Clinical Practice. Compliance Conference. (formerly known as the Physician Practice/Clinic Compliance Conference) OCTOBER 14 16, 2012

Transcription

1 Clinical Practice Compliance Conference (formerly known as the Physician Practice/Clinic Compliance Conference) OCTOBER 14 16, 2012 PHILADELPHIA, PA Doubletree by Hilton Hotel Philadelphia City Center WHY YOU SHOULD ATTEND Get updated on government initiatives specific to physicians and their practices Network with your peers Learn the latest enforcement trends Topics include correct documentation, billing and coding practices, and operating on a limited budget

2 AGENDA SUNDAY, OCTOBER 14 8:00 10:00 am pream1 The Art and Science of Designing a Physician Practice Audit: Unique Techniques Lori Laubach, Partner, Moss Adams LLP Best practices for reducing error risks, fraud, misconduct, and choosing and working with the internal and external audit team What are the best way to calculate an error and what constitutes and error? How to detect errors, fraud, misconduct, and deconstruct coding rules so the audit results are meaningful and useful Tips for creating and disseminating audit reports and taking corrective action to provide results without creating additional risk; discussion of case studies and potential electronic monitoring tools for risk areas 10:00 10:15 am 10:15 am 12:15 pm pream2 ICD-10-CM Transition: Key Activities for Physician Practices Deborah Neville, Director Revenue Cycle, Coding and Compliance, Elsevier/MC Strategies Judy Breuker, President, Medical Education Services, LLC Identify important similarities and differences between ICD-9-CM and ICD-10-CM/PCS Pinpoint key focus areas for education Determine methods for providing education 12:15 1:30 pm Lunch (on your own) 1:30 3:30 pm prepm1 Keeping Privacy Practices REAL Danna Teicheira, System Privacy Officer, St. Lukes Health System Teri Campbell, Education/Privacy Officer, RegionalCare Hospital Partners Rules: Implementing HIPAA Privacy Safeguards, discuss HITECH implications and OCR audits. Ethics: creating the right tone through education, awareness and incentives Accountability: designing channels of accountability and responsibility Listening and leveraging: scenarios, FAQ, and the patient experience 3:30 3:45 pm 3:45 5:45 pm prepm2 Meaningful Use: Security and Privacy Implications for Meaningful Use Feisal Nanji, Executive Director, Techumen Amy Derlink, RHIA, Corporate Privacy Officer, IOD Incorporated New security considerations under HITECH/meaningful use Privacy and compliance, and release of information requirements How best to manage, patients, vendors and business associates 5:45 7:00 pm Opening Reception

