2022 Agenda

Over two days of virtual learning, hear from industry practitioners on timely topics addressing the ever-evolving regulatory updates, best practices to mitigate risk, and strategies to ensure successful audit outcomes.

Tuesday - October 11, 2022

10:00 AM 10:10 AM

9:00 AM 9:10 AM

8:00 AM 8:10 AM

7:00 AM 7:10 AM

Welcome and Chairperson’s Opening Remarks

Ana Handshuh, Principal
CAT5 Strategies

10:10 AM 11:25 AM

9:10 AM 10:25 AM

8:10 AM 9:25 AM

7:10 AM 8:25 AM

Risk Adjustment Litigation and Risk Areas for MA Plans, Vendors and Downstream Entities

  • Examine the current state of risk adjustment litigation and learnings from recent audit activity
  • Assess risk areas and liability under the false claims act with insights into where the government is pursuing litigation related to chart reviews, physician incentives and home health risk assessments
  • Gain a better handle on how regulators are pursuing or responding to litigation and how to stay on the right side of the line

Mary Inman, Partner
Constantine Cannon

Edward Baker, Of Counsel
Constantine Cannon

11:25 AM 11:30 AM

10:25 AM 10:30 AM

9:25 AM 9:30 AM

8:25 AM 8:30 AM


11:30 AM 12:10 PM

10:30 AM 11:10 AM

9:30 AM 10:10 AM

8:30 AM 9:10 AM

A Regulatory Retrospective and Outlook: What Happened During COVID

  • Learn how health plans are prepared for a review of services specifically offered during COVID that were not prior reimbursable 
  • Hear the latest regulatory changes on telehealth and assess how to remain compliant and prepared for changes when PHE (Public Health Emergency) ends 
  • Evaluate impact of OIG (Office of Inspector General) report on MA denials and identify critical factors to avoid complications 
  • Discuss upcoming enforcement actions and penalties of No Surprises Act

Ana Handshuh, Principal
CAT5 Strategies

Rafael Gonzalez, Esq., Partner
Cattie & Gonzalez, PLLC

12:10 PM 12:25 PM

11:10 AM 11:25 AM

10:10 AM 10:25 AM

9:10 AM 9:25 AM


12:25 PM 1:05 PM

11:25 AM 12:05 PM

10:25 AM 11:05 AM

9:25 AM 10:05 AM

CMS Audits Review: Part C, Part D, and Dual Eligible Special Needs Plans

  • Gain insights from recently audited health plans and prepare your team for future audits 
  • Evaluate CMS interpretation of requirements by analyzing the primary focus of audit officials to ensure successful outcomes 
  • Identify common pitfalls in program audits and take away how to adjust your compliance program   
  • Learn best practices for audit readiness and ensure a positive outcome during an audit 

Nichole Hageman, Compliance Director
Mutual of Omaha

Isis Pastrana Lopez, VP & Medicare Compliance Officer
Medical Card System, Inc.

Shavonne Wyche-Davis, Director of Compliance
Algnmnt, LLC

1:05 PM 1:35 PM

12:05 PM 12:35 PM

11:05 AM 11:35 AM

10:05 AM 10:35 AM

Lunch Break

1:35 PM 2:15 PM

12:35 PM 1:15 PM

11:35 AM 12:15 PM

10:35 AM 11:15 AM

Lessons Learned from CMS’s Targeted Probe and Educate (TPE) program and Supplemental Medical Review Contractor (SMRC) from Sleep Studies Audits

  • Hear failures and bumps when providing additional documentation on claims selected for medical review of sleep studies  
  • Understand what to look at when addressing an internal investigation that can affect your performance during an audit 
  • Identify key actions to ensure a successful outcome during your next audit

