Fall Conference
October 9, 2013 to October 11, 2013
Oglebay Resort Wheeling
Co-sponsored with
The WV Society of CPA’s
(12 CPE Credits)
West Virginia Healthcare Financial Management
Fall Education Meeting Agenda
October 9-11, 2013
Oglebay Resort – Wheeling WV
Wednesday, October 09, 2013
3:00 pm - 6:00 pm
Vendor Set Up
4:00 pm – 5:00 pm
WV HFMA Board Meeting
6:00 pm – 7:00 pm
Networking Reception – Vendor Hall
7:00 pm – 10:00 pm
Evening Entertainment
Thursday, October 10, 2013
7:00 am – 8:00 am
BREAKFAST - Vendor Hall
8:00 am – 8:15 am
Opening Remarks – Belinda Bennett – President WV HFMA
8:15 am – 9:55 am
Ten Critical Questions For Healthcare Financial Management
General Session
Scott Houk – Cleverley & Associates
2 CPE
Session will identify ten critical financial questions that are often raised by
healthcare boards and executives. The questions address areas of financial
performance, profitability and cash targets, and facility level hospital operational
issues of overall cost and price defensibility. The presentation will address each
question using actual case-hospital data.
Objectives:



Highlight ten critical questions frequently asked by US hospital
governing boards
Determine relevant financial metrics to help answer the question
Illustrate how the use of comparative benchmarking can impact current
and future organizational performance
9:55 am – 10:15 am
BREAK – Vendor Hall
10:15 am – 11:05 am
WV Hospital Association Update
General Session
Joe Letnaunchyn - President WV Hospital Association
1CPE
Session will provide a status on the latest developments at the state level with
coverage expansion under Medicaid and the insurance exchanges/marketplace
and with Medicaid regulatory and operational issues. Washington issues will
include a focus on the federal budget; the deficit and Medicare and Medicaid
legislative and regulatory issues affecting hospital, health systems and other
providers.
11:05 am – 11:55 am
PFS Breakout Session
Breakout Sessions
Patient Centered Medical Homes – Care Coordination and New Payment
Models in WV
1 CPE
Dr. James Becker – WV Insurance
Session will provide an overview of the concept of patient-centered medical
homes (PCMH). It will review the history, goals and methods of PCMH. He will
describe several programs in WV that utilize care coordination and the outcomes
for these programs. It will also describe some of the reimbursement models
currently in place.
CFO Breakout Session
Exchanges, Medicaid Expansion and Payer Initiatives
Bill Maclean – Vice President Insurance Services – West Virginia United Health
System
Objectives:






How will West Virginia’s exchange operate
What payers are planning to participate
How will the exchange and the Medicaid expansion interact
What will the exchange mean for providers and insurers
Will the exchange be used for Medicaid
What to watch out for
11:55 pm – 1:00 pm
LUNCH
1:00 pm – 2:45 pm
Professional Ethics: A Preventive Maintenance Approach
General Session
Christopher Bauer
2 CPE
Session will help attendees gain insight on how to prevent costly ethical
problems on the job rather than paying the high financial and reputational costs
of cleaning up after them.
Objectives:



Articulate a minimum of five often-ignored or overlooked red flags
for ethical risks that are actually easy to spot
Four values on which it is essential to focus in order to reduce
ethical risks
How a small change in focus on ethics can significantly improve
their organization’s bottom line
2:45 pm – 3:05 pm
BREAK – Vendor Hall
3:05 pm – 3:55 pm
PFS Breakout Session
Breakout Sessions
ICD-10: Financial Impacts and Insights
1 CPE
Douglas Whinnie – Principal with The Wellington Group LL.C.
Objectives:



While CMS says the national financial impact of ICD-10 will be minimal,
individual hospital impacts will vary
Within a hospital, impacts can vary significantly by line of business and
by payer
ICD-10 training plans should take into account physicians and services
whose DRG reimbursement will be heavily affected
CFO Breakout Session
State of the Capital Markets, Credit Trends and Borrowing Solutions for Not For
Profit Hospitals
Christopher M. Buehler – Director Healthcare Public Finance
Objectives:



