Health Care Compliance Certificate Program

This seminar will provide an overview of the compliance function in a hospital as well as in a large provider’s office. It will look at challenges and best practices in implementing and measuring compliance with Medicare conditions of participation and payment, survey and certification requirements, HIPAA, Stark, anti-kickback, professional relations, coding obligations and guidelines, and quality.

This seminar will build on the Hospitals and Providers seminar and look at real-world examples of federal enforcement activities, what went wrong in the compliance program implementation and how things could have been done differently. It will also address topics such as managing internal and governmental investigations and managing up, dealing with business leaders, CEOs, and politically sensitive situations.

The focus of this seminar will be the privacy and security provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Environmental and Clinical Health (HITECH). Students will obtain a full understanding of what it means for a health care organization to be HIPAA compliant, how to monitor and measure HIPAA/HITECH compliance, how to develop effective compliance programs, training, risk assessment, and how best to utilize a privacy officer and a privacy and security infrastructure to minimize risk and ensure full HIPAA compliance across a complex organization.

This seminar will examine the interplay between HIPAA and other federal and state health privacy laws and the application and enforcement of those laws in a variety of health care settings. The class will address differences in state and federal law. The class will also address detection, analysis and responses to unauthorized disclosures, security incidents and HIPAA breaches. This class will look beyond HIPAA at technology and innovation, at the requirements for electronic health record certifications, and the challenges to a goal of portable health records.

Patient quality measures and achievements are growing in importance in the compliance profession. This seminar will provide an overview of the key components of, and importance of quality in the realm of patient safety, while incorporating techniques to continuously improve and transform a health care system. We will explore critical health care quality issues at the organizational and microsystem levels, and detail current strategies, tactics, and methods for understanding quality. Students will discuss foundational health care quality principles, and look at practical tools necessary for measuring quality, improving health care performance, and promoting transparency of clinical pathways and outcomes.

An effective compliance program is tailored to a company’s risk. Compliance risk assessments also serve to protect and defend companies. In fact, a company's approach to compliance risk assessment was identified by the U.S. Department of Justice as a foundational consideration when evaluating whether to bring charges against a company. With that in mind, this seminar focuses on practical approaches to conducting a compliance risk assessment in the health care setting. Students will learn how to develop a risk framework, and different approaches to scoring company risk. This will include everything from building a risk register to prioritizing and reporting out on a top systematic risk assessment process.

This seminar will address the fundamental ethical issues that are the driving force behind research rules and regulations. Students will evaluate how to create effective compliance programs that address issues in basic human subject research, animal research, the responsible use of research results, responsible conduct of research and conflicts of interest.

This seminar will provide an overview of key sources of law that cover the approval, manufacturing and marketing of prescription drugs and devices. Students will study policies and practices designed to ensure effective compliance with these laws, especially as it relates to safety, efficacy, kickback risks, and off-label marketing.

This seminar will examine the key compliance issues health insurers face in connection with their business models. Students will examine challenges and best practices in implementing and measuring compliance with the Affordable Care Act and other federal and state requirements, understanding and preparing for government program compliance audits, and other unique obligations of payers in today’s health care environment.