Bianca Nicosia, Coordinator Billing Compliance
Renown Health

Heidi Frey, Coordinator Billing Compliance
Renown Health

Veronica Camargo, RAC Coordinator
Renown Health


2:15 PM 2:20 PM

1:15 PM 1:20 PM

12:15 PM 12:20 PM

11:15 AM 11:20 AM


2:20 PM 3:00 PM

1:20 PM 2:00 PM

12:20 PM 1:00 PM

11:20 AM 12:00 PM

Staying a Step Ahead: Creating and Testing your CMS Audit Universes

  • Identify the best tools to validate your universes 
  • Create a plan to test your universe and avoid errors 
  • Evaluate the need for a CMS playbook that outlines audit areas, timeframes, scope, and stakeholders involved to ensure collaboration and activates a sense of urgency  

Tracy Jones, Senior Compliance Coordinator

Angela Lloyd, Director, Medicare Audit & Corrective Action
Health Partners Plans

Gabe Viola, SVP

Julie Mason, President
Integritas Medicare


3:00 PM 3:05 PM

2:00 PM 2:05 PM

1:00 PM 1:05 PM

12:00 PM 12:05 PM


3:05 PM 3:45 PM

2:05 PM 2:45 PM

1:05 PM 1:45 PM

12:05 PM 12:45 PM

Effective Vendor Oversight Strategies

  • Identify critical factors in a contract to ensure appropriate oversight over delegated vendors 
  • Evaluate pros and cons of including pre-delegation audits and discuss actions when they are non-compliance 
  • Analyze corrective action plan processes to avoid future costly complications  

JoAnn McDaniel-Chinn, Medicaid Compliance Officer
Simply Healthcare Plans

Mark Dwinnells, Compliance Manager
Commonwealth Care Alliance

Isabella Howells, Internal Compliance Monitoring Analyst
Commonwealth Care Alliance

3:45 PM 4:00 PM

2:45 PM 3:00 PM

1:45 PM 2:00 PM

12:45 PM 1:00 PM

Closing Remarks

Ana Handshuh, Principal
CAT5 Strategies

Wednesday - October 12, 2022

10:00 AM 10:15 AM

9:00 AM 9:15 AM

8:00 AM 8:15 AM

7:00 AM 7:15 AM

Welcome Remarks and Day One Takeaways

Ana Handshuh, Principal

CAT5 Strategies

10:15 AM 11:00 AM

9:15 AM 10:00 AM

8:15 AM 9:00 AM

7:15 AM 8:00 AM

Special Presentation: Health Care Regulatory Scrutiny and Enforcement Risk

  • Evaluate how the recent increase in government enforcement of risk adjustment coding issues by the Office of the Inspector General (OIG) and the Department of Justice (DOJ) would affect your compliance program
  • Hear latest updates regarding DOJ steps to battle Medicare Advantage fraud through the False Claims Act (FCA) following whistleblower cases
  • Understand how upcoming CMS regulation implementing extrapolation methodology would affect future audits

Jesse A. Witten, Partner
Faegre Drinker Biddle & Reath LLP

11:00 AM 11:05 AM

10:00 AM 10:05 AM

9:00 AM 9:05 AM

8:00 AM 8:05 AM


11:05 AM 11:50 AM

10:05 AM 10:50 AM

9:05 AM 9:50 AM

8:05 AM 8:50 AM

Too Easy to Risk it: Have You Reviewed your Provider Directory?


  • Evaluate how the sanction screening process has speed up provider directories accuracy  
  • Understand the important balance of online monitoring protection and providing director accuracy for members 
  • Compare best practices and success strategies that health plans are using for provider directory accuracy 
  • Evaluate including telehealth providers  

Deborah Marine, Former Compliance Officer
Summa Care

Beth Socoski, Medicare Compliance Director
Longevity Health Plan

11:50 AM 12:05 PM

10:50 AM 11:05 AM

9:50 AM 10:05 AM

8:50 AM 9:05 AM


12:05 PM 12:50 PM

11:05 AM 11:50 AM

10:05 AM 10:50 AM

9:05 AM 9:50 AM

CMS New Marketing Guidelines: A summarized version?

