Rules and regulations for hospital case management departments have been expanding and changing, especially over the past decade. They are more complex and impact the way the case management staff operationalize their roles. In the past, there was little focus on the case management department compliance—but that was then and this is now! With this increased oversight and additional regulations, case managers must be compliant with any of these regulations that affect their patients. From the CMS conditions of Participation to such rules as the 2-midnight rule, the MOON, the NOTICE Act, medical necessity, and levels to care, to very recent final rules for the discharge planning section of the Conditions of Participation—it’s our responsibility to maintain compliance in case management.

This webinar will review the compliance regulations affecting your patients. Never has this been more important than it is now/

Learning Objectives:-

• Compliance: What it is and who it affects
• Compliance at your access points
• Compliance Regulations
• 2 Midnight-Rule
• CMS Conditions of Participation:  Utilization Review
• Condition Code 44 and Provider Liable
• Important Message
• ABNs and HINNs
• CMS Conditions of Participation:  Discharge Planning
• Current Rule
• Final Rule
• MOON
• NOTICE Act
• Detailed Notice of Discharge
• Payer Compliance
• Compliance and the physician:  Attendings, consultants and physician advisors
• Case management compliance strategies
• Sample compliance gap analysis

Why Should You Attend?

As case management professionals, we work with rules and regulations that require compliance. Therefore, we must be up to date on each and every compliance requirement. Some of our most recent compliance changes are the Conditions of Participation final rule for discharge planning and the 2020 updates for the Important Message and. In this webinar, the most recent rules will be discussed, as will suggestions for successful implementation. 

As we collaborate with physicians and other healthcare team members, we must assist them in understanding these rules and regulations. Physician advisors must also understand these in their interactions with physician providers. But, it’s not only compliance knowledge, but it’s also actually operationalizing it. This webinar will bring you up to speed on what you need to know to be successful in your compliance role as an RN case manager or social work case manager. It will help you identify where you may have compliance practice gaps, as well as how to ensure you are compliant.

Who Should Attend?

• Director of Case Management
• RN Case Managers
• Director of Compliance
• Director of Social Work
• Social Worker Case Managers
• Physician Advisors
• Compliance Directors
• Executive Responsible for Case Management