3 AGENDA MONDAY, OCTOBER 15 8:15 9:15 am General Session: The New Compliance for Physician Practices: How Mandatory Reporting of Overpayments, Payments for Outcomes, and Big Data Will Change Compliance James Sheehan, JD, Chief Integrity Officer/Executive Deputy Commissioner, New York City Human Resources Administration 9:15 9:30 pm 9:30 10:30 am General Session Ambulatory Care/Office Documentation that Can Meet Compliance in Support of Inpatient Admissions Betty Bibbins, MD, President & Chief Medical Officer, DocuComp LLC Discuss Office E & M clinical components that document failed outpatient management Communicate clinical documentation improvement that support medical necessity in the ambulatory and inpatient environments. 10:30 11:00 am 11:00 am 12:00 pm 101 The Risk of Being Non-Compliant/The CIA Bret S. Bissey, MBA, FACHE, CHC, Senior Vice President, Chief Ethics and Compliance Officer, UMDNJ Understand the obligations of one of the most rigorous CIAs in the Country at UMDNJ Understand how the government monitors contracts for Anti Kickback and Stark compliance under a CIA Appreciate the cost of implementing a compliance program under a CIA 102 Clinical Research Compliance: You Can Run But You Can t Hide Wanda Kay North, PhD, MBA, RN, CCRC, CIM, Manager, St. Joseph s/candler Health System Discuss the overall responsibilities of a clinical investigator Identify and discuss potential traps of non-compliance Identify and discuss opportunities to prevent the perfect storm 1:00 2:00 pm 201 They ll Never Investigate Me: RAC Audits, HIPAA Breaches..and Doctors D. Scott Jones, CHC, Senior Vice President, Claims, Risk Management, and Corporate Compliance, HPIX Richard E. Moses, DO, JD, Physician/Attorney Medical/ Risk Management Consultant, HPIX RAC Audits: Do your doctors know they are coming? Teach them how to respond HIPAA Breaches: More frequent than ever. Teach doctors and staff how to avoid them Learn how physicians think and why they think they will never be investigated 202 Separate, But Not Distinct: The Appropriate Use of Modifiers 25 and 59 Sandy Giangreco, RHIT, CCS, CPC, CPC-H, CPC-I, COBGC, PCS, Director of Consulting, Coding Strategies, Inc. Jenny Studdard, CPC, CPCO, RCC, Senior Consultant, Coding Strategies What is meant by separate/distinct with modifier 25 and modifier 59 What role does NCCI edits play in the appropriate use of modifiers What resources are available to understand the inherent components of a surgical procedure to accurately reimburse these high risk modifiers 2:00 2:30 pm 2:30 3:30 pm 301 Fear and Loathing in Physician Practices: Mandatory Refund of Medicare/Medicaid Overpayment Within the 60 Days Howard Young, Partner, Morgan, Lewis & Bockius, LLP Colleen Fusetti, CPC, Sharon M. Galup & Assoc. LLC Affordable Care Act 6402 and CMS Proposed Regulation: What s it all mean fact and fiction? Case Study: Your billing manager tells you she made a mistake for the last three years Strategy for reporting and refunding overpayments 12:00 1:00 pm Networking Lunch

4 AGENDA 302 Recent Findings in Physician Compliance Audits Cristine Miller, CMPE, CCS-P, CHC, Partner, Mountjoy Chilton Medley Physicians need to educate themselves on self-assessment of risk related to compliance audits Private physician and hospital owned practices are being targeted for compliance audits Compliance targets are regionally and nationally identified 3:30 4:00 pm 4:00 5:00 pm 401 The New and Improved Compliance Program: Bridging the Gap Between Integrity and Performance Craig Garner, Adjunct Professor, Pepperdine University School of Law Andrew Woodward, Director, Garner Health, LLC Identify the impending changes to the core of our nation s health care structure as a result of the shift toward performance based initiatives Familiarize participants with both safe harbors and potentially costly regulatory provisions monitoring fraud and waste, including Stark laws, anti-kickback statutes, RACs, MACs, MICs and ZPICs Demonstrate the positive effects on a provider s bottom line: Understanding the benefits of a diligent and well-executed compliance program 402 Monitoring Managed Care Contracting Relationships Rick Langosch, Senior Vice President, Coker Group Identify do s and don ts of contact negotiations Recognize problematic contract terms affecting both reimbursement and operations Review the driving forces in managed care (including healthcare reform) that are driving change 5:00 6:30 pm Networking Reception TUESDAY, OCTOBER 16 8:15 9:15 am General Session: Health Care Fraud Enforcement Update Sean McKenna, Assistant U.S. Attorney, Northern District of Texas Joseph Price, Assistant United States Attorney, Deputy Chief, Civil Division, United States Attorney s Office, Southern District of California Overview of government investigations of physicians and related entities Examples of enforcement trends Areas of concern for physicians and practice groups 9:15 9:30 am 9:30 10:30 am General Session: Medical Identity Theft Julie Taitsman, MD, JD, Chief Medical Officer, U.S. Department of HHS OIG Christi Macrina Grimm, Special Assistant to the Principal Deputy IG, U.S. Department of HHS OIG Medical identity theft What to advise patients to protect their medical identities Safeguarding your provider information against misuse for billing and prescribing 10:30 11:00 am 11:00 am 12:00 pm 501 A Physician Led Comprehensive Coding Compliance Program from Datamining to Disciplinary Actions Plans Keith Ponitz, MD, University Hospitals Physician Compliance Officer, University Hospitals of Cleveland Ensure that your institution receives every penny they are entitled to, and not a penny more or a penny less As the OIG, CMS, and DOJ turn up the HEAT, make sure your coding compliance function s air conditioning is working Find out if a physician, healthcare administrator, or a certified coder should lead your coding compliance department

