidance on Hospital Inpatient Admission Decisions
Access New CMS Podcast Based on MLN SE 1037 here
SE 1036: (December 2010) Recovery Audit Contractor (RAC) Demonstration High-Risk Vulnerabilities for Physicians
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NEW ISSUE OF CMS MEDICARE QUARTERLY COMPLIANCE NEWSLETTER
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In addition to the Medicare Learning Network documents noted below, CMS is also publishing a quarterly provider compliance newsletter. Click here for the February 2011 issue of the Medicare Quarterly Provider Compliance Newsletter, the second in the series.
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CMS INTERACTIVE MAP ON STATE MEDICAID RACs
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CMS has created an interactive national map showing the status of State Plan Amendments (SPAs) submitted by States in connection with the establishment of Medicaid RACs. Click here to view the map.
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CMS DELAYS IMPLEMENTATION OF STATE MEDICAID RACs
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A joint February 1 letter from Dr. Peter Budetti and Cindy Mann announces that CMS will delay the April 1, 2011 implementation date for State Medicaid RACs "out of consideration for State operational issues." A Final Rule will be issued later in the year. Click here for the full text.
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NEW CMS GUIDANCE ON PHYSICIAN ADR
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On February 14, 2011 CMS issued new guidance on Physician/Non-Physician Practitioner Additional Documentation Request (ADR) Limits. Click here for the document.
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CMS TO ROLL OUT PEPPERs TO CAHs IN APRIL
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As reported in AHA News, the CMS in April will roll out to critical access hospitals its Program for Evaluating Payment Patterns Electronic Report. The free report, known as PEPPER, provides hospital-specific data on Medicare discharges identified as being at high risk for erroneous payment, such as short stays, improper coding and potentially avoidable readmissions. CMS has contracted with TMF Health Quality Institute to develop and distribute the reports, previously available only to short- and long-term acute care hospitals. "Many general acute hospitals find them to be a useful tool and we are pleased these reports will be available to critical access hospitals," said Rochelle Archuleta, AHA senior associate director of policy. The PEPPER files will be sent to the CAH's QualityNet administrator. CAHs without a QualityNet administrator account may work with their quality improvement organization to access the reports. Later this year, CMS will begin distributing PEPPERs to inpatient psychiatric facilities and inpatient rehabilitation facilities. For more on the distribution schedule and a sample CAH report, visit www.PEPPERresources.org.
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RAC SUMMIT APPROVED FOR AAPC CEUs
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This program has the prior approval of the American Academy of Professional Coders (AAPC) for up to 8.5 continuing education hours, depending upon session attendance. Certificates will be issued onsite. Online attendees must enroll in, complete, and successfully pass the final examination for the Medicare RAC Certificate Program in order to earn their CEUs.
Granting of prior approval in no way constitutes endorsement by the AAPC of the program content or the program sponsor.
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NEW CMS PROPOSED RULE ON MEDICAID RACS
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On November 5, 2010 CMS published a proposed rule in the Federal Register regarding the new State Medicaid contingency RACs. Click here for the document.
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SEPTEMBER 2010 FOURTH MEDICARE RAC SUMMIT POST CONFERENCE MULTIMEDIA, ONLINE ARCHIVE AND EXAM NOW AVAILABLE
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Click here post-conference multimedia from the Fourth National Medicare RAC Summit.
Click here for online archive of the
Fourth National Medicare RAC Summit.
Click here for 2010 post conference online examination.
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FIFTH NATIONAL MEDICARE RAC SUMMIT
March 9 - 11, 2011
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ONSITE
Wardman Park hotel
Washington, DC
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ONLINE
In your own office or home live via the Internet
with 24/7 access for six months
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CO CHAIRS
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Day Egusquiza
President, AR Systems, Inc., Twin Falls, ID |
Barbara Flynn, RHIA, CCS
Vice President, Health Information and Denial Management Services, Florida Hospital Association Management Corporation, Inc., Orlando, FL |
Ryan D. Meade
Principal, Meade & Roach, LLP, Chicago, IL
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Michael Taylor, MD
Vice President of Operations, Executive Health Resources, Inc., Newtown Square, PA |
Andrew B. Wachler, Esq.
