Webinar - 2017 Legislative Changes: Medicaid Provider Overpayment Audits & Active State Supervision of Professional Licensing Boards
-Approved for 1.0 Montana CLE Credit
What will you learn?
Medicaid provider groups supported legislation in the 2015 Montana Legislature to establish reasonable protections for providers subjected to Medicaid overpayment audits. Despite DPHHS opposition, the 2015 Legislature passed House Bill 237 but Governor Bullock vetoed the bill. Providers brought the issue back to the Legislature in the 2017 session, resulting in the enactment of Senate Bill 82, which was signed into law by the Governor. This presentation will cover the background, history and content of Senate Bill 82, and provide suggestions for representation of providers involved in such audits.
In addition, the presenters will summarize the United States Supreme Court decision in North Carolina State Board of Dental Examiners v. the Federal Trade Commission and discuss the background and content of the 2017 Legislature’s House Bill 141, which established a system of active state supervision of potentially anticompetitive actions by professional licensing boards. The presenters will discuss the Montana Department of Labor’s first active supervision process under HB 141.
Who are the Speakers?
Greg Gould is an attorney in private practice with the Helena firm Luxan & Murfitt, PLLP. Greg earned his law degree from the University of Montana in 1983. He has broad legal experience representing individuals, government agencies and businesses, including health care providers, lenders and health insurers. Greg has 11 years of experience as in-house counsel at Montana’s state Medicaid agency, 6 years of experience as in-house counsel for Montana’s largest health insurer, and over 15 years in private practice. His areas of practice include health care, housing finance, government and administrative law, insurance, real property, business and commercial law and litigation.
On behalf of the Montana Dental Association, Greg initially drafted and lobbied for the adoption of Senate Bill 82, establishing standards and requirements for Medicaid provider audits, in the 2017 Montana Legislature, and for the bill’s predecessor, House Bill 237, in the 2015 session. Greg was also involved in the drafting of House Bill 141, enacted by the 2017 Montana Legislature to establish a process for active state supervision of potentially anticompetitive actions by professional licensing boards.
Dave Hemion was appointed Executive Director of the Montana Dental Association, the professional organization for 650 Montana dentists, in 2011. He previously served as MDA’s ED from 1996 to 2000, and was then appointed Assistant Executive Director for the Washington State Dental Association through 2011.
Since 2011, Dave has managed bills in the Montana Legislature to protect dentists from unfair third-party practices, establish reasonable and fair audits of Medicaid providers by the Department of Public Health and Human Services, establish expanded functions for dental hygienists and dental assistants, and require third-party payment for services provided by teledentistry. He has also been closely involved in legislation establishing active supervision of licensing boards to provide immunity from litigation, a necessity to comply with the U.S. Supreme Court’s restraint of trade ruling.
In 1998 Dave led development of the initial proposal for the dental hygiene program at Great Falls College and established the Montana Oral Health Foundation in 1999 to raise funds from dentists and others to launch the program. Dave developed and successfully managed legislation in Washington to create authority for expanded function dental assistants (EFDA) and led a work group of dentists, educators, regulators, and auxiliaries to launch EFDA programs in Seattle, Olympia and Spokane.
He has held positions as chief executive of chambers of commerce in Helena and San Antonio, Texas and has been a contract lobbyist and public affairs consultant. Dave has served on numerous professional, charitable and government agency boards. He earned a Masters of Public Administration from the University of Montana and a Bachelors of Science - Radio Television Film from The University of Texas. His spouse Susan Hemion is a psychiatric nurse practitioner and they have two adult sons and two grandsons.
Registration & Pricing - $55.00
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