5 AGENDA 502 EMRs Are Great: Look at All the Documentation They Do for Me! Sandy Giangreco, RHIT, CCS, CPC, CPC-H, CPC-I, COBGC, PCS, Director of Consulting, Coding Strategies, Inc. Jenny Studdard, CPC, CPCO, RCC, Senior Consultant, Coding Strategies Review appropriate ways to leverage the EMR technology to enhance documentation and provide better clinical documentation Discuss trends to watch for in coding audits that may point to EMR documentation concerns Key elements that should be found in the medical record to support services and how to handle the situation if they are absent 12:00 1:00 pm Networking Lunch 1:00 2:00 pm 601 Successful on-boarding: Integrating Newly Acquired Physician Practices into Your Corporate Compliance Program Laura Lyon, MHA, Assistant Vice President, Corporate Compliance, Carolinas HealthCare System Pam Rowell, RHIA, CPC, CHCO, CCEP, Vice President, Corporate Compliance, Carolinas Healthcare System Assessing the newly acquired practice s compliance culture, program infrastructure and resource needs Implementing your compliance auditing and monitoring program and evaluating potential compliance risk Learning strategies to overcome potential challenges during the on-boarding process 602 How New Corporate Integrity Requirements Impact Physician Practices Thomas Beimers, Special Counsel, Faegre Baker Daniels LLP 2:00 2:15 pm 2:15 3:15 pm 701 Compliance Investigations and Self Disclosures Andrea Merritt, CHC, CIA, Director of Compliance and Audit Services, Hall, Render, Killian, Heath, and Lyman Regan Tankersley, Shareholder, Hall, Render, Killian, Heath, and Lyman Understand the protocols of pre-investigation, investigation, on-site searches, document requests, in-person interviews, and contact letters Address the role of Compliance Counsel in the investigation protocols Understand the self-disclosure protocol and its associated benefits 702 Improving Compliance with Service and Quality Measurements Jacqueline Nash Bloink, MBA, CHC, CPC-I, CPC, Director of Compliance, Arizona Community Physicians Quality patient care service equals good compliance Quality patient care service generates more revenue Quality patient care service is good medical care HCCA s Clinical Practice Compliance Conference Thanks Our Chairperson DEBBIE TROKLUS CHC-F, CCEP F, CHRC, CHPC Managing Partner, AEGIS Compliance & Ethics Center What are the current enforcement priorities of relevant agencies (DOJ, OIG, FDA, CMS, MFCUs, State AGs) as they impact physician practices? What do enhanced provisions in recent corporate integrity agreements tell physician practices about what their fraud and abuse compliance priorities should be? What does the Sunshine Act mean for fraud and abuse compliance programs?

