Medicaid Compliance for Early Intervention (0-5)

Medicaid Compliance for Early Intervention Primer

Course Outcomes:

Please scroll down for outcomes per discipline and other information, such as Target Audience, Course Content and Level

Course intent: To provide speech language pathologists & occupational therapists, as well as other early intervention providers with the ethical, legal, programmatic and professional background to understand the relevant issues regarding Medicaid compliance so as enable them to practice early intervention in a manner that is ethically compliant with the mandates of federal and state early intervention regulations.

Relevance to occupational, speech language pathology, physical therapy & other early intervention providers: Aforementioned disciplines therapists and other early intervention providers treating children between the ages of 0-3 in the early intervention setting may be legally liable for errors and malfeasance for non-compliance of procedures, and must practice in accordance to standards of conduct required of early intervention providers.

Outcomes:

Provider will be able to: Identify the components of rampant fraud which occurs with increased frequency in the early intervention practice setting which, unlike physician billing, invoices on a per-unit basis for given time span.

Provider will be able to: Identify the meaning of operational, programmatic, and fiscal compliance, and how to incorporate these standards into your professional practice.

Provider will be able to: Identify self-examination and introspection of one’s own invoicing and time-keeping practices, to ensure proper fiduciary and programmatic moral and ethical conduct.

Provider will be able to: identify practical situations via examples of real/hypothetical situations; understand the theoretical basis for decision making as well as legal standards of behavior consistent with the Texas (and other State board) Practice Acts & APTA code of ethics for professional conduct.

Provider will be able to: Identify terms and concepts such as the investigative process, self-disclosure, incident, reporting, restitution, non intimidation and retaliation, as well as whistleblower protection.

Provider will be able to: Identify the ethical constraints and professional obligations imperative to early intervention professionals with respect to Medicaid.

Speech Language Pathology Classification Code:

Target Audience: Speech Language Pathologists, Speech teachers and Audiologists, Occupational therapists, COTA, PT, PTA, SE/SI, SW

Course Level: Various Content: Related

Subject Code: 7025 Public Policy Issues Associated with Speech, Language, Hearing and Related Disorders

AOTA Classification Codes:

Classification Code:
Professional Issues
Contemporary Issues & trends
Evidence Based Practice
Globalization of Profession
Professional Development & Continued Competency

Target level: All practitioners; Introductory

Course Agenda

Introduction

Case Studies

What is "Regulatory Compliance"

OMIG

Impact on Early Intervention

Outcome of "Non-Compliance"

Corporate Integrity Agreement

Fiduciary Vs. Operation (Programmatic)

Compliance Enforcement

Reporting an "Incident"

Self Disclosure Protocol

Investigative Process

Resolution & Closure

Mandated Elements of Formal Compliance

Minimum Requirements of Compliance

Program Interrelation Between Code of Conduct and Procedures & Code of Ethics

Code of Conduct Policy & Procedures

Employee/Staff Guidance & Training

Central Role of "Board" in Compliance Programs

Role of Compliance Officers

Fiduciary-Ethical Compliance

Mandatory Reporting and Disciplinary Policies

Responding to, & Resolution of Compliance Issues

Operational Compliance

Quality Assurance

Special Needs

Contribute

Welcome

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$ 89.95

Exam Questions = 25

Includes BOTH CEU & EI Contact Hours

Medicaid Regulatory and Ethical Compliance in EI

Course Objectives, Outcomes & Course Agenda

Early intervention therapy providers are ethically obligated to be compliant with the professional imperative for honest billing and treating by the office of the Medicaid Inspector General’s office (OMIG). State Medicaid pays for up to 50% of early intervention costs in some States, in addition to entitlement monies paid toward the birth-3 program by the US Department of Education. Given the enormous growth of these programs and their financial strain on Medicaid and Federal resources, as well as the exponential growth of fraud, it is now mandatory to have an effective compliance program, or risk being denied access to bill Medicaid. Some early prevention providers have been criminally prosecuted for fraudulent billing, and have served prison time. OMIG is actively seeking to identify fraud in Early Intervention. Early Intervention providers are at risk by auditors for mistaken paperwork and must learn to take care and be wary of unintentional mistakes.