General market conditions
Overview of recent tax-exempt hospital bond financing
Continuing disclosure requirements for hospitals
Rating agency perspective on healthcare borrowers (credit medians and trends:
anticipated byer covenants, etc.)
3:55 pm – 4:45 pm
What You Don’t Know Can Cost You – HIPAA In A HITECH World
General Session
Alaina N. Crislip – Counsel with Jackson Kelly PLLC
1 CPE
Objectives:




Overview of increased individual rights to access
Update on new breach notification requirements
Review of enforcement changes to HIPAA and penalties for HIPAA
violations
Analysis of recent OCR enforcement activity
4:45 pm – 5:30 pm
Program Committee Meeting
6:00 pm – 7:00 pm
Reception – Vendor Hall
7:00 pm – 10:00 pm
Dinner, Dancing and Music by TNT DJ’s
Friday, October 11, 2013
7:00 am – 8:00 am
BREAKFAST – Vendor Hall
8:00 am – 8:15 pm
Opening Remarks – Belinda Bennett – WVHFMA President
FY 14 – Inpatient CMS Payment Programs
Frank Briggs – Vice President, Quality and Patient Safety WVU Healthcare
8:15 am – 9:05 am
General Session
1 CPE
Objectives:



Describe the changes in Value Based Purchasing (VBP)
Explain the Hospital Acquired Condition (HAC) penalty program
Estimate the impact of changes in the Inpatient Prospective Payment
System (IPPS)
9:05 am – 10:00 am
Medicaid Expansion
General Session
Michael D. Wilmoth– Advanced Patient Advocacy
1 CPE
Objectives:



Illustrate how healthcare reform will affect provider enrollment programs
Build strategies to mitigate the risk and maximize the revenue from
uninsured patients
Techniques to integrate Health Insurance Exchange enrollment
10:00 am – 10:20am
BREAK – Vendor Hall
10:20 am – 12:00 pm
Vendor Tear Down
10:20 am – 11:10 am
990 Schedule H
General Session
Rod Hardy – Arnett Foster Toothman, PLLC
1 CPE
Objectives:



What are requirements for reporting information from your hospital’s
Community Health Needs Assessment
Have you considered hospital services that may meet the definition as a
“subsidized health service”
What options are available to calculate “unreimbursed charity” and
“unreimbursed Medicaid” cost
11:10 am – 12:00 pm
Hot Topics: Maintaining Compliance in Times of Change
General Session
Jill Newberry – Senior Manager Arnett Foster Toothman, PLLC
1 CPE
Objectives:




