Regina, Gary and Kortney sit down at HCCA’s Compliance Institute to discuss the impact of compliance on Drug Diversion, including:
- What drug diversion is and why it is an important compliance issue;
- Statistics that show how harmful drug diversion can be, including:
- In 2015, Medicare spent $4 billion on commonly abused opiods;
- A large percentage of pharmacists, nurses, and MDs self-disclose drug abuse issues;
- 1 in 3 Medicare beneficiaries is receiving some type of opiod;
- Why Compliance is in a unique position to break the silos;
- How compliance can address issues in real time, where criminal investigations can’t;
- Compliance officers can engage in conversations with employees to gain insight into what is happening in the facility;
- The importance of reporting the illegal prescribing of opiods;
- Is compliance training enough?
- We need to concentrate on preventing diversion – once it happens it’s too late; and
- How compliance can proactively help clinicians avoid diversion issues (using data).
Regina Gurvich has worked in health care in New York City for over 15 years, specializing in compliance and regulatory affairs. She currently heads the compliance effort for AdvantageCare Physicians, a newly-created 450-physician and 3,500-employee private medical practice in New York City. Prior to promotion, she served as a CCO of Manhattan’s Physician Group, one of the 4 legacy practices comprising AdvantageCare Physicians. Prior to joining Manhattan’s Physician Group, she served as Chief Compliance Officer of University Physician Associates, a faculty practice plan of University of Medicine and Dentistry New Jersey in Newark, where she was responsible for the compliance education and audit program for 700 New Jersey Medical School faculty physicians. She also served as a Director of Compliance and Special Investigations Unit for Health Plus PHSP Inc., one of the largest Medicaid managed healthcare plans in New York City.
Regina served on an Advisory Task Force for New York Office of Medicaid Inspector General Compliance Guidance for Managed Care Organizations. She is a frequent speaker at the industry forums with Health Care Compliance Association and Healthcare Financial Management Association and is a member of the editorial review board of HCCA Auditing & Monitoring Tools publication.
Gary Cantrell is the Deputy Inspector General for Investigations and leads the Office of Investigations (OI) within the Department of Health and Human Services (HHS), Office of Inspector General (OIG). Since 2012, he has been overseeing the operations and resources of OI, an office with more than 600 employees including investigators, analysts, forensic examiners, and administrative staff. Under Mr. Cantrell’s leadership, OI has had record accomplishments with nearly 6,800 criminal and civil actions, more than 18,000 exclusions, and over $21 billion in investigative receivables.
Through his engagement with the Health Care Fraud Prevention and Enforcement Action Team (HEAT), Mr. Cantrell coordinates with the Department of Justice and State law enforcement agencies to prevent fraud in the Medicare and Medicaid programs. In June 2016, this partnership oversaw the largest national health care fraud takedown in history, resulting in charges against 301 individuals for approximately $900 million in false billing