The AIS Guide to Blue Cross and Blue Shield Plans: 2010

Webinars on: Conducting Internal Investigations; Electronic Health Records; Star Ratings for Medicare Quality Bonuses; Medication Therapy Management


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AIS's Directory of Health Plans: 2010

Report on Patient Privacy and AIS's HIPAA Compliance Center

2000-2009 Survey Results: Pharmacy Benefit Trends & Data

Guide to Managing Never Events and HACs

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The AIS Guide to Blue Cross and Blue Shield Plans*

Managed Medicare and Medicaid Factbook: 2010

Special Needs Plans: Regulatory Challenges and Market Strategies

Health Reform’s Impact on Commercial and Medicare Health Plans

*Not affiliated with the Blue Cross Blue Shield Association or its member companies.

Best Sellers
AIS's Directory of Health Plans: 2010

Report on Patient Privacy and AIS's HIPAA Compliance Center

2000-2009 Survey Results: Pharmacy Benefit Trends & Data

Guide to Managing Never Events and HACs

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AIS Marketplace

New on AISHealth.com: Upcoming Health Business Meetings & Health Business Job Openings

Free Report: Strategies to Reduce Oncology Care Costs -- Without Sacrificing Outcomes

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AIS Compliance Marketplace

Scroll down to read short descriptions of AIS's Compliance products.

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49 Steps to Implement Sarbanes-Oxley Best Practices
The AIS Guide to Medicare Compliance Risks & Strategies
A Comprehensive Guide to Managing Never Events and Hospital-Acquired Conditions
A Guide to Complying With Stark Physician Self-Referral Rules

High-Risk Areas in Medicare Billing

  AIS's HIPAA Compliance Center
Medicaid Compliance News
Medicaid Compliance Strategies for Hospitals and Other Providers

RACs: Strategies to Reduce Your Risk and Successfully Appeal Payment Denials
Report on Medicare Compliance
Report on Patient Privacy
Report on Research Compliance
Vendor Gifts and Relations

Print an order form: If you do not wish to place your order online, click here to download a printable order form (PDF file), then submit your order via fax or mail, as directed on the form.

Newsletters

The HCCA-AIS MEDICAID COMPLIANCE NEWS, monthly news and valuable how-to strategies for identifying and reducing the top Medicaid compliance risks. Co-published by the Health Care Compliance Association (HCCA) and AIS. 12 issues annually ($467 per year; HCCA member discount available); subscriptions include print copy and e-mail delivery of the newsletter.
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REPORT ON MEDICARE COMPLIANCE, the industry's top source of news and analysis on Medicare compliance, fraud and abuse, billing errors, and a range of complex compliance issues. Includes unique strategic guidance not available anywhere else ... from the desk of veteran compliance reporter Nina Youngstrom, who has written this newsletter since 1992. 45 issues annually ($648 per year) or 2-month intro ($92 for 8 issues); both include print copy and e-mail delivery.
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REPORT ON PATIENT PRIVACY (and AIS’s HIPAA Compliance Center), a highly practical print and Web service that will help your organization safeguard patient privacy and data security — and reduce your chances of fines and penalties, private lawsuits and public relations nightmares. Annual subscriptions include 12 issues of the industry-leading newsletter Report on Patient Privacy, and access to a regularly updated Web site — with 32 narrative sections written by experts (and packed with sample forms, policies, procedures and other practical tools you can adapt to your privacy and security compliance), a convenient listing of links to official documents pertaining to HIPAA privacy and security, and searchable archives of Report on Patient Privacy. ($429)
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REPORT ON RESEARCH COMPLIANCE, co-published by the National Council of University Research Administrators (NCURA) and AIS, provides the best information there is to help institutions avoid the negative publicity, financial setbacks, and management problems that compliance requirements can create.12 issues annually, plus weekly e-mail newletters and unlimited access to a password-protected Web site. ($379 for NCURA members, $479 for non-members.)
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Web Services &
Looseleaf Guides


A COMPREHENSIVE GUIDE TO MANAGING NEVER EVENTS AND HOSPITAL-ACQUIRED CONDITIONS provides guidance on patient safety and preventable adverse events to help you reduce risks, prevent lost reimbursement, increase quality of care and improve outcomes. Written by three top patient safety leaders — Robert F. Bunting, Jr., Jay Schukman, MD, and Wesley B. Wong, MD — this resource is the first of its kind to chronicle the efforts of the past decade to address the challenge of patient safety. Subscription includes a looseleaf guide, companion CD and one biannual update. ($287)
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A GUIDE TO COMPLYING WITH STARK PHYSICIAN SELF-REFERRAL RULES is a comprehensive looseleaf service written by a team of experienced health care attorneys. It features easy-to-follow explanations of the prohibitions and exceptions under the Stark rules, chapters devoted to the special Stark interests of different stakeholders, summaries of Stark Advisory Opinions issued by the OIG, and copies of regulations and other formal documents. Subscription includes quarterly updates and news summaries (in print and CD formats). ($524 annually).
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HIGH-RISK AREAS IN MEDICARE BILLING is a comprehensive Web site with sophisticated compliance auditing tools for hospitals and health systems. Co-published by Strategic Management Systems, Inc. — one of the nation’s leading compliance consulting firms — and AIS, the site organizes (by high-risk area) hundreds of checklists, policies, best practices and other tools in downloadable formats that can be adapted by subscribers. Also includes a valuable monthly newsletter. ($787 per year)
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Books, Directories & Reports

