Health Care Compliance Online Graduate Certificate Program Courses and Seminars

Below is an in-depth overview of the courses and seminars in the Health Care Compliance (HCC) Online graduate certificate program. Students apply to the program online at Pitt Online.

Introduction to the Legal System for Health Care and Compliance
(3 credits) | Professor Mary Crossley

Good compliance decision-making depends on a clear understanding of the legal framework that regulates the health care industry. This course will explore aspects of tort, contract, corporate, and administrative law against a backdrop of the business of health care and compliance needs. For example, students will learn fundamental tort concepts while discussing malpractice issues and will learn basic concepts of corporate law while examining shifting alliances in the health care market. Students will also gain an understanding of administrative law by examining the authority of federal regulators and their influence on how health care is delivered.

Legal Aspects of Health Care Compliance (3 credits)
| Professor Tina Hershey

This course will examine the substantive law that generates most compliance risk issues against a backdrop of recent enforcement actions. It will cover the compliance program elements, fraud and abuse laws (the False Claims Act, the Anti-Kickback Statute, Stark), conditions of participation, coding and billing, documentation, medical necessity, cost reports, internal investigations, the attorney client privilege, CMS/State Medicaid contractors, HIPAA/HITECH privacy & security, and OIG guidances.

Professional Judgment and Ethics, the Canvas of Compliance (3 credits)
| Professor David Schweighoefer

Health care organizations can face a broad array of ethical issues and often the chief compliance officer is called on to publicize and monitor the organization’s code of ethics, vision, and values, as well as oversee the training of employees. In health care compliance, ethical issues can be especially challenging. Health care organizations are also businesses and the tension between business decisions and health decisions creates many of the topics we will discuss in this ethics course. This course will cover organizational ethics, mission and values, professional judgment, core values and managing conflict, and health care ethics and business decisions.

Effective Compliance Program Development and Skills (3 credits)
| Professor Barbara Vimont

This course focuses on the fundamentals required to develop and maintain an effective compliance program. Students will study the seven elements of a successful compliance program in practical detail and will learn best practices for compliance programs. Specifically, this will include learning how best to design and implement compliance oversight and committees, practicing policy drafting, and exploring the most effective ways to educate and train and compliance. This will also include developing an excellent understanding of audit, investigation, and corrective action skills and strategies.  

Selected Aspects in Compliance (3 credits) | Mary Nell Cummings 

Students will select four subject matter seminars to customize their substantive focus. Learning assessments taken in the four seminars will make up 80 percent of a student’s grade in this course. At the end of the eight weeks each student will submit a written project to demonstrate application of the substantive content of his or her individually tailored course. The grade on this final project will constitute 20 percent of the student’s grade for the course.

Operationally, students will select any four seminars they wish.  For example, they could take Hospitals and Providers, Compliance for Insurers, Privacy, and Health Care Quality, and have a regular class work load over the eight weeks. Or they could select Compliance for Insurers, Privacy, Advanced Privacy, and Research and have no work in the first two weeks, and double course work in weeks five and six.

Weeks 1-2

Weeks 3-4

Weeks 5-6

Weeks 7-8

Hospitals and providers

Advanced Hospitals and Providers

Privacy

Advanced Privacy

Life Sciences

Compliance for Insurers

Compliance in research

Health Care Quality

Subject matter industry experts, will teach the seminars with coordination by one instructor responsible for the overall course. These seminars will offer an in depth look at each subject covered.

Seminar Descriptions

  • Hospitals and Providers (Instructor: Faccenda): This seminar will provide an overview of the compliance function in a hospital as well as in a large provider’s office. It will look at challenges and best practices in implementing and measuring compliance with Medicare conditions of participation and payment, survey and certification requirements, HIPAA, Stark, anti-kickback, professional relations, coding obligations and guidelines, and quality.
  • Advanced Hospitals and Providers (Instructor: Faccenda): This seminar will build on the Hospitals and Providers seminar and look at real world examples of federal enforcement activities, what went wrong in the compliance program implementation and how things could have been done differently. It will also address topics such as managing internal and governmental investigations and managing up, dealing with business leaders, CEOs, and politically sensitive situations.
  • Privacy (Instructor: Maruca): The focus of this seminar will be the privacy and security provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Environmental and Clinical Health (HITECH). Students will obtain a full understanding of what it means for a health care organization to be HIPAA compliant, how to monitor and measure HIPAA/HITECH compliance, how to develop effective compliance programs, training, risk assessment, and how best to utilize a privacy officer and a privacy and security infrastructure to minimize risk and ensure full HIPAA compliance across a complex organization.
  • Advanced Privacy (Instructor: Maruca): This seminar will examine the interplay between HIPAA and other federal and state health privacy laws and the application and enforcement of those laws in a variety of health care settings. The class will address differences in state and federal law. The class will also address detection, analysis and responses to unauthorized disclosures, security incidents and HIPAA breaches.  This class will look beyond HIPAA at technology and innovation, at the requirements for electronic health record certifications, and the challenges to a goal of portable health records.
  • Health Care Quality (Instructor: Lloyd): This seminar will provide an overview of the key components and importance of quality, while incorporating techniques to continuously improve and transform a healthcare system. Students will explore critical quality issues at the organizational and microsystem levels, and detail current strategies, tactics, and methods for understanding quality. The class will discuss foundational healthcare quality principles, and look at practical tools necessary for measuring quality, improving healthcare performance, and promoting transparency of clinical pathways and outcomes.
  • Compliance in Research (Instructor: Odwazny): This seminar will address the fundamental ethical issues that are the driving force behind research rules and regulations. Students will evaluate how to create effective compliance programs that address issues in basic human subject research, animal research, the responsible use of research results, responsible conduct of research and conflicts of interest.
  • Life Sciences (Instructor: Cummings): This seminar will provide an overview of key sources of law that cover the approval, manufacturing and marketing of prescription drugs and devices. Students will study policies and practices designed to ensure effective compliance with these laws, especially as it relates to safety, efficacy, kickback risks, and off-label marketing.
  • Compliance for Insurers (Instructor: Phillips): This seminar will examine the key compliance issues  health insurers face in connection with their business models. Students will examine challenges and best practices in implementing and measuring compliance with the Affordable Care Act and other federal and state requirements, understanding and preparing for government program compliance audits, and other unique obligations of payers in today’s health care environment.

 

Apply now at Pitt Online