Compliance Events

Is It Really Maintenance Care? Let’s Find Out!
Never has it been more important to understand the difference between clinically appropriate care and medically necessary care. Third party payer regulations and federal guidelines dictate that providers clearly identify for a patient when the line crosses from active treatment to maintenance care. New regulations such as the 2022 No Surprises Act may place providers in the hot seat if they do not notify patients properly when care is no longer considered a covered service. Proper case management and advance notice to the patients when the active treatment transitions from active care is vital. Following the guidance in a meticulous fashion is imperative to stay on the right side of the rules. Kathy takes this difficult subject and demystifies one of the most important tenets in case management that DCs deal with.

Risk Management and Compliance take on many forms in this very highly regulated industry of healthcare. It’s estimated that 75% of Chiropractic practices are non-compliant with HIPAA. Additionally, the eight fundamental elements of an effective compliance program are specifically mentioned in the Patient Protection and Affordable Care Act as a “must have” for certain healthcare providers as a condition of participation in Medicare. A typical roadblock to a successful compliance program is appropriate and systematic implementation in the practice. This session will review the four most important Risk Management issues faced by a typical chiropractic office, and what to do to protect your practice and your patients.

Compliance Implications of the No Surprises Act-Now and Next Year
Presented by Kathy (KMC) Weidner, MCS-P, CCPC, CCCA
The Consolidated Appropriations Act of 2021 was enacted on December 27, 2020, with aspects of the No Surprises Act portion enforced on January 1, 2022. It resulted in providers nationwide scrambling to identify and implement the necessary changes. Unfortunately, even as the year progresses, providers are putting their practices at risk by ignoring the part of the rule that applies to them. The rule is complex – aspects of it are in a transition stage and portions are being challenged by medical associations. This does not mean that a provider can ignore the rules. Enforcement means penalty if the requirements are not followed. Unfortunately, presenters are providing incorrect information about the rule and making it more difficult for providers to fall into line with the requirements. We’ll help providers identify what portion of the law applies to them and immediately make changes to be compliant, provide real-time examples, and important forms to make the process compliant in the practice.