Principal, Wachler & Associates, PC, Royal Oak, MI |
Sara Kay Wheeler
Partner, King & Spalding, Atlanta, GA
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KEYNOTE SPEAKERS
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Rochelle Archuleta
Senior Associate Director, Policy Development, American Hospital Association, Washington, DC |
Elizabeth Baskett, MPA
Associate Director for Policy, American Hospital Association, Washington, DC |
Kimberly Brandt, CHC, JD
Chief Healthcare Investigative Counsel, Senate Finance Committee Minority Staff; former Counsel, Allston & Bird LLP; former Director, Medicare Program Integrity Group, CMS, Washington, DC
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Deborah Grider, CPC, CPC-H, CPC-I, CPC-P, CPMA, CEMC, COBGC, CPCD, CCS-P
President and CEO, American Academy of Professional Coders, Salt Lake City, UT |
Matt Kazan, MPP
Health Policy Advisor, Senate Finance Committee Majority Staff, Washington, DC |
Thomas Newman
Vice President, Finance, UPMC St. Margaret, Pittsburgh, PA
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James G. Sheehan, Esq.
New York State Medicaid, Inspector General; Former Associate United States Attorney, US Attorney's Office, Eastern District of Pennsylvania, Albany, NY |
Susan Shiflett, RHIA, CHC
Director, Corporate Responsibility, Catholic Health Initiatives, Denver, CO
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PRECONFERENCE BOOT CAMP FOR SMALL AND CRITICAL ACCESS HOSPITALS
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Ann M. Brannan RN, BSN
RAC Coordinator (Retired), Wallace Thomson Hospital, Union, SC |
Rita Ford, RHIA, CHC
Health Information Manager, Paris Community Hospital, Paris, IL |
Steve Griffin, MSN
Director, Central RAC Appeals Unit, Quorum Health Resources, Brentwood, TN
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Joanie Perkins, CPC, CHCM
RAC Coordinator, North Sunflower Medical Center, Ruleville, MS |
Ron Smith, CPA
Chief Financial Officer, Wickenburg Hospital, Wickenburg, AZ |
Day Egusquiza
President, AR Systems, Inc., Twin Falls, ID (Preconference Chair)
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ADVANCED PRECONFERENCE ON CODING ISSUES IN PROGRAM INTEGRITY
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Margi Brown, RHIA, CCS, CCS-P, CPC, CCDS
Independent Consultant, Orlando, FL |
Andrew Rothschild, MD, MS, MPH, FAAP, CCDS
Associate Director, Navigant Consulting, Inc., Austin, TX |
Barbara Flynn, RHIA, CCS
Vice President, Health Information and Denial Management Services, Florida Hospital Association Management Corporation, Inc., Orlando, FL (Preconference Chair)
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PLENARY SESSION ROUNDTABLE ON HOSPITAL IMPLEMENTATION ISSUES
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Charles Cataline
Senior Director of Health Policy, Ohio Hospital Association, Columbus, OH |
Tish Hollingsworth
Director of Reimbursement, Kansas Hospital Association, Topeka, KS |
Stew Presser
Vice President, Greater New York Hospital Association, New York, NY
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Kathy Reep, MBA
Vice President, Financial Services, Florida Hospital Association, Orlando, FL |
Cheryl J Golden, CPA, MHA, CHC, CPC-A, CHRC
Senior Manager, Health Sciences, Regulatory Risk & Compliance, Deloitte & Touche LLP, Tampa, FL (Moderator)
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PLENARY SESSION ON KEY PROVIDER ISSUES ... AND SOME DO'S AND DON'TS
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Day Egusquiza
President, AR Systems, Inc., Twin Falls, ID |
Barbara Piascik, CHFP, CHC
Chief Compliance Officer, MedeAnalytics, Emeryville, CA |
Andrew Rothschild, MD, MS, MPH, FAAP, CCDS
Associate Director, Navigant Consulting, Inc., Austin, TX
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Jane Snecinski
President, Post Acute Advisors, Atlanta, GA |
Michael Taylor, MD
Vice President of Operations, Executive Health Resources, Inc., Newtown Square, PA
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LEGAL UPDATE PANEL
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Linda Fotheringill, Esq.