49 STEPS TO IMPLEMENT SARBANES-OXLEY BEST PRACTICES IN PRIVATE AND NONPROFIT HEALTH CARE ENTITIES, a highly practical book — written by experienced compliance experts at Strategic Management Systems, Inc., led by former HHS Inspector General Richard P. Kusserow — that identifies and describes steps your organization can take to adopt what have become consensus best practice standards for adhering to this landmark corporate responsibility law. Includes a companion CD with templates that can be customized by your organization. ($385)

THE AIS GUIDE TO MEDICARE COMPLIANCE RISKS & STRATEGIES FOR HOSPITALS, PHYSICIAN GROUPS AND OTHER PROVIDERS, overview and analysis on the big-dollar topics of greatest concern to health care compliance professionals and anyone responsible for running a Medicare program. The book includes chapters on coding and billing, documentation, reimbursement, Recovery Audit Contractors, OIG audits, fraud and abuse, anti-kickback and Stark laws, privacy and data security, and more. CD version also available. ($378)
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MEDICAID COMPLIANCE STRATEGIES FOR HOSPITALS AND OTHER PROVIDERS: How to Prepare for Federal Health Reform Mandates and State Initiatives is filled with articles that will help Medicaid providers understand what to expect when state or federal auditors come calling, and show how certain facilities handled major cases and settlements. This report focuses on a variety of compliance challenges, regarding Medicaid Integrity Contractors (MICs) and Recovery Audit Contractors (RACs), provider self-audits, data mining and more. ($84) PDF version also available.
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RACs: STRATEGIES TO REDUCE YOUR RISK AND SUCCESSFULLY APPEAL PAYMENT DENIALS is a comprehensive report that offers guidelines on areas ripe for review and strategies on how to effectively appeal recovery audit contractor (RAC) payment denials. Learn about keys to success, including auditing and evaluating particular areas before the RACs do, establishing processes for records requests and appeals, and reducing your risk exposure. ($84) PDF version also available.
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VENDOR GIFTS AND RELATIONS: EFFECTIVE STRATEGIES FOR HEALTH SYSTEMS AND HOSPITALS, a report that shows you how to identify and manage potential gift conflicts, avoid possible compliance minefields and make sure patient care decisions are not influenced by vendor gift-giving. It provides guidance in the applicable laws and regulations, and offers samples of policies and real-world experiences of compliance officers who have successfully implemented these programs. ($84) PDF version also available.
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Webinars

Webinars are listed below in reverse chronological order,
with the most recent first.

