Medicare/Medicaid Knowledge-Pt 4: Ethical Challenges: Treatment, Coding, Billing

Tuesday, March 7, 2023
4:00 P.M. - 6:00 P.M. ET
.20 ASHA CEUs

Speech-language pathologists (SLPs) have a responsibility to adhere not only to their profession’s clinical and ethical standards but all applicable laws, regulations, and policies.

This presentation will begin with an explanation of terms critical for professional compliance: qualified provider, skilled intervention, reasonable and necessary, habilitation, rehabilitation, and maintenance intervention. Documentation provides proof of compliance; common documentation errors will be explored as well as Medicare’s minimum documentation requirements.

The presenter will provide an overview of relevant federal laws that govern waste, abuse, and fraudulent billing behaviors and highlight three policy documents of the American Speech Language Hearing Association (ASHA) that characterize practice standards and guide ethical conduct. Clinical examples of treatment, coding, and billing scenarios will be presented to illustrate the interface between ASHA’s Code of Ethics and federal laws. 1)Define 4 common terms related to professional compliance.

Learning Objectives

• Define 4 common terms related to professional compliance.
• Name the number one documentation compliance error.
• Identify two non-compliant or inappropriate billing behaviors for Medicare outpatient services that may be considered violations of the False Claims Act.

Webinar Cost

CAPCSD Member	$50.00
CAPCSD Affiliate Member	$75.00
CAPCSD Non-Member	$75.00

Time Ordered Agenda
4:00 - 4:03 p.m. ET   Introduction & Objectives
4:04 - 4:30 p.m. ET   Explain terms critical for professional compliance: qualified provider, skilled intervention, reasonable and necessary, habilitation, rehabilitation, and maintenance intervention
4:31 - 4:51 p.m. ET   Medicare documentation requirements and compliance
4:51 - 5:10: Highlight three policy documents of the American Speech Language Hearing Association (ASHA) that characterize practice standards and guide ethical conduct
5:11 - 5:30 p.m. ET   Highlight three policy documents of the American Speech Language Hearing Association (ASHA) that characterize practice standards and guide ethical conduct
5:31 - 5:45 p.m. ET   Discuss clinical scenarios of treatment, coding, and billing scenarios to illustrate the interface between ASHA’s Code of Ethics and federal laws
5:45 - 6:00 p.m. ET   Questions from the audience

Speaker
Dee Adams Nikjeh, Ph.D., CCC-SLP, ASHA Fellow
Dee Adams Nikjeh, Ph.D., CCC-SLP, ASHA Fellow, is an expert in health care code sets, compliance requirements, and billing practices for the field of speech-language pathology (SLP). She co-chairs ASHA's Health Care Economics Committee and is the SLP advisor on the American Medical Association's Relative Value Update Committee/Health Care Professionals Advisory Committee. Dr. Nikjeh's professional career in the field of communication sciences and disorders spans four decades as a clinician, researcher, educator, expert witness for the US Department of Justice Civil Division, coding and claims consultant, and an advocate for the profession. She has served on ASHA's Legislative Council and the Executive Board of the Council of State Association Presidents and is a past president of the Florida Association of Speech-Language Pathologists and Audiologists.

Disclosures:
Financial: Dee is receiving an honorarium from CAPCSD for presenting this webinar
Non-Financial: SLP Advisor and member of American Medical Association’s Relative Value Update Committee Healthcare Professional Advisory Committee Review Board