  • Gain a better understanding of the latest changes in the Medicare Communications and Marketing Guidelines 
  • Prepare a toolkit with do’s and don’ts that educate your organization and vendors to ensure all your communications are compliant 
  • Learn best practices while working with providers to promote your health plan 

Deborah Marine, Former Compliance Officer
Summa Care

Ana Handshuh, Principal
CAT5 Strategies



12:50 PM 1:20 PM

11:50 AM 12:20 PM

10:50 AM 11:20 AM

9:50 AM 10:20 AM

Lunch Break

1:20 PM 2:05 PM

12:20 PM 1:05 PM

11:20 AM 12:05 PM

10:20 AM 11:05 AM

Panel Discussion: Women in Compliance: The Unseen Barriers



  • Discuss key strategies to move up in the compliance industry 
  • Hear what actions are needed to bridge the gender pay gap  
  • Identify common experiences where women's willingness to talk openly and take risks helps them to gain visibility at the to

Ana Handshuh, Principal
CAT5 Strategies

Nichole Hageman, Compliance Director
Mutual of Omaha

JoAnn McDaniel-Chinn, Medicaid Compliance Officer
Simply Healthcare Plans 

Deborah Marine, Former Compliance Officer
Summa Care

2:05 PM 2:10 PM

1:05 PM 1:10 PM

12:05 PM 12:10 PM

11:05 AM 11:10 AM


2:10 PM 2:55 PM

1:10 PM 1:55 PM

12:10 PM 12:55 PM

11:10 AM 11:55 AM

Compliance Programs in a Hybrid Work Environment

  • Learn best practices to protect PHI (Protected Health Information) when your team switches from work from office to remote work 
  • Create and implement new approaches to ensure an efficient transfer of knowledge and education in a hybrid work environment 
  • Conceptualize the roles and responsibilities between your compliance, your product, and your teams, and how you can navigate the continuously changing landscape 

Angela Keenan, Compliance Officer
Network Health

Jordan Muhlestein, Compliance & Ethics Director
Intermountain Healthcare


2:55 PM 3:10 PM

1:55 PM 2:10 PM

12:55 PM 1:10 PM

11:55 AM 12:10 PM


3:10 PM 3:55 PM

2:10 PM 2:55 PM

1:10 PM 1:55 PM

12:10 PM 12:55 PM

Case Studies: Compliance Programs Best Practices

  • Examine how a thumb drive missing triggered a full review and change of a compliance program 
  • Evaluate how an engaged relationship with top management was strategic to implement new changes in a health plan 
  • Assess how your response to non-compliant incidents could mitigate regulators response 
  • Hear how a Compliance Championship involving all functional areas brings visibility and builds a compliance culture in the organization 

Brian Colonna, Director of Compliance Program
Renown Health

Sarah Simmerson, Consultant, Business Support
Florida Blue

12:00 AM 12:00 AM

12:00 AM 12:00 AM

12:00 AM 12:00 AM

12:00 AM 12:00 AM


4:00 PM 4:45 PM

3:00 PM 3:45 PM

2:00 PM 2:45 PM

1:00 PM 1:45 PM

Perfect Score Program Audit Results: Audit Experiences from an Employer Group Waiver Plan (EGWP)

  • Hear the journey from a health plan that scored a perfect result after a program audit and take away lessons to apply in your organization 
  • Understand the need of an audit playbook that guides your team during a CMS audit process 
  • Evaluate the key factors you can control before, during and after and audit that ensures you a perfect outcome 

Michelle Juhanson, Vice President, Chief of Staff II
Magellan Rx

Todd Boyer, Director, Clinical Pharmacy Operations, Medicare Part D
Magellan Rx

4:45 PM 5:00 PM

3:45 PM 4:00 PM

2:45 PM 3:00 PM

1:45 PM 2:00 PM

Closing Remarks

Ana Handshuh, Principal
CAT5 Strategies

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