Healthcare Compliance Professional On-Demand Webinars

Registration Rates for On Demand Webinars

Member          $75
Non-member  $105


Best Practices for Managing (and Avoiding) Provider Disputes

With the Affordable Care Act (ACA) now in place, new health plans are entering the market and existing plans are expanding. The changing terrain in the marketplace inevitably leads to disputes with providers. In this webinar, we will explore techniques for avoiding provider disputes before they arise, and effectively handling them when they do. For participating providers, we will evaluate various contracting issues, how to approach terminations, and arbitration strategies. Non-participating providers present different issues, and we will focus on UCR challenges and recovering overpayments. And, of course, narrow networks on the exchanges are creating issues in the context of healthcare reform. Many of these areas that have proven ripe for litigation recently, and certainly more litigation is on the horizon. But some prudent steps can avoid litigation altogether, or at least minimize the risks. If litigation does arise, plans should be conversant with some key hot topics and strategies, including matters related to Medicare, ERISA, the ACA, and class actions.

Click here to purchase this On Demand Webinar


Wellness Programs: Navigating the Legal Compliance Issues and EEOC Enforcement Activities-On Demand

Recent court cases involving the Equal Employment Opportunity Commission and private employers have raised a number of compliance questions for companies that offer wellness programs to employees. This webinar will explore the legal and regulatory issues that could arise when wellness programs offer incentives to individuals to change their lifestyles and improve their health. This webinar will discuss how many different interpretations exist for concurrent – but sometimes conflicting – legal requirements. Topics covered will include the Affordable Care Act, the Genetic Information Nondiscrimination Act, the Health Insurance Portability and Accountability Act, and the Americans with Disabilities Act.

Click here to purchase this On Demand Webinar


Affordable Care Act (ACA) Compliance and the “3Rs” (Reinsurance, Risk Corridors, and Risk Adjustment)

The Affordable Care Act created three “premium stabilization” programs — reinsurance, risk adjustment, and risk corridors — that will have a significant impact on health insurance markets.  It is important that health plan professionals have an understanding of these highly complex topic areas.  This requires an understanding and integration of financial and actuarial principles, information technology, compliance risks, public policy, and business savvy related to how these programs, alone and working together, are designed to achieve more certainty and stability in various health insurance markets.

Click here to purchase this On Demand Webinar


Compliance Issues to Consider When Designing Wellness Programs Under the ACA

Gain an understanding of the complex legal and compliance issues that should be evaluated when designing and offering wellness programs to individuals and/or employer customers.  The Affordable Care Act, recent corresponding regulations, as well as the Americans with Disabilities Act, interpretations from the Equal Employment Opportunity Commission, and other legal requirements will be discussed.   Practical implementation tips will be covered to help those who are designing health insurance products, offering wellness programs, or providing legal or compliance counsel to internal or external  clients.

Click here to purchase this On Demand Webinar


Fighting Health Care Fraud – The Legal Landscape, the ACA, and Public Private Partnership

This course focuses on the health care fraud legal landscape, how the Affordable Care Act (ACA) is bringing about change in fraud and fraud-fighting, and a new public-private partnership to combat fraud. The first segment will focus on the legal landscape and issues arising in connection with fraud detection and prevention. The second segment will address how the ACA has altered fraud risks and anti-fraud priorities and approaches. The third segment will provide an overview of a new partnership of Federal agencies and private health plans to find and fight health care fraud and abuse.

Click here to purchase this On Demand Webinar


Developing Consumer Marketing Materials in the New ACA Regulatory Environment

The ACA and the new Exchange environments have drastically altered the ways through which health insurance plans engage consumers. This course will highlight the new compliance issues that companies should consider when developing consumer marketing materials.

Click here to purchase this On Demand Webinar


Addressing Network Adequacy Issues With Innovative Business and Delivery Models

This module will encapsulate a comprehensive review of compliance risks – both legal and operational – to enable health insurance plans operating with different business and delivery models to understand the new challenges under the ACA.

Click here to purchase this On Demand Webinar


Understanding Compliance with the New Mental Health Parity Regulations

November 8, the U.S. Departments of the Treasury, Health and Human Services, and Labor issued final regulations implementing the Mental Health Parity and Addition Equity Act. These long-awaited rules will take effect in 2014 and present a number of compliance issues. This webinar will focus on the practical effects of the new regulations, which require parity between mental health or substance use disorder benefits and medical/surgical benefits relating to financial requirements and treatment limitations. Group health plans as well as group and individual health insurance coverage issuers will benefit from this compliance-focused discussion.

Click here to purchase this On Demand Webinar


New Areas of Potential Legal Risk Under the ACA, the False Claims Act, and Related Laws

This course will inform health insurance plans of the potential legal exposures under fraud statutes (e.g., the False Claims Act) and related case law with a focus on how the ACA has or will change legal risks. Specifically, this course will devote a substantive discussion to the new Exchange environments to enable health insurance plans to identify and analyze new areas of potential risk.

Click here to purchase this On Demand Webinar


Understanding the Challenges and Legal Requirements of the ACA’s Tax Provisions

The ACA’s tax concepts are some of the more challenging aspects of the law. Federal agency guidance and interpretations continue to refine the legal requirements, but the tax reporting and payment provisions are likely to present some of the biggest compliance risks for health insurance plans. This course will enable the participant to gain a broad overview of the key tax concepts and challenges.

Click here to purchase this On Demand Webinar


Understanding Medical Loss Ratio (MLR) Requirements Under the Affordable Care Act (ACA)

Medical loss ratio requirements were made part of the Affordable Care Act (ACA) to provide for rebates if certain MLR standards were not met.  These requirements have important implications related to health plan premium pricing and financial management.  While the basic concept is fairly simple — requiring health insurance companies to spend 80 to 85 percent of premium dollars on medical care, health care quality improvement, and other qualifying expenses – implementing and complying with the requirements raises a host of implications for how to do the proper calculations, data reporting, distributing rebates, and the potential for audits and reviews.

Click here to purchase this On Demand Webinar