Back in February, CMS announced changes that seem to allow medical students a lot more freedom to document a patient’s medical record. Which could sound like a dream to physicians who might be thinking that the students will help ease the heavy burden of bureaucracy, but auditors are a little worried. Auditors are going, “Wait, hold on, we’ve got to really look at this before we jump the gun.” I spoke with expert compliance auditor, Charla Prillaman, who’s lived and breathed auditing for decades. The hard part, it turns out, isn’t understanding the new rule; the hard part is re-educating doctors. Tune into our latest episode of Compliance Conversations, The Teaching Physician Rule: A Blessing or a Curse, to learn the:New Specifics of Student Documentation for E/M Services and HPI, Dangers of Improper Documentation Teaching Physician’s Responsibility to Verify and Attest to Student Documentation.

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We kicked off this episode of Compliance Conversations with a guest host, our very own compliance expert, Marcie Swenson, and her special guest, Emily Haley, who has worked as a Chief Privacy Officer and Compliance Director at Intermountain healthcare and is currently working in Care Transformation. In the first half of the show, Haley gave us a full fledged rundown on gap analysis, risk analysis and risk management plans. In the second half of the show, we dove unapologetically into the OCR’s phase 2 desk audits and what we can all learn from them. “Everybody is familiar with OCR’s phase 2 desk audits, where they audited 63 covered entities, and I think 40 something business associates. They used a scale 1 through 5, 1 being the very best risk analysis or risk management plan, and 5 being the very worst...more than half both business associates and the covered entities had scored a 4 and a 5. That’s shocking. That means most of us are not doing the right things.” Tune into our latest episode of Compliance Conversations, Smart Strategies to Holistically Tackle Your Organization’s Risks, with guest host Marcie Swenson. In this podcast we’ll cover how: Every Department Must Work Together to Reduce RisksRisk Analysis is Dependent on Gap Analysis and Management PlansTo Mitigate the Lack of Updated Risk Analysis Information From the OCR

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Weed. Pot. Ganja. Marijuana goes by many names and has been a part of the global counterculture scene for decades. But now it’s quickly becoming a part of healthcare, as medical marijuana continues to be legalized across the nation. In my latest episode of Compliance Conversations, I talked with Judy Cassel, JD, MBA, an expert legal advisor on all things medical marijuana. I asked her how medical marijuana will impact physicians, compliance officers, and hospitals. There are dangers in prescribing it even if it’s legal. While each state is able to decide on whether or not to legalize medical marijuana, it’s still illegal at a federal level–this is where things get complicated. Cassel explained the dangers of physicians, or a practice, prescribing medical marijuana and how you and your organization can recommend it while still remaining compliant. Listen to this episode to learn how to: Reduce Opioid Deaths and Addiction Avoid Violating the Federal Law with Medical MarijuanaRecommend Medical Marijuana and Stay Compliant

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Let’s say you’re a Medicare Advantage organization and one day you receive a notification from CMS that you’ve been selected for program audit. What should you do? Recently, I sat down with Scott Robinson, director of compliance at Davis Vision, and former medicare contractor who used to accompany the folks at CMS to conduct effectiveness audits. Robinson gave me the details on what to do and what not to do when and if you receive the news. “The first thing is to not panic,” Robinson said, “All you really need to do is explain yourself. You just need to articulate your usual business practices in a way that CMS will understand and agree with.” But doing this requires you to be ready for it. Tune into this episode to learn how to:Prepare for a CMS Audit Before it HappensStay Calm During a CMS AuditEffectively Explain Yourself to CMS

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Michael Warner, an Osteopathic physician, board certified in family medicine, turned patients’ rights advocate has a lot say about a patient’s rights to access. Warner is passionate about empowering patients to co-author their medical record. Through his research, Warner has found that giving patients the opportunity to take control of their information greatly increases accuracy, efficiency, and patient satisfaction. In a post-study follow-up survey, most patients reported that they “appreciated being given the chance to co-author” their medical records. For any healthcare organization, this is music. Listen to this episode, Patients Empowered: Improving Accuracy Through Co-Authorship, to learn how to: Collect patient data before their visit to maximize efficiency. Share history, exam, and Medical Decision Making with patients for accuracy. How HIPAA’s privacy rule allows patients to amend their records.

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Everything You Never Knew You Needed to Know About ACO Compliance by CJ Wolf

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In this episode of Compliance Conversations, I sat down with Stephani Scott, VP of Audit Services for Healthicity, to chat about her twenty years of experience and pick her brain on important auditing issues. As all of you know, auditing is a crucial component of an effective compliance program. Stephani explains how she approaches post-audit education with difficult providers, “I always tell them to be prepared first and foremost.” Then she adds, “make sure you’ve reviewed the audit and you know where they did well. Sometimes the effectiveness depends on your approach.” Scott provides rules for post-audit education, like how to deal with a physician who inherently distrusts auditors or bad apples who code incorrectly on purpose. Tune in to learn the auditing ropes with expert Stephani Scott and learn how to: • Build Trust with Providers• Effectively Change Behaviors• Approach Post Audit Educations Like a Pro• Deal with Bad Apples

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In this episode of Compliance Conversations: I asked compliance and healthcare law expert Marcie Swenson, “What do you think the hot topics will be for 2018.” And she gave us two answers: “Benchmarking and data breaches and cyber security.” Organizations will be utilizing OIG guidance to create their own benchmarks and rate their own compliance program. I also asked Marci what she hoped to see differently in 2018 and she passionately responded, “more risk assessments. To be proactive in compliance you have to perform a risk assessment.” Tune in to this episode of Compliance Conversations: Benchmarking Your Way to Compliance, for hot topic predictions and tips for 2018 including how to: Use the OIG Guide to Benchmark Your ProgramPrepare for Cyber Threats and Data BreachesUtilize Risk Assessments

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Find out how Culture can Solve Compliance Issues“Compliance professionals were people before they were in compliance,” said Rudy Green in our most recent episode of Compliance Conversations. Green told me about his long and interesting path to compliance from an undergraduate degree in organizational behavior, to being drafted into the NFL, then to law school. He did all of this before taking a position as the compliance officer at the University of Texas in Austin. He added, “life experience is what makes a great compliance officer,” he said. Compliance professionals are critical to a company’s success (especially in healthcare). So, it only makes sense that company culture counts. Could company culture be the answer to solving compliance issues? The data suggests yes but — big surprise — it’s not always that easy.Tune in to this episode of Compliance Conversations to learn how to: Effectively Deal with Complex Issues as They AriseTackle Risk Assessment the Right WayUse Patience as a Compliance Tool

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In this episode, compliance expert CJ Wolf sits down with product development expert Jeff Young to discuss tools that can simplify compliance and make you so much more effective as a compliance officer. Young explains how tools are changing healthcare organizations, “with the tools that are out there today you can gather data consistently in one location, identify risks based on data trends and decide what to do. Maybe you need to put a new policy in place, or you need to introduce training to your organization. The idea is that it gives you the power to get away from some of this manual work by utilizing technology to help automate and optimize what you’re doing as a compliance officer.” Regarding random audits, Young asks, “if you’re looking at just ten random records, how do you know those are representative of what the physicians doing, and how does it really help you to understand where you need to focus for that physician?” Listen to this episode to learn how to utilize technology to decrease manual labor, improve training, easily identify risks, and much, much more!

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