6 PROGRAM AT A GLANCE SUNDAY, OCTOBER 14 7:00 am 6:30 pm Registration 8:00 10:00 am pream1 The Art and Science of Designing a Physician Practice Audit: Unique Techniques Lori Laubach, Partner, Moss Adams LLP 10:00 10:15 am 10:15 am 12:15 pm pream2 ICD-10-CM Transition: Key Activities for Physician Practices Deborah Neville, Director Revenue Cycle, Coding and Compliance, Elsevier/ MC Strategies; Judy Breuker, President, Medical Education Services, LLC 12:15 1:30 pm Lunch (on your own) 1:30 3:30 pm prepm1 Privacy Danna Teicheira, System Privacy Officer, St. Lukes Health System; Teri Campbell, Education/Privacy Officer, RegionalCare Hospital Partners 3:30 3:45 pm 3:45 5:45 pm prepm2 Meaningful Use: Security and Privacy Implications for Meaningful Use Feisal Nanji, Executive Director, Techumen; Amy Derlink, RHIA, Corporate Privacy Officer, IOD Incorporated 5:45 7:00 pm Opening Reception MONDAY, OCTOBER 15 7:00 am 6:00 pm Registration 7:00 8:00 am Continental fast 8:00 8:15 am Opening Remarks 8:15 9:15 am General Session: The New Compliance for Physician Practices: How Mandatory Reporting of Overpayments, Payments for Outcomes, and Big Data Will Change Compliance James Sheehan, JD, Chief Integrity Officer/Executive Deputy Commissioner, New York City Human Resources Administration 9:15 9:30 am 9:30 10:30 am General Session: Ambulatory Care/Office Documentation that Can Meet Compliance in Support of Inpatient Admissions Betty Bibbins, MD, President & Chief Medical Officer, DocuComp LLC 10:30 11:00 am 11:00 am 12:00 pm 101 The Risk of Being Non-Compliant/The CIA Bret S. Bissey, MBA, FACHE, CHC, Senior Vice President, Chief Ethics and Compliance Officer, UMDNJ 102 Clinical Research Compliance: You Can Run But You Can t Hide Wanda Kay North, PhD, MBA, RN, CCRC, CIM, Manager, St. Joseph s/candler Health System 12:00 1:00 pm Networking Lunch 1:00 2:00 pm 201 They ll Never Investigate Me: RAC Audits, HIPAA Breaches.. and Doctors D. Scott Jones, CHC, Senior Vice President, Claims, 202 Separate, But Not Distinct: The Appropriate Use of Modifiers 25 and 59 Sandy Giangreco, RHIT, CCS, CPC, CPC-H, CPC-I, COBGC, PCS, Risk Management, and Corporate Compliance, HPIX; Richard E. Moses, Director of Consulting, Coding Strategies, Inc.; Jenny Studdard, CPC, CPCO, DO, JD, Physician/Attorney Medical/Risk Management Consultant, RCC, Senior Consultant, Coding Strategies HPIX 2:00 2:30 pm 2:30 3:30 pm 301 Fear and Loathing in Physician Practices: Mandatory Refund of Medicare/Medicaid Overpayment Within the 60 Days Howard Young, Partner, Morgan, Lewis & Bockius, LLP; Colleen Fusetti, CPC, Sharon M. Galup & Assoc. LLC 3:30 4:00 pm 4:00 5:00 pm 401 The New and Improved Compliance Program: Bridging the Gap Between Integrity and Performance Craig Garner, Adjunct Professor, Pepperdine University School of Law; Andrew Woodward, Director, Garner Health, LLC 302 Recent Findings in Physician Compliance Audits Cristine Miller, CMPE, CCS-P, CHC, Partner, Mountjoy Chilton Medley 402 Monitoring Managed Care Contracting Relationships Rick Langosch, Senior Vice President, Coker Group 5:00 6:30 pm Networking Reception TUESDAY, OCTOBER 16 7:30 am 3:00 pm Registration 7:30 8:15 am Continental fast 8:15 9:15 am General Session: Health Care Fraud Enforcement Update Sean McKenna, Assistant U.S. Attorney, Northern District of Texas; Joseph Price, Assistant United States Attorney, Deputy Chief, Civil Division, United States Attorney s Office, Southern District of California 9:15 9:30 am 9:30 10:30 am General Session: Medical Identity Theft Julie Taitsman, MD, JD, Chief Medical Officer, U.S. Department of HHS OIG; Christi Macrina Grimm, Special Assistant to the Principal Deputy IG, U.S. Department of HHS OIG 10:30 11:00 am 11:00 am 12:00 pm 501 A Physician Led Comprehensive Coding Compliance Program from Datamining to Disciplinary Actions Plans Keith Ponitz, MD, University Hospitals Physician Compliance Officer, University Hospitals of Cleveland 12:00 1:00 pm Networking Lunch 1:00 2:00 pm 601 Successful on-boarding: Integrating Newly Acquired Physician Practices into Your Corporate Compliance Program Laura Lyon, MHA, Assistant Vice President, Corporate Compliance, Carolinas HealthCare System; Pam Rowell, RHIA, CPC, CHCO, CCEP, Vice President, Corporate Compliance, Carolinas Healthcare System 2:00 2:15 pm 2:15 3:15 pm 701 Compliance Investigations and Self Disclosures Andrea Merritt, CHC, CIA, Director of Compliance and Audit Services, Hall, Render, Killian, Heath, and Lyman; Regan Tankersley, Shareholder, Hall, Render, Killian, Heath, and Lyman 502 EMRs Are Great: Look at All the Documentation They Do for Me! Sandy Giangreco, RHIT, CCS, CPC, CPC-H, CPC-I, COBGC, PCS, Director of Consulting, Coding Strategies, Inc.; Jenny Studdard, CPC, CPCO, RCC, Senior Consultant, Coding Strategies 602 How New Corporate Integrity Requirements Impact Physician Practices Thomas Beimers, Special Counsel, Faegre Baker Daniels LLP 702 Improving Compliance with Service and Quality Measurements Jacqueline Nash Bloink, MBA, CHC, CPC-I, CPC, Director of Compliance, Arizona Community Physicians