12:00 pm – 12:15 pm
Proposed changes in the 2013 OPPS rules involving the changes to
inpatient and observation status as well as physician supervision
Updates on the latest medical necessity battles
Updates on the quickly approaching transition to ICD-10
Review of new RAC approved items
Door Prized and Closing Comments – Belinda Bennett - President
Speaker Biographies
Scott Houk, CPA – Senior Strategic Advisor Cleverley + Associates
Mr. Houk consults with hospital and healthcare organization to identify financial and operating
opportunities, as well as related strategies for performance improvement. Prior to joining the firm, he
was a Senior Manager in the health Sciences Advisory Services division of Ernst & Young. He has 20
years of experience working with hospital financial managers across the United States. His experience
includes performing hospital cost-reduction studies and procedures pricing studies, analyzing Medicare
Disproportionate Share, completing financial audits of hospitals and healthcare systems, and performing
many other financial Analyses. Mr. Houk received his B.A. in Business Administration with accounting
emphasis form Transylvania University in Lexington, KY. He is a current member of the Healthcare
Financial Management Association and the Ohio Society of CPAs
Joe Letnaunchyn – President and CEO West Virginia Hospital Association
Mr. Letnaunchyn has over 38 years of healthcare experience, 26 of those years working with state
hospital associations representing multi-hospital health systems specialty hospitals and small, rural and
critical access hospitals. He is actively involved in state and federal legislative activities and participates
in several business and other healthcare related organizations that interact with hospitals. He has been
with WVHA since 2006.
Dr. James Becker – Medical Director WV Bureau for Medical Services and Physician Director WV
Offices of the Insurance Commissioner
Dr. James Becker of Huntington, WV, is an Associate Professor in the Department of Family and
Community Health at Marshall University Joan C. Edwards School of Medicine. Dr. Becker joined the
West Virginia Workers’ Compensation Commission in July 2003 as the system began a major overhaul
process. He served as the Medical Director from July 2003 until January 2006 when the system was
privatized. He continued as Medical Director of Brick Street Insurance until January 2007. In 2008 he
joined the Department of Health and Human Resources, first as a consultant and then as medical
director. Dr. Becker is a graduate of Marshall University School of Medicine. He is board certified in
family practice. He was chief of the Section of Industrial, Occupational and Environmental Medicine from
January 1996 to 2005. Dr. Becker is a clinical professor at West Virginia University, Department of
Community Medicine and serves on the Resident Advisory Committee for the Department of
Occupational Medicine at West Virginia University. In his role as Medical Director at Medicaid, Dr. Becker
has responsibility for many of the policies that guide coverage decisions for various medical therapies. He
reviews appeals on individual cases and has helped develop policy related to drug treatment programs,
coverage for medical devices and new diagnostic tools. Dr. Becker is actively involved in Department’s
grants and the effort to create health homes for Medicaid members with chronic health conditions.
William G MacLean – Vice President Of Insurance Services – West Virginia United Health System
and Chief Operating Office Of Health Partners Network
Health Partners Network is a non-integrated PHO with 1,200 physician participants and 13 hospital
participants with contracts covering eighteen product lines of thirteen third party payers. William’s office
handles over 180 managed care contracts and has delegated credentialing authority from most payers.
He created and manages the WVUHS stop loss shared risk arrangement and high deductible plans, both
of which have resulted in significant savings. He also analyzes and recommends changes to the
employee health plans of WVUHS and the faculty practice plans covering over 20,000 lives. William l is
the chair of the WVUHS Patient-Centered Medical Home Committee and he is the project leader for
WVUH’s initiative in PCMH and Population Health with Geisinger Health Plan. He is a CPA and has
degrees form William and Mary ad George Washington University.
Christopher Bauer, PhD, HSP, CSP, CFS – Bauer Ethics Seminars
Dr. Bauer is a clinical psychologist by training with over twenty-five years of experience as a speaker,
trainer, consultant and author on both professional ethics and values-driven business strategies.
Between speaking, coaching and consulting, his clients have run the gamut from small and mediumsized organizations to every level of staff and management at Fortune 500 companies. He works
primarily with financial and healthcare organizations and is a frequent speaker at HFMA chapters and
conferences. Dr. Bauer’s articles on building personal and organizational ethics have appeared in CEO
Refresher, CRO Magazine, Financial Executive, Internal Auditor and many other print and online outlets.
The latest edition of his book, “Better Ethics NOW: How To Avoid the Ethics Disaster You Never Saw
Coming” has been a business ethics top seller on Amazon.com. Dr. Bauer has been awarded the
Certified Fraud Specialist designation from the Association of Certified Fraud Specialist and the Certified
Speaking Professional designation by the National Speakers Association.
