In the complex landscape of federal healthcare regulations, providers face the constant challenge of staying compliant with ever-changing guidelines. The 2023 Semi-Annual Report to Congress revealed a projected $4-Billion Dollar “recoupment and recovery” effort, indicating the severity of improper payments and potential fraud. The 2024 audits will focus on specific areas, including Medicare Advantage high-risk diagnosis coding, implantable medical device credits, OPPS outlier payments, the Two-Midnight Rule, outpatient Observation Services, Hyperbaric Oxygen Therapy reporting, and individual practitioner E/M requirements.  The looming threat of audits from entities such as OIG, RACs, ZPIC, CERT, MACs, and Medicaid Integrity Programs creates a pressing need for healthcare facilities and practitioners to stay informed.

In an exclusive RACmonitor webcast, certified compliance officer Michael G. Calahan addresses these concerns by identifying and exploring the highest risk federal audit targets, offering insights into compliance requirements, and providing best practices for these risky areas. Michael will dive into the Top 10 compliance risk areas for 2024, shedding light on exactly what federal auditors are targeting and how to avoid the most common errors.

Why This Is Relevant:

Navigating the intricate web of federal compliance guidelines requires a deep understanding of the ever-changing directives issued by CMS. Providers often face denials and financial penalties due to a lack of awareness and understanding of these complex regulations. Michael bridges knowledge gaps of healthcare providers, offering insights into the audit targets for 2024. Attendees will gain essential knowledge about federal and state audit focus areas, potential vulnerabilities, and specific targets. In the realm of healthcare compliance, knowledge is power, and our webcast empowers providers to proactively address potential issues, mitigate risks, and ensure ongoing compliance.

Learning Objectives:

• Learn the “Top 10” likely compliance target areas of federal auditing entities for 2024.
• Drill down within these areas, identifying specific “compliance risk pain points.”
• Understand new, revised, or re-emphasized program guidelines for 2024, focusing on federal coverage and provider compliance.
• Analyze and review prior federal audit findings in highlighted areas, extracting valuable “lessons learned.”
• Review best practices for avoiding or successfully managing federal audits within each highlighted area, providing actionable insights for healthcare facilities and practitioners.

Who Should Attend:

• C-Suite Executives (hospitals, health systems & networks: CFO, CEO, COO)
• Health System Legal Teams (Compliance Counsel, Attorney, Associate Attorney)
• Compliance Officers, Specialists & Auditing Teams
• Corporate Responsibility Officers
• Revenue Cycle Services (1-V.P., 2-Director, 3-Manager)
• Patient Financial Services (V.P., Director)
• Patient Billing Manager
• Patient Registration Director
• In-house Hospitalist Teams and Practices
• Emergency Department Physicians & Providers
• Physicians – Any & All Interested
• Radiation Oncology Outpatient Department (Physicians/Physicists, Rad Techs, Staff)
• Inpatient Rehabilitation Facilities, Physicians and NPPs
• Inpatient Psychiatric Facilities, Physicians & NPPs
• Case Managers (Inpatient, Outpatient Observation)
• Quality Assurance (QA) Staff
• Utilization Review (UR) Staff and Committee members
• Operating Room (OR) Inpatient Director, Manager, Inpatient Liaison
• Same Day Surgery (SDS) Director/Manager
• CathLab Director & Associated Coders/Billers
• Post-Anesthesia Care Unit (PACU) Director, Manager, Inpatient Liaison
• HIM Department (V.P., Director, Manager, Assistant Director, Assistant Manager)
• Clinical Documentation Improvement (CDI) Specialists
• Recovery Audit (RA) and Recovery Audit Contractor (RAC) Audit Team Coordinators
• Quality Improvement Org (QIO) Audit Team Coordinator
• Medicare Advantage Liaisons