Consider, in the past several years, service providers – therapists – have served prison time, been fined tens of thousands of dollars, and have lost their professional licensure because of greed. From falsifying information, submitting incorrect and inappropriate billing, to downright forgery, the need for fiscal and ethical standards is past due. These standards take the written form of a Compliance Manual, and reflect a dynamic compliance program which is enforced by a company Compliance Officer with Board oversight.

Learn about the expected standard fiduciary and ethical compliance, and how to write a compliance manual, and how to implement it within your agency. Read real case-studies of scenarios to illustrate these concepts. More importantly, learn how OMIG will also audit for operational compliance, that is to ensure that you are compliant with the rules and regulations of your early intervention, pre-school, and SEIT programs, respectively. Finally, you may download several documents, including a template of an actual Compliance Manual and Code of Conduct. This course is essential for early intervention providers who wish to stay compliant with the increasingly stringent laws which are aggressively enabling auditors to identify and discipline both agencies and individual providers.

Learn about diverse concepts, include corporate integrity agreements, disclosure of an ‘incident,’ self-disclosure, investigative process, restitution, non-intimidation, and non-retaliation, and whistle-blower protection. Learn how to avoid errors in your invoicing and session note-writing and how to mistakenly avoid poor judgement and simple errors that can mushroom into an audit. Course outline includes examples of real/hypothetical situations, the theoretical basis for decision making as well as legal standards of behavior consistent with the Texas (and other State board) Practice Acts & APTA code of ethics for professional conduct.

This program is offered for 0.50 ASHA CEU's (Level: Various Content: Related)

ASHA LEARNERS PLEASE NOTE: There are 2 purchase options above, EI Continuing Education and CEU. If you wish to earn ASHA CEUs for this course and you select the CEU option, your information including name, address, e mail and ASHA ID, will be sent to ASHA CE. If you do not want your information sent to ASHA, please select the option for continuing education.

EITTOC is an AOTA Approved Provider of professional development. Course approval ID# 8922. This distance learning-independent is offered at 0.5 CEUs, introductory, Professional Issues. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA or indicate AOTA approval of a certification or other professional recognition.

- Meets NY State (NYSOTA) Continuing Compliancy Requirements for continued Core Competency Hours (CCH) -

This course meets the Indiana State requirements for the annual credentialing process in the area of “Conferences & Workshops”
This course meets the NY State Provider's Agreement (IV - M, p.5) "Provider shall be familiar with a comply with all acceptable Medicaid rules and regulations."

- Approved by the National Association of Social Workers (NASW) –

Disclosure: David C Saidoff PT - course developer/presenter - has the following relevant financial relationships to disclose: he receives monetary compensation for the preparation of this course, in addition to a percentage of company sales, and has the following relevant non-financial relationships to disclose: EITTOC Board of Directors: volunteer member. Melissa Whelan, OTR - course developer/presenter - has the following relevant financial relationships to disclose: she receives monetary compensation for the preparation of this course, in addition to a percentage of company sales, and has the following relevant non-financial relationships to disclose: EITTOC Board of Directors: volunteer member. Declaration: Approval of this course does not necessarily imply that any of the governing bodies (e.g., West Virginian Board of Physical Therapy, or other such governmental or NGO’s supports the views of the presenter or sponsor. Information provided should be used within the scope of practice. No relevant financial or non-financial relationships exists between EITTOC or the products discussed any course; no such relationship or endorsement exists for any products mentioned in any courses sponsored by EITTOC, or in any of the items (such as specific AED or Epinephrine injection product) or any testing instrument used to evaluate children; the above course is specific to said-topic, and may not be extrapolated to any other course or topic outside the scope of this course. Course instructor(s) have no other financial or non-financial remuneration - whether prior to or following course delivery; the above advertisement is made available to all physical therapy (and other) licensee on a non-discriminatory basis. Information provided should be used within scope of practice. AOTA does not endorse specific course content, products, or clinical procedures. The onus of responsibility for this course – granted contact hours by the AOTA – is for each OT professional to check with their State board of OT to see if this course meets licensure requirement for continuing education.

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