7 Want to become Certified in Healthcare Compliance (CHC)? BE RECOGNIZED for your experience and knowledge! The Certified in Healthcare Compliance (CHC) designation demonstrates expertise in the healthcare compliance field. Earn yours today: Meet eligibility requirements in both work experience and continuing education Pass the CHC exam Maintain your designation by earning approved continuing education units Questions? Contact For more details on earning and maintaining this designation, please find the CHC Candidate Handbook or other information at under the CHC tab.

8 CONTINUING EDUCATION UNITS HCCA is in the process of applying for additional certification for continuing education units. Please visit for updates or contact the certification department for further information at hcca-info.org or ACHE: The Health Care Compliance Association is authorized to award 19 hours of pre-approved ACHE Qualified Education credit (non-ache) for this program toward advancement, or recertification in the American College of Healthcare Executives. Participants in this program wishing to have the continuing education hours applied toward ACHCE Qualified Education credit should indicate their attendance when submitting application to the American College of Healthcare Executives for advancement or recertification. Nursing Credit: The Health Care Compliance Association is preapproved by the California Board of Registered Nursing, Provider Number CEP 12990, for a maximum of 22.8 contact hour(s). The following states will not accept CA Board of Nursing contact hours: Delaware, Florida, New Jersey and Utah. Massachusetts and Mississippi nurses may submit CA Board of Nursing contact hours to their state board, but approval will depend on review by the board. Please contact the Accreditation Department at hcca-info.org with any questions you may have. Oncology Nurses who are certified by ONCC may request CA Nursing Credit (check box or indicate Nursing on the CEU form). CLE: The Health Care Compliance Association/Society of Corporate Compliance and Ethics is a State Bar of California Approved MCLE provider, a Pennsylvania Accredited Provider, a Rhode Island Accredited Provider, and a Texas Accredited Sponsor. An approximate maximum of 19 clock hours of CLE credit will be available to attendees of this conference. All CLE credits will be awarded based on individual attendance. Compliance Certification Board (CCB): Certified in Healthcare Compliance (CHC), Certified in Healthcare Compliance Fellow (CHC-F), Certified Compliance & Ethics Professional (CCEP), Certified Compliance & Ethics Professional Fellow (CCEP-F), Certified in Healthcare Research Compliance (CHRC), Certified in Healthcare Privacy Compliance (CHPC) : CCB has awarded a maximum of 22.8 CEUs for these accreditations in the following subject areas: Application of Management Practices for the Compliance Professional; Application of Personal and Business Ethics in Compliance; Written Compliance Policies and Procedures; Designation of Compliance Officers and Committees; Compliance Training and Education; Communication and Reporting Mechanisms in Compliance Enforcement of Compliance Standards and Discipline; Auditing and Monitoring for Compliance; Response to Compliance Violations and Corrective Actions; HIPAA Privacy Implementation and/or Complying with Government Regulations. NASBA/CPE: The Health Care Compliance Association is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE sponsors, Sponsor Identification No: State boards of accountancy have final authority on the acceptance of individual courses for CPE credit and may not accept one-half credits. To verify if your state board of accountancy has adopted one-half credits, please visit our website at accountancycredits. Complaints regarding registered sponsors may be addressed to the National Registry of CPE Sponsors, 150 Fourth Avenue North, Suite 700, Nashville, TN Website: A recommended maximum of 22.5 credits based on a 50-minute hour will be granted for the entire learning activity. This program addresses topics that are of a current concern in the compliance environment. This is an update, group-live activity. For more information regarding administrative policies such as complaints or refunds, call the HCCA at or RACC: Attendees seeking CRA credits through the Research Administrators Certification Council (RACC) may request a certificate of attendance from HCCA by completing an Application for Continuing Education and indicating RACC/CRA on the form. A certificate of attendance along with a complete brochure should be submitted to RACC at the end of each individual s RACC renewal period. The Research Administrators Certification Council (RACC) promotes the concept of voluntary certification by examination for all research and sponsored programs administrators. Certification in research and sponsored programs administration is highly valued and provides formal recognition of basic knowledge in the field. SoCRA: The Society of Clinical Research Associates (SoCRA accepts documentation of candidate participation in continuing education programs for recertification if the program is applicable to clinical research regulations, operations or management, or to the candidate s clinical research therapeutic area. This program offers 19 hours of CE credit. SoCRA s requirements for recertification Continuing Education credit are quite general, as they pertain to clinical research regulations, operations and management, and to the therapeutic area of the clinical research in which the candidate participates. We therefore leave it to the candidate to determine whether a course or program would be acceptable for SoCRA s CE requirement. SoCRA does not validate individual training courses/workshops

