Insights

Session 1:

“Medicare Reimbursement and Effective Cost Reporting”

Understanding a hospital’s Medicare reimbursement is becoming more complex each year. A significant aspect of the reimbursement is tied to the annual hospital Medicare cost report. With additional scrutiny of the annual reports by Medicare Administrative Contractors (MACs), hospitals must file accurate reports and supporting documentation for smooth cost report audits. Settlement impacts tied to the annual cost report may have a significant consequence on an organization’s reimbursement.

During this session, Emily Wetsel discussed the various reimbursement impacts tied to the annual hospital Medicare cost report and their influence on your organization’s reimbursement.   

• Understand the key prospective payment system hospital settlement impact items
• Learn key cost-based reimbursement strategies for critical access hospitals for efficient cost reporting
• Learn provider-based rural health clinic settlement impacts from and strategies for the Medicare cost report
• Understand the wage index and what it means for your organization’s Medicare reimbursement
• Gain helpful tips for smooth Medicare cost report reviews or audits

Session 2:

“Insights from the DOJ: Management Accountability for an Effective Compliance Program”

• Karin Anderson, PYA Principal & Corporate Counsel
• Tynan Kugler, PYA Principal

The U.S. Department of Justice (DOJ) released a playbook that its healthcare fraud prosecutors will use to evaluate an entity’s compliance program in February 2017 and revised in June 2020 and again in March 2023. Accordingly, management should be well versed in the factors fraud prosecutors will use to evaluate the effectiveness of an entity’s compliance programs, which, in turn, influence the severity and materiality of any charging decisions.

During this session, Karin Anderson and Tynan Kugler provided an overview of these factors including industry best practices management teams can implement to demonstrate an effective compliance program. They incorporated insights obtained while serving as the compliance subject matter expert as part of the compliance monitorship team for the largest DOJ-imposed non-prosecution agreement of a health system in U.S. history.

• Hear an overview of the “Principles of Federal Prosecution of Business Organizations” in the U.S. Justice Manual
• Learn from an overview of the U.S. Department of Justice Criminal Division’s “Evaluation of Corporate Compliance Programs”
• Understand the government’s expectations for demonstrating an effective compliance program
• Gain best practices for assessing and implementing the key provisions of the DOJ’s guidance.

Session 3:

“Annual Accounting & Auditing Update”

• Trevor Brown, PYA Senior Manager
• Mimi Grachek, PYA Senior Manager

During this session, Trevor Brown and Mimi Grachek discussed recently issued or effective authoritative literature along with current accounting and auditing issues impacting organizations today. They explained changes to date made by the Financial Accounting Standards Board, Auditing Standards Board, and Governmental Accounting Standards Board.

In particular, Brown and Grachek discussed changes related to supplier finance program obligations, common control arrangements, joint venture formations, crypto assets, risk assessment process, and information technology controls, among many other changes. The PYA thought leaders also provided timelines for effective dates for the updates, discussed immediate and future impacts of the changes, and offered an outlook on upcoming changes.

• Describe accounting, auditing, and other attest issues important to the industry
• Share best practices for complying with professional, technical, and regulatory requirements related to common accounting and auditing issues faced by public and industry accountants
• Apply examples and illustrations to “real-life” circumstances

Session 4:

“Critical Pathway Information Technology and How To Prepare for a Cyber Disaster”

• Hear methods to identify critical pathways in healthcare IT and recognize their significance in clinical and operational settings
• Understand the common vulnerabilities and threats facing healthcare IT systems
• Learn strategies to prepare for and respond to cyber disasters effectively, including the development of an incident response plan