Co-Founder and Partner, Washington & West, LLC, Baltimore, MD |
Charles A. Luband
Counsel, Ropes & Gray, New York, NY
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Ryan D. Meade
Principal, Meade & Roach, LLP, Chicago, IL |
Sara Kay Wheeler
Partner, King & Spalding, Atlanta, GA
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CONCURRENT SESSION ON MEDICARE RAC ISSUES
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Day Egusquiza
President, AR Systems, Inc., Twin Falls, ID |
Linda Fotheringill, Esq.
Co-Founder and Partner, Washington & West, LLC, Baltimore, MD |
Larry T. Hegland, MD
Chief Medical Officer, Ministry Saint Clare's Hospital, The Diagnostic and Treatment Center,Weston, WI
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Jane Snecinski
President, Post Acute Advisors, Atlanta, GA |
Michael Taylor, MD
Vice President of Operations, Executive Health Resources, Inc., Newtown Square, PA (Chair)
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CONCURRENT SESSION ON MEDICAID RAC ISSUES
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Harry M. Feder
Senior Vice President/Chief Operating Officer, IPRO, Albany, NY |
Charles A. Luband
Counsel, Ropes & Gray, New York, NY |
Thomas E. McGraw
Senior Vice President, Government Products, Ingenix Government Solutions, Richmond, VA
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Barbara Piascik, CHFP, CHC
Chief Compliance Officer, MedeAnalytics, Emeryville, CA |
Laurie Rock
Director, Bureau of Program Integrity, Department of Public Welfare, Commonwealth of Pennsylvania, Harrisburg, PA
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Andrew B. Wachler, Esq.
Principal, Wachler & Associates, PC, Royal Oak, MI |
Sara Kay Wheeler
Partner, King & Spalding, Atlanta, GA (Chair)
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NATIONAL PROGRAM INTEGRITY CONTRACTOR MAPS
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Click below to see larger versions of the maps of the national landscape for the RAC Contractors, Medicaid Integrity Audit Contractors (MICs), Zone Program Integrity Contractors (ZPICs), and Medicare Administrative Contractors (MACs A/B).
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RAC Map
Map prepared by and used with permission of King & Spalding
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MICs Map
Map prepared by and used with permission of King & Spalding
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ZPICs Map
Map prepared by and used with permission of King & Spalding
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MACs A/B Map
Map prepared by and used with permission of King & Spalding
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PARTICIPATION OPTIONS
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TRADITIONAL ONSITE ATTENDANCE
Simply register, travel to the conference city and attend in person.
Pros: subject matter immersion; professional networking opportunities; faculty interaction
LIVE AND ARCHIVED INTERNET ATTENDANCE
Watch the conference in live streaming video over the Internet and at your convenience
at any time 24/7 for the six months following the event.
The archived conference includes speaker videos and coordinated PowerPoint presentations.
Pros: Live digital feed and 24/7 Internet access for next six months; Accessible in office, at home or anywhere worldwide with Internet access; Avoid travel expense and hassle; No time away from the office |
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INTERNET INTERFACE SAMPLE
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Click here for a sample stream
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THE GROUP REGISTRATION/ONLINE TRAINING ALTERNATIVE
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By arranging to license online group access to the Summit Medicare RAC Certificate Program, health care providers subject to RAC audits can implement an organization-wide online Certificate Program on preparing for, responding to and appealing a RAC audit. The organization's training coordinator can assign and track online participation. Successful completion of the training can be evidenced by passing the post conference training examination.
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HERE IS AN EXAMPLE OF A HEALTH SYSTEM RAC CERTIFICATE PROGRAM
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