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HCPro Boot Camps
Formerly HRAI Coding Specialists
200 Hoods Lane,
Marblehead, MA 01945
Phone: (877) 207-4036
Fax: (800) 738-1553
Copyright 2000-2008,
HCPro, Inc., All Rights Reserved
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Health Law Boot CampSM - Hospital Version
Learning Objectives
Module 1: Federal Sentencing Guidelines and Office of Inspector General (OIG) Compliance Program Guidance
- Be able to understand the role of the Federal Sentencing Guidelines in healthcare enforcement
- Be able to identify the components of an effective compliance plan
- Be able to identify key compliance risk areas for hospitals, according to the OIG
- Be able to understand options for voluntary self-reporting of violations, including the OIG's Self-disclosure Protocol
Module 2: False Claims Act
- Be able to identify the elements of the civil False Claims Act
- Be able to understand the rights of potential whistleblowers in False Claims Act qui tam suits
- Be able to identify major criminal laws applicable to false claims
- Be able to identify the requirements of the False Claims Act compliance program mandated by the Deficit Reduction Act of 2005
Module 3: Anti-kickback Statute
- Be able to identify the elements of the Anti-kickback Statute
- Be able to identify Anti-kickback Statute "safe harbors"
- Be able to identify arrangements that raise special concerns under the Anti-kickback Statute
- Be able to analyze common arrangements under the Anti-kickback Statute
Module 4: Stark Law
- Be able to identify the elements of the Stark Law
- Be able to understand the framework for analyzing arrangements under the Stark Law
- Be able to identify financial relationships that may implicate the Stark Law
- Be able to identify exceptions to the Stark Law
- Be able to identify sanctions and reporting requirements for the Stark Law
Module 5: Civil Monetary Penalties laws and Exclusion Authority
- Be able to identify key components of the Civil Monetary Penalties laws
- Be able to understand the problems of "gainsharing" and "gifts to beneficiaries" under the civil monetary penalties laws
- Be able to identify the potential penalties and mitigation for civil monetary penalties laws
- Be able to identify the key components of the Office of Inspector General's Exclusion Authority
Module 6 : Non-profit Hospital Issues
- Be able to identify the key elements of the tests for establishing and maintaining tax exempt status
- Be able to identify relevant factors under the community benefit standard for maintaining the charitable mission of a tax exempt hospital
- Be able to avoid problems of private insurement and private benefit
- Be able to avoid inappropriate political activity that could jeopardize tax exemption
- Be able to identify and avoid "excess benefit" situations that could result in potential intermediate sanctions
- Be able to understand the applicability of the Sarbanes-Oxley Act to non-profits
- Be able to identify the core fiduciary duties of nonprofit directors
Module 7: Antitrust Laws
- Be able to identify the core Antitrust laws and their key elements
- Be able to identify the Antitrust enforcement agencies and the rights of private parties under the Antitrust laws
- Be able to identify common conduct by hospitals that potentially implicates the Antitrust laws
- Be able to identify federal enforcement agency guidance for healthcare organizations under the antitrust laws
Module 8: Medicare Conditions of Participation
- Be able to identify the requirements for certification under the Medicare Conditions of Participation for hospitals
- Be able to differentiate Medicare certification from Joint Commission accreditation
- Be able to identify the process of certification under the Conditions of Participation
- Be able to use the State Operations Manual on Medicare Conditions of Participation for hospitals
- Be able to differentiate between conditions and standards of participation
- Be able to identify the new Conditions of Participation for restraints and seclusion
- Be able to understand the processes that could lead to loss of certification under the Medicare Conditions of Participation
Module 9: Emergency Medical Treatment and Labor Act (EMTALA)
- Be able to identify the elements of EMTALA for hospitals with emergency departments
- Be able to determine applicability of EMTALA in common situations
- Be able to use the State Operations Manual for evaluating hospital compliance with EMTALA, including the standards for screening, stabilizing, and transferring patients
- Be able to understand the relationship of EMTALA to the Conditions of Participation
Module 10: Health Insurance Portability and Accountability Act (HIPAA)
- Be able to identify the key elements of the Privacy Rule
- Be able to identify the key elements of the Security Rule
- Be able to differentiate between "standard" and "implementation specifications"
- Be able to use HIPAA regulations to answer common questions
- Be able to determine the obligations of a covered entity under the Privacy Rule and the Security Rule
- Be able to maintain compliant business associate agreements
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