This seminar is designed to provide an update on various state and federal legislative and regulatory initiatives for attorneys and their clients.
Attendees of this seminar will gain valuable information on health care legislation and regulations, including general provisions governing security and privacy of medical records of the Health Insurance Portability and Accountability Act (HIPAA) and its affect on those operating in the health care industry. These provisions encompass privacy, security, and electronic transactions standards for maintaining and transmitting personal health information.
The federal and state governments and third party payors have concentrated significant resources on the prosecution of health care fraud. Since 1986, the federal government has recovered approximately $5.2 billion under the False Claims Act. In this environment, everyone who serves in or advises the health care industry needs to stay abreast of the current fraud and abuse issues and how to deal with them.
Topics to be discussed:
- Federal legislation
- Case law and regulatory update
- Government reorganization
- Regulation of insurance, HMOs and PPOs
- HIPAA security regulations
- Regulation of licensed health professionals
- Fraud and abuse update
8:30 a.m. - 9:00 a.m.
A. Speaker Introduction And Housekeeping
B. The Current State Of Health Care In Texas And The U.S.
9:00 a.m. - 9:50 a.m.
II. Federal Legislation
A. Analysis Of The Medicare Prescription Drug Improvement And Modernization Act Of 2003
B. Other Pending Federal Legislation That Would Affect The Health Care Industry
9:50 a.m. - 10:00 a.m.
10:00 a.m. - 10:50 a.m.
III. Case Law And Regulatory Update
A. Hospital Liability
B. Physician Credentialing
C. Claims Under The Medical Liability And Insurance Improvement Act
D. Damage Caps
E. House Bill 4 - Health Care Liability Reform
10:50 a.m. - 11:35 a.m.
IV. Government Reorganization
A. House Bill 2292: Consolidation And Reorganization Of Health And Human Service Agencies
B. Abolition Of Existing Agencies
C. Department Of State Health Services
D. Department Of Family And Protective Services
E. Department Of Assistive And Rehabilitative Services
F. Department Of Aging And Disability Services
11:35 a.m. - 12:35 p.m.
Lunch (On Your Own)
12:35 p.m. - 1:30 p.m.
V. Regulation Of Insurance, HMOs
A. House Bill 418
B. Texas Department Of Insurance Rules
C. Clean Claims
D. Prompt Payment Of Claims
E. Audits And Recoupment
F. Penalties For Late Payment
1:30 p.m. - 2:20 p.m.
VI. HIPAA Security Regulations
B. Required versus Addressable Standards
C. Administrative Procedures
D. Physical Safeguards
E. Technical Security
F. Business Associates
G. Deadline For Compliance And Penalties
2:20 p.m. - 2:30 p.m.
2:30 p.m. - 3:05 p.m.
VII. Regulation Of Licensed Health
A. Texas State Board Of Medical Examiners
B. Consolidation Of Nursing Boards
C. Surgical Assistants
D. Pharmacies And Pharmacists
3:05 p.m. - 4:00 p.m.
VIII. Fraud And Abuse Update
A. Telemarketing By DME Suppliers
B. Malpractice Insurance Subsidies
C. Contractual Joint Ventures
D. Pharmaceutical Compliance Program Guidance
E. Advisory Opinions
F. New Texas Medicaid Fraud Laws
G. Federal Sentencing Guidelines
H. Case Law Update
4:00 p.m. - 4:30 p.m.
IX. Other Issues
A. Advance Directives - Senate Bill 1320
B. New Corporate And Partnership Laws - House Bill 1156 And House Bill 1165
D. EMS And Trauma