Texas Dentists for Medicaid Reform assisted Star Compliance Services this past Friday to hold a one-day healthcare compliance seminar in Houston at the Norris Conference Center – City Centre. It is the first in a series of seminars that were demanded by dental Medicaid providers after TDMR’s first such seminar in Weslaco in February. Further seminars are scheduled for San Antonio on June 26 and Dallas July 17.
Dr. Juan D. Villarreal, DDS and founder of TDMR and 17-year veteran in healthcare law, TDMR president Gregory Ewing were the presenters at the Houston seminar, addressing 61 attendees. As healthcare compliance affects more than dental Medicaid providers and information on HIPAA and OSHA go beyond Medicaid, a number of medical and other types of providers also attended.
Release of Compliance Starter Kit
The seminar marked the release of the Compliance Starter Kit, developed by Greg Ewing, which was made available to attendees online and will be made available shortly to the attendees from the Weslaco seminar. The kit contains 120 pages of checklists, templates and detailed information on putting in place a compliance program.
Experiences with Medicaid enforcement
Dr. Villarreal, just as in Weslaco, talked about his experiences with “credible allegations of fraud” payment holds and investigations done by the state’s Health and Human Services Commission Office of Inspector General relating to Medicaid orthodontic billings. Over the last three years, Dr. Villarreal has received vindicating judgements from the State Office of Administrative Hearings, Travis County District Court and the Texas Court of Appeals. By banding with other Medicaid dentists and founding TDMR, severe problems with OIG’s conduct was brought to the attention of legislators and the media, leading to major legislative changes about to be signed into law by Governor Abbott on how OIG operates and treats Medicaid providers.
Need to fight back and be prepared
His main point was about the need to fight back and defend one’s self if one hasn’t done anything wrong.
In depth presentation of compliance issues
Gregory Ewing spent the better part of the day going over in depth the need for dentists and other Medicaid providers to be in compliance and to what they needed to comply.
He went over the seven parts of a compliance program that each provider must have since compliance programs are now mandatory under the Affordable Care Act. He also spent considerable time detailing what is going on with HIPAA (Health Insurance Portability and Accountability Act) and its Texas equivalent HB 300. Attendees heard that being out of compliance with electronic personal health information security requirements will not be tolerated.
He said enforcement efforts across the board are just ramping up federally and in the state, despite the disorganization of HHSC-OIG, and providers need to have all their “t’s crossed and i’s dotted.” He pointed out that even minor lapses in compliance or imprecision in documentation can have regulatory agencies demanding, through extrapolation, large amounts of dollars to be repaid. Further, the federal OIG has stated that it gets back $7 for every dollar it spends, making program enforcement a lucrative investment for Medicaid agencies.
Small practices can be hurt more easily
Unfortunately, he said, for small practices and healthcare businesses, compliance can be complex and therefore more susceptible to having things out due to a lack of trained staff. Hence the purposes of the seminars.
Attendees found seminar “informative” and “outstanding”
The majority of attendees found the seminar information very useful as demonstrated by the after-event survey results.
- the seminar was given an average overall score of 9 out of 10
- 98% wrote they would recommend the seminar to others
- 96% wrote the Instructors demonstrated a comprehensive knowledge of the subject
- 97% wrote the Instructors appeared to be interested and enthusiastic about the subject!
Here are some of the comments from attendees:
- “Outstanding info!”
- “Very informative”
- “Brought informative things to light that I had not considered before!”
- “Seminar was resourceful”
- Another loved it because it was “informative and organized”
- Still another appreciated “the info on compliance (the list), HIPAA safeguards and protecting our data”
We have heard from one attendee that he is already doing a presentation to his staff on the material he obtained from the seminar.
For more information about the upcoming seminars in San Antonio and Dallas, go to starcomplianceservices.com or call BeLinda Dashiell at 888-988-1802.