9 REGISTRATION Clinical Practice Compliance Conference October 14 16, 2012 Doubletree by Hilton Hotel Philadelphia City Center Philadelphia, PA Name: (please type or print) Sharing your demographic information with HCCA will help us create better networking opportunities for you. Please fill out the following information. 1 DEMOGRAPHIC INFORMATION What is your functional job title? Please select one. Academic/Professor Consultant Administration Controller Asst Compliance Officer Ethics Officer Attorney (In-House Counsel) Executive Director Attorney (Outside Counsel) General Counsel Audit Analyst HIM Professional Audit Manager/Officer HIPAA/Privacy Officer Billing Manager/Officer Human Resources Charger Master Medical Director Chief Compliance Officer Nurse CEO/President Nurse Manager Chief Financial Officer Patient Safety Officer Chief Information Officer Pharmacy Director Chief Medical Officer Physician Chief Operating Officer Quality Assurance/ Clinical Quality of Care Coder Regulatory Officer Compliance Analyst Reimbursement Coordinator Compliance Coordinator Research Analyst Compliance Director Risk Manager Compliance Fraud Examiner Trainer/Educator Compliance Officer Vice President Compliance Specialist Other (please list below) List others not listed here: Please tell us if you are a first-time attendee of the Clinical Practice Compliance Conference: This is my first Clinical Practice Compliance Conference What is your primary health care entity? Academic Long-Term Care Ambulance/Transportation Managed Care Behavioral Health Medical Device Manufacturer Consulting Firm Medical/Clinical Research Durable Medical Equipment Nursing Government Provider Other Provider of Services/ Health System Products to Health Care Entities Health System/Teaching Payor/Insurance Home Care/Hospice Pharmaceutical Manufacturer Hospital Physician Practice Hospital/Teaching Rehabilitation Integrated Delivery System Retail Pharmacy Integrated Health System Third-Party Billing Laboratory Other (please list below) Law Firm List others not listed here: What certifications do you hold? Select all that apply. BA BBA BS BSN CCEP CEM CCS CCS-P CFE CHC CHE CHP CHPC CHRC CIA CPA CPC CPHQ DDS ESQ List others not listed here: FHFMA JD LLM MA MBA MHA MPA MPH MS MSHA MSN MT NHA PhD RHIA RHIT RN REGISTRATION CONTINUES ON NEXT PAGE (OVER)