COMPLIANCE PITFALLS TO AVOID WHEN IMPLEMENTING ELECTRONIC HEALTH RECORDS, a 90-minute Webinar on September 16, 2010. Learn what strategies hospitals and providers should use to limit their compliance risks when implementing an electronic health records system — from Bobbi Bonnet, national practice leader for health information management compliance at Kaiser Permanente. ($329)
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PROVEN STRATEGIES FOR CONDUCTING INTERNAL INVESTIGATIONS, a 90-minute Webinar on September 14, 2010. Learn how to set up an effective process to investigate and respond appropriately to employee complaints, including tips for successful interviewing and gathering all the information and evidence needed to assess, act on and resolve potentially complex workplace problems — from former HHS Inspector General Richard Kusserow, who is now CEO of Strategic Management Systems, LLC. ($329)
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MAJOR NEW HIPAA RULES ISSUED: LEARN WHAT STEPS YOU NEED TO TAKE SOON, a 90-minute Webinar first held on August 18, 2010. Learn what specific steps your organization will have to take soon to incorporate the new rules into your existing HIPAA privacy and security compliance programs. Veteran HIPAA attorney Reece Hirsch, with Morgan, Lewis & Bockius LLP in San Francisco, will summarize the major new requirements (and pitfalls) in these mammoth new regs, and what you will need to do to comply. CD or On-Demand Recording available. ($329)
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HOW TO AMEND HIPAA BUSINESS ASSOCIATE AGREEMENTS TO COMPLY WITH THE HITECH ACT, a 90-minute Webinar first held on April 7, 2010. Veteran HIPAA attorney Reece Hirsch, a partner with Morgan, Lewis & Bockius LLP in San Francisco, outlines specific steps your organization should consider for revising your business associate agreements to comply with new HITECH Act rules … despite a lack of guidance from HHS’s Office for Civil Rights. CD or On-Demand Recording available. ($329)
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VENDOR GIFTS AND RELATIONS: STRATEGIES FOR REDUCING YOUR COMPLIANCE RISKS, a 90-minute Webinar first held on March 10, 2010. Learn how to identify and manage vendor gifts and relationships, and what successful strategies hospitals and other providers should incorporate into their policies and procedures that will minimize vendor gift compliance risks. Speakers are Richard Kusserow, CEO of Strategic Management Systems, Inc., and Julie Chicoine, compliance director for the Ohio State University Medical Center. CD or On-Demand Recording available. ($329)
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HIPAA SECURITY BREACHES: 10 STEPS TO TAKE WHEN A BREACH OCCURS, a 90-minute Webinar first held on February 24, 2010.  Find out the exact steps you should take to minimize the damage caused by a security breach and prevent impermissible disclosures down the road from two privacy experts, Rebecca Fayed, an attorney with Sonnenschein Nath and Rosenthal LLP in Washington, D.C., and Greg Young, the privacy and information security officer at Mammoth Hospital in Mammoth Lakes, Calif. CD or On-Demand Recording available. ($329)
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MEDICARE PART D REFORM: STRATEGIES TO PREPARE FOR POTENTIALLY ENORMOUS CHANGES IN 2010, a recording of a 90-minute audioconference held on August 6, 2009. With Medicare Part D a major focus of pending health care reform legislation, there is an urgent need for Part D plan sponsors to work with their PBMs and other first-tier entities to prepare for possible changes. Susan Hayes of Pharmacy Outcome Specialists and Steve Arbaugh of ATTAC Consulting Group provide details of what to do now to prepare for the potential impact of various health care reform proposals on Part D. ($329)
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THE TOP 5 PART D AUDIT RISKS: HOW YOU CAN AVOID BECOMING A CMS TARGET, a recording of a 90-minute audioconference held on May 28, 2009. Dorothy DeAngelis and Richard Merino of FTI Consulting outline the areas CMS is now stressing in its Part D audits, and what preventive steps you should take to reduce your chances of strict penalties and sanctions. ($329)
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COMPLYING WITH THE NEW FEDERAL SECURITY BREACH NOTIFICATION LAW: STRATEGIES FOR HIPAA COVERED ENTITIES, a recording of a 90-minute audioconference held on May 5, 2009. Learn from veteran health care privacy and security attorney Reece Hirsch, a partner in the San Francisco office of the law firm of Morgan, Lewis & Bockius LLP, what the components of your federal security breach compliance program should be — and what new steps your organization should take immediately following a security breach — to comply with the rigorous new federal security breach notification law. ($329)
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MAJOR NEW HIPAA REQUIREMENTS: HOW TO COMPLY WITH STRONG PRIVACY AND SECURITY MEASURES SIGNED BY PRESIDENT OBAMA, a recording of a 90-minute audioconference held on March 11, 2009. Veteran HIPAA attorney Reece Hirsch outlines specific steps your organization must take to incorporate the groundbreaking new federal law — which contains the most significant changes to federal health care privacy and security law since the enactment of HIPAA — into your existing compliance program. ($329)
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RECONCILING PART D ENROLLMENT DATA: STRATEGIES TO AVOID BECOMING AN ENFORCEMENT TARGET, a recording of a 90-minute audioconference held on January 13, 2009. Learn the details of effective strategies to improve your enrollment and membership reconciliation processes and ensure that they are in compliance with CMS requirements, from three experts with Global Pharmaceutical Solutions (GPS) — Managing Partner Erin Costell, and Senior Consultants Marye Issacs and Julian Nadolny. ($329)
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STRATEGIES TO PREVENT AND SUCCESSFULLY APPEAL RAC PAYMENT DENIALS, a recording of a 90-minute audioconference held on November 18, 2008. Learn what your organization should do to prepare for RAC audits and which strategies have been used with terrific success to reverse unfavorable outcomes and to prevent future risk exposure — from two industry leaders with vast experience in representing hospitals and health systems during RAC audits: Diane Cahalan, a director in PricewaterhouseCoopers LLP’s (PwC) Health Industries Advisory Practice, and Lawrence Vernaglia, a partner with Foley & Lardner LLP. ($329)
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VACCINE COVERAGE AND BILLING STRATEGIES UNDER PART D, a 90-minute audioconference on September 25, 2008. Patrick Liedtka, associate director of vaccine public policy in the Merck Vaccines and Infectious Diseases division at Merck & Co., will provide valuable intelligence about CMS’s new vaccine coverage and administration billing requirements and options. Learn how to cover and bill for vaccines correctly to avoid CMS sanctions and enforcement action. ($329)
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VENDOR GIFTS AND RELATIONS: HOW TO REVISE YOUR HOSPITAL’S STRATEGIES AS THE FEDS CRACK DOWN, a CD of a 90-minute audioconference held on March 25, 2008. Learn how to identify and manage potential vendor gift conflicts, to avoid possible compliance minefields and ensure patient care decisions are not influenced by vendor gift-giving. Speakers are: Donald E. Koenig, Jr., vice president and assistant general counsel of corporate responsibility and enterprise risk management for Catholic Healthcare Partners (CHP) in Cincinnati, and Nickie Braxton, corporate compliance officer for Hartford (Conn.) Hospital/Hartford Health Care Corp. ($329)

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