[3643] TPE Audits, ADRs Prepayment Reviews, Postpayment Audits and Suspensions | The Impact of these Administrative Enforcement Tools on Home Health and Hospice Agencies
A 2022 TAHC&H Member Webinar - Now Available to All!
Presentation Info:
- TAHC&H Virtual Event | 2022 Monthly Member Webinars | Recorded for On-Demand Access
- Presentation Date | May 4, 2022
Program Description: Effective September 2021, Target, probe and Educate (TPE) audits were reimplemented by most
Medicare Administrative Contractors around the country. TPE audits are merely the latest iteration of prepayment reviews being conducted by CMS contractors.
While the government has placed some restrictions on their use, contractors continue to exercise great latitude in their scope and the length that they are
imposed. Similarly, contractors remain in control of postpayment audits conducted and suspension actions recommended to CMS. In this webinar,
attorneys Lorraine Rosado and Lester Johnson will discuss these enforcement actions and outline the adverse impact each action can have on your
home health or hospice agency.
HCSSA Topic(s) Addressed:
- §558.259[d][4]agency responsibilities
- §558.260[a][3]basic principles of management in a licensed health-related setting
- §558.260[a][6]risk assessment and management
- §558.260[a][7]financial management
Education-Training Credits:
- TX HCSSA Administrator/Alternate Continuing Education
- Continuing Education for Nurses
- 1.0 Contact Hr(s)
- This program awards CNE until 05.04.2024
Texas HCSSA CE Approval Statement
This program meets continuing education requirements for Administrators and Alternates under Texas HCSSA licensing regulations.
Nurse CE Approval Statement
Texas Association for Home Care & Hospice is an approved provider of continuing nursing education by Louisiana State Nurses
Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. LSNA Provider No. 4002151
Requirements for Successful Completion
To receive continuing education credits for this online presentation participant must view the entire online presentation, complete an evaluation, and post-test attestation.
Reporting of Perceived Bias
Bias, as defined by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC COA/LSNA) is the “tendency or inclination to cause partiality, favoritism, or influence.”
Commercial bias may occur when a CNE activity promotes one or more product(s) (drugs, devices, services, software, hardware, etc.). This definition is not all inclusive and participants may use
their own interpretation in deciding if a presentation is biased. The ANCC COA is interested in the opinions and perceptions of participants at approved CNE activities, especially in the presence
of actual or perceived bias in continuing education. Therefore, ANCC invites participants to access their “ANCC Accreditation Feedback Line” to report any noted bias or conflict of interest in the
education activity. The toll free number is 1(866) 262-9730.
TAHC&H Faculty/Presenter(s): Lorraine Rosado and Lester Johnson | Liles Parker Attorneys & Counselors at Law
About the Presenter(s):
Lorraine Rosadois a key member of Liles Parker’s healthcare team and has been an attorney at the firm for
nearly six years. She defends healthcare providers facing overpayment claims and counsels clients nationwide on compliance with healthcare statutes, regulations, and contract matters.
She has represented providers in panel qualification and termination matters. She has extensive experience working on complex cases involving both Federal and State violations of the
False Claims Act, including whistleblower cases. She is skilled in administrative litigation and appeals.
Lorraine has handled claims disputes involving most major healthcare payors, including Medicare, Medicaid, TRICARE, various BlueCross BlueShield entities,
and UnitedHealthcare. She is experienced working on large, complex administrative appeals of extrapolated alleged overpayments assessed by Centers for Medicare and Medicaid Services
(CMS) contractors, including Zone Program Integrity Contractors (ZPICs), Medicare Administrative Contractors (MACs), Recovery Audit Contractors (RACs), and Medicaid Integrity
Contractors (MICs).
About the Presenter(s):
Lester Johnson is a Partner at Liles Parker PLLC and is the Supervising Attorney for the
Firm’s Baton Rouge office. In addition, Les also serves as Co-Leader of the Firm’s Health Law Practice Group. Les helps clients navigate the myriad of regulatory,
compliance and business issues facing today’s health care providers and practitioners. Core areas of Les’s practice include handling Medicare & Medicaid appeals;
Medicare and Medicaid participation and compliance; Stark and Anti-kickback law compliance, state self-referral prohibitions and any other regulatory issues a client
may face. Les assists clients with operational and business issues involving hospital/medical staff relations, practitioner credentialing, health care contracting
issues, mergers and acquisitions, antitrust hurdles, joint ventures, and practice formation and restructuring.
Les is a frequent presenter on regulatory compliance, fraud & abuse, and business issues facing health care providers and practitioners.
He was named a Health Care Hero by New Orleans City Business Magazine, and was also recognized by the Gillis Long Poverty Law Center for his work to help open the
Lower 9th Ward Health Clinic, a free clinic opened in early 2006 in New Orleans’ flood ravaged Lower 9th Ward neighborhood.
[3643] TPE Audits, ADRs Prepayment Reviews, Postpayment Audits and Suspensions | The Impact of these Administrative Enforcement Tools on Home Health and Hospice Agencies