10 REGISTRATION Clinical Practice Compliance Conference October 14 16, 2012 Doubletree by Hilton Hotel Philadelphia City Center Philadelphia, PA 2 CONTACT INFORMATION Mr. Mrs. Ms. Dr. HCCA Member ID First Mi Last Credentials (CHRC, CHC, etc.) Title Place of Employment Address City State Zip Phone Fax (required for registration confirmation) 3 SESSION SELECTION Please indicate below which sessions you would like to attend. This information will be used to assist us in planning. You are not obligated to attend selected sessions. SUNDAY (additional fees apply after 9/7/12) PRE-CONFERENCE AM 8:00 10:00 am pream1 10:15 am 12:15 pm pream2 PRE-CONFERENCE PM 1:30 3:30 pm prepm1 3:45 5:45 pm prepm2 MONDAY 11:00 am 12:00 pm :00 2:00 pm :30 3:30 pm :00 5:00 pm TUESDAY 11:00 am 12:00 pm :00 2:00 pm :15 3:15 pm REGISTRATION OPTIONS HCCA Members... $745 Non-Members...$845 Membership Renewal & Registration...$1,040 New Membership & Registration...$945 new members only. dues regularly $295 annually. Pre-Conference Registration am...$125 Pre-Conference Registration pm...$125 Group Discount: subtract from my total (see details for more information) 5 PAYMENT OPTIONS Mail check to: HCCA 6500 Barrie Road, Suite 250 Minneapolis, MN Fax to: Invoice me Purchase Order # Check enclosed I authorize HCCA to charge my credit card (choose below) CREDIT CARD: AmericanExpress Diners Club MasterCard Visa Credit Card Account Number TOTAL HEALTH CARE COMPLIANCE ASSOCIATION 6500 Barrie Road, Suite 250, Minneapolis, MN phone fax hcca-info.org Credit Card Expiration Date Cardholder s Name Cardholder s Signature PGPC12 Please fax your completed registration form with payment information to , or visit to register online.

11 DETAILS HOTEL INFORMATION DoubleTree by Hilton Hotel Philadelphia Center City 237 South Broad Street, Philadelphia, Pennsylvania Phone: TREE Fax: A special rate of $199 per night, plus tax, has been arranged. Please make your reservations directly with the hotel and mention HCCA s Clinical Practice Compliance Conference to receive the reduced rate. Reservations will be accepted at the group rate until Monday, September 10, 2012, or until the group block is sold out, whichever comes first. Reservations received after this date, or after the group block is filled, will be accepted based on space and rate availability. Individual reservations may be canceled up to twenty-four (24) hours prior to arrival without charge. If individual reservations are not canceled 24 hours prior to arrival, a cancellation penalty equal to one night s room and tax will be charged unless the cancellations are due to illness. CONTINUING EDUCATION UNITS Please see page 8 for a listing of Continuing Education Units offered. REGISTRATION TERMS & CONDITIONS Checks are payable to HCCA. Credit cards accepted: American Express, Diners Club, MasterCard, or Visa. HCCA will charge your credit card the correct amount should your total be miscalculated. Group Discount: 5 or more: $50 discount for each registrant 10 or more: $100 discount for each registrant Discounts take effect the day a group reaches the discount number of registrants. Please send registration forms together to ensure that the discount is applied. A separate registration form is required for each registrant. Note that discounts will NOT be applied retroactively if more registrants are added at a later date, but new registrants will receive the group discount. Tax Deductibility: All expenses incurred to maintain or improve skills in your profession may be tax deductible; including tuition, travel, lodging and meals. Please consult your tax advisor. Cancellations/Substitutions: No refunds will be given for no-shows or cancellations. You may send a substitute or receive a conference credit. If you have questions, please call HCCA at Additional charges may apply. Cancellation by telephone is NOT valid. Please fax written cancellations to or hcca-info.org. Dress Code: Business casual dress is appropriate. Prerequisites: None. Questions/Concerns: Contact HCCA at or hcca-info.org. NO AUDIO OR VIDEO RECORDING OF HCCA CONFERENCES IS ALLOWED

12 6500 Barrie Road, Suite 250 Minneapolis, MN Clinical Practice Compliance Conference October 14 16, 2012 Doubletree by Hilton Hotel Philadelphia City Center Philadelphia, PA Clinical Practice Compliance Conference (formerly known as the Physician Practice/Clinic Compliance Conference) OCTOBER 14 16, 2012 PHILADELPHIA, PA Doubletree by Hilton Hotel Philadelphia City Center