Douglas Whinnie – Principal with The Wellington Group, L.L.C.
Mr. Whinnie has over 30+ years of healthcare experience with a background in systems analysis
prospective payment systems, large database modeling, and analysis and project management. His
responsibilities have included development of ICD-10 coding and financial modeling system. Denial
reporting systems. APC assessments for multi-hospital systems, academic medical centers and
community hospitals. Development of utilization and state regulatory reporting for Medicaid HMO’s.
Conducted HMO operations and compliance reviews including work flows, organizational structuring,
staffing, Federal compliance audits, benefits design and claims payment system evaluations. Mr.
Whinnie has associate degrees in business and marketing and holds a bachelor’s degree in Economics
from St. Martin’s University in Lacey, Washington.
Alaina N. Crislip – Counsel with Jackson Kelly PLLC
Ms. Crislip works in the HealthCare and Finance Practice Group. She represents a variety of health care
provider organizations, including hospitals and physicians. Ms. Crislip routinely advises clients in
matters involving healthcare regulation and litigation, with an emphasis on compliance advice to
providers under HIPAA, Stark, Anti-Kickback and other state and federal laws. In addition, she assists
with corporate structuring, provider accreditation and certification, medical staff affairs, certificate of
need, professional licensure, health insurance regulation, health information technology and e-health
matters. Most recently, Ms. Crislip has been involved in the development of a statewide health
information exchange in West Virginia, having advised the exchange on its contracts, policies,
procedures, and other operational issues. Ms. Crislip is active in the American Health Lawyers
Association and is a frequent author and speaker on multiple emerging health law issues.
Frank Briggs – Vice President, Quality and Patient Safety WVU Healthcare
Dr. Briggs is currently the Vice President of Quality and Patient Safety at West Virginia University
Healthcare. He is a pharmacist by training completing both his Bachelor of Science and Doctor of
Pharmacy training at Massachusetts College of Pharmacy in Boston. He completed three years of
residency training in pharmacy and administration at The Johns Hopkins Hospital. While in Baltimore,
he earned his Master of Public Health and Certificate in Healthcare Finance and Administration from The
Johns Hopkins University Bloomberg School of Public Health. Frank joined West Virginia University
Healthcare in 2002 as a manager in the pharmacy. He became the first director of the Center for Quality
Outcomes in 2006 and in 2012 became Vice President. In his current role, Frank has reporting
responsibility for inpatient and ambulatory quality, patient safety, employee safety, patient satisfaction,
care management, and performance improvement. Frank has published in the field of quality and
currently serves on the CMS Technical Expert Panel for the development of new quality measures.
Mike Wilmoth – Advanced Patient Advocacy
Mr. Wilmoth is the Chief Operating Officer for Advanced Patient Advocacy. He has worked for more than
15 years helping patients access the resources that cover the cost of care. His background as a litigator,
regulatory specialist and lobbyist has helped influence state and federal health policy. His most recent
focus has been on developing public/private partnerships that streamline the enrollment process for
Medicaid applicants. His areas of expertise include: improving enrollment strategies & results,
healthcare reform’s impact on enrollment, Social Security Disability and Exchange preppers.
Rod Hardy – Member – Arnett Foster Toothman, PLLC
Mr. Hardy is a member of the healthcare consulting practice. He is a CPA with approximately thirty years
of healthcare finance experience with a primary focus on Medicare and Medicaid reimbursement issues.
He has been providing consulting services to large tertiary teaching hospitals, community-based
hospitals (including critical access hospitals) for thirteen years. His prior experience included work as a
Medicare auditor as well as serving as a Director of Reimbursement in a tertiary care hospital. Rod is a
member of the Healthcare Financial Management Association and the American Institute of Certified
Public Accountants. He graduated from Marshall University.
Jill Newberry – Senior Manager – Arnett Foster Toothman, PLLC
Mrs. Newberry is a CPA and a Certified Professional Coder. Her expertise in the health care regulatory
field includes twenty eight years of auditing and reimbursement functions related to healthcare entities as
well as establishing and implementing ethics and compliance programs. She has eleven years of
experience in large tertiary teaching hospitals including four years with OhioHealth Corporation in
Columbus, OH where she was the system Corporate Director for Reimbursement and the Interim
Director of Ethics and Compliance and 5 years with CAMC where she developed and implemented the
system’s corporate compliance program. She is a member of the American Institute of Certified Public
Accountants, Healthcare Compliance Association, Healthcare Financial Management Association,
Association of Certified Fraud Examiners and American Academy of Professional Coders. Jill graduated
from the University of Charleston.
Meeting Information
MEETING LOCATION
The meeting will be held at Oglebay Resort in Wheeling, WV. A block of rooms has been reserved for
the conference. They are available at a special group rate of $119 for a traditional room, $139 for an
intermediate room, $159 for a deluxe room, $169 for a premium room, $250 for a suite and $750 for a
mansion suite. Rates quoted are subject to the addition of the city hotel tax (currently 6%) and the WV
state sales tax (currently 6%) unless otherwise stated. All groups and individuals are subject to the city
hotel tax. Individual guests will make their own reservations directly with Oglebay Resort. Guaranteed
room reservations at these rates can be made through September 9, 2013 by calling 304-243-4000.
After September 9, 2013 the rate will not be guaranteed. A deposit equal to one night’s rate plus taxes
will be due with each room reservation request. Check in at Wilson Lodge begins at 3:00 PM and check
out is at 11:00 AM.
SMOKING
The Wheeling Park Commission promotes safe and healthy lifestyles in all areas of the Park System. In
accordance with the Clean Indoor Air Regulations of the Wheeling-Ohio County Board of Health, all
indoor public spaces at Oglebay and Wheeling Park are smoke free and the staff will enforce the
regulation.
REGISTRATION INFORMATION
Registration for the program includes all meals and breaks during the program. The registration fee is set
by the Board of Director for members and non-members. There is also a special fee of $75 for guests
who want to attend the social/meal functions of the group. Members of the WV Chapter should register
as a member all other attendees should register as a non-member. All attendees must register including
speakers and vendors.
Online registration can be access through the chapter website www.wvhfma.org.
REFUND POLICY
Requests for refunds made at least 2 weeks prior to the meeting (September 25, 2013) will be 100%
refunded. Requests at least 3 days prior to the meeting (October 6, 2013) will be 80% refunded.
Requests made less than 3 days prior to the meeting will not be refunded.
GOLF
Members who would like to play golf on Wednesday afternoon October 9, 2013 should contact Okey
Silman at 304-637-3439 or silman.okey@davishealthsystem.org. The fee to play golf will be $73 per
round. The first tee time will be 12:00 pm. For tracking purposes please refer to the booking ID 16003
during any communication regarding this event. No adjustments or rain checks will be given unless the
courses are closed for the day due to inclement weather. Golf is scheduled for the Palmer Course but the
resort reserves the right to switch golf courses up to 60 days prior to the scheduled event.
CONTINUING EDUCATION
Up to 12 CPE credits will be provided by the WV Society of CPAs for attendance at this meeting. Sign-up
sheets will be provided at each session to validate session attendance. A summary sheet will be
provided in the program packet. Attendees need to have the summary sheet signed off by one of the
program chairs.
Questions
regarding
registration
can
be
directed
to
Lisa
Simmons
304-598-6247
simmonsl@wvuhealthcare.com or Nikki Carper 304-267-8985 nrcarper@martinandseibert.com.
Registration Form
October 9 – 11, 2013 – Oglebay Resort Wheeling, WV
NAME: _____________________________________________________________________________
E-MAIL: _______________________________________ MEMBER #/CHAPTER: _________________
POSITION/TITLE: ____________________________________________________________________
EMPLOYER: _____________________________________________ CPA ___ CHFP ___ FHFMA ___
ADDRESS: _________________________________________________________________________
CITY: ________________________________________________ STATE: ______ ZIP: ____________
PHONE NUMBER: ___________________________________________________________________
MEMBER: _____ NON-MEMBER:_____ SPEAKER: ______ VENDOR: _____ OFFICER: _________
In order to help us better prepare and minimize costly waste, please indicate which or the
following events you will be attending:
Wednesday: Reception/Entertainment ______
Thursday:
Breakfast
___________
_______ Lunch
_______
Friday:
Breakfast ______
___________________________
Do
Dinner
you
Will
a
guest
be
joining
you?
______________________________________________
______ Reception/Entertainment
have
any
If
dietary
yes
restrictions?
–
RATES:
HFMA/CPA MEMBER – before September 9th
$200 _____
HFMA/CPA NON-MEMBER – before September 9th
$250 _____
HFMA/CPA MEMBER – after September 9th
$210 _____
HFMA/CPA NON- MEMBER – after September 9th
$260 _____
GUEST FEE (includes meals only)
$75 _____
WV HFMA SPONSOR 2013-2014 (are you using you free registration yes or no?)
$275 _____
NON WV HFMA SPONSOR
$350 _____
PAST PRESIDENT
$75 _____
OFFICER (President, President Elect, Treasurer, Secretary)
$00 _____
SPEAKER
$00 _____
Make Checks payable to “West Virginia HFMA Chapter”
Mail checks and registration form to:
Lisa Simmons
231 Wayland Street
Morgantown, WV 26505
NAME:
2013 – 2014 WV HFMA Corporate Sponsors
EMERALD SPONSOR
Healthcare Financial Services
RUBY SPONSOR
Arnett Foster Toothman, PLLC
Helvey & Associates, Inc.
SAPPHIRE SPONSOR
Advanced Patient Advocacy, LLC
Credit Bureau Systems, Inc.
Credit Management Co.
Highmark West Virginia
The Mash Program
ParenteBeard
Passport Health Communications, Inc.
Quadax, Inc.
United Collection Bureau, Inc.
The Wellington Group, LLC
PEARL SPONSOR
CBCS
Collection Service Center, Inc.
HealthNet Aeromedical Services
RevSpring
**This list of sponsors is based upon sponsorship renewals or additions received at the time of this publication **