Last Year's Agenda

Thursday - October 28, 2021

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 and Chairperson’s Opening Remarks

John Tanner, Chief Compliance Officer
Beacon Healthcare Systems

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

CMS Audit Shakeup Part 1: Tackle the Enormity of Medicare Advantage and Part D Program Audit Changes to Protocols

• Dive into CY 2022 protocols for Medicare Advantage and Part D program audits to understand what new programming and workflows are needed
• Review an in-depth analysis of the changes from current protocols to better understand what CMS is looking for

Deborah Marine, Compliance Officer
SummaCare

11:00 AM 11:15 AM

10:00 AM 10:15 AM

9:00 AM 9:15 AM

8:00 AM 8:15 AM

Break

11:15 AM 12:00 PM

10:15 AM 11:00 AM

9:15 AM 10:00 AM

8:15 AM 9:00 AM

CMS Audit Shakeup Part 2: Shore up Your Fraud, Waste and Abuse Activities with Integrity Audit Lessons Learned

• Gain insight from plans that went through the CY 2021 Program Integrity Audit to see where your gaps are and how to fill them
• Better prepare your compliance team and ensure reporting mechanisms measure up
• Ensure you have the right proactive activities as well as the right oversight structure in place to prevent and correct potential FWA

Nichole Hageman, Compliance Director
Mutual of Omaha

Ana Handshuh, Principal
CAT5 Strategies

12:00 PM 12:15 PM

11:00 AM 11:15 AM

10:00 AM 10:15 AM

9:00 AM 9:15 AM

Break

12:15 PM 1:00 PM

11:15 AM 12:00 PM

10:15 AM 11:00 AM

9:15 AM 10:00 AM

Get Ahead of the Changes in CMS’ One-Third Financial Audit

• Learn directly from a health plan which underwent a recent One-Third Financial Audit unlike the previous ones they have experienced
• Discover exactly how CMS financial audits have expanded in scope and better prepare your response
• Understand what CMS is looking for, the areas of interest, and the depth, to plan ahead

Jessica Vander Zanden, Vice President, Compliance and Audit
Network Health

1:00 PM 1:15 PM

12:00 PM 12:15 PM

11:00 AM 11:15 AM

10:00 AM 10:15 AM

Break

1:15 PM 2:00 PM

12:15 PM 1:00 PM

11:15 AM 12:00 PM

10:15 AM 11:00 AM

Choose Your Own Adventure Lunch-and-Learn

• The Interoperability and Transparency Rollout: Learn how plans are meeting the challenges of working with vendors and checking-off critical compliance milestones

 Facilitator: Gail Blacklock, Director Compliance/Compliance Officer
Inter Valley Health Plan 

• Top five skills a compliance professional should have and what distinguishes a great professional from a good one

 Facilitators: Sarah Peix, Director, Compliance and Janette Rojas, Compliance Manager
ChenMed

• Creating a universe file for CMS: how to test, what to look for, common problems, and programming logic

 Facilitator: Vanessa Turner, Director, Medicare Compliance
Integra Managed Care

• Information and the Challenges of Compliance with the Cures Act

Facilitator: Michelle O'Neill, Vice President, Corporate Compliance & Privacy
Summit Medical Group of New Jersey

• Offshoring of patient health information and managing stringent attestation requirements

 Facilitator: Joseph Piccolo, Vice President, Corporate Compliance & Ethics, Corporate Compliance and Privacy Officer
Inspira Health Network

• Patient Right of Access under HIPAA

 Facilitator: Beth Socoski, Chief Strategy Officer
Socoski Design & Consulting

 

2:00 PM 2:15 PM

1:00 PM 1:15 PM

12:00 PM 12:15 PM

11:00 AM 11:15 AM

Break

2:15 PM 3:00 PM

1:15 PM 2:00 PM

12:15 PM 1:00 PM

11:15 AM 12:00 PM

Increasing Access to Care for Mental Health and Substance Use Disorder Treatment Amid Unclear Requirements

• Discuss mitigation efforts for the disjointed guidance for compliance with mental health parity requirements and the need for uniformity between state and federal regulators
• Gain clarity and understand why it is important that Part 2 aligns with HIPAA (Health Insurance Portability & Accountability Act) standards
• Understand why eliminating or relaxing the X-waiver is critical to treating opioid addiction

Deepti Loharikar, Director, Regulatory Affairs
Association for Behavior Health and Wellness

3:00 PM 3:15 PM

2:00 PM 2:15 PM

1:00 PM 1:15 PM

12:00 PM 12:15 PM

Break

3:15 PM 4:00 PM

2:15 PM 3:00 PM

1:15 PM 2:00 PM

12:15 PM 1:00 PM

The Changing Landscape for Compliance

• Delve into best practices to manage relationships with a growing list of involved regulators to pivot successfully in the Biden Administration era of expanded scrutiny
• Survey how other health plans are managing HIPAA compliance and related concerns as employees migrate back to the office

Moderator:

Osato Chitou, Principal
NMOC Heathcare Compliance Consulting d/b/a Compli by Osato

Panelists:

Michelle O'Neill, Vice President, Corporate Compliance & Privacy
Summit Medical Group of New Jersey

Joseph Piccolo, Vice President, Corporate Compliance & Ethics, Corporate Compliance and Privacy Officer
Inspira Health Network

Beth Socoski, Chief Strategy Officer
Socoski Design & Consulting

4:00 PM 4:15 PM

3:00 PM 3:15 PM

2:00 PM 2:15 PM

1:00 PM 1:15 PM

Break

4:15 PM 5:00 PM

3:15 PM 4:00 PM

2:15 PM 3:00 PM

1:15 PM 2:00 PM

The Value of AI, Rules, and SMEs for Compliance and Combating FWA

• Understand the framework to leverage congruent use of Artificial Intelligence (AI) and traditional rules-based approach for best outcomes
• Explore the importance of incorporating subject matter experts into your prevention program
• Survey COVID-19 FWA, EEGs, and other case studies and learn why an integrated solution is the most efficient way to combat FWA

Karen Weintraub, Executive Vice President
Healthcare Fraud Shield

5:00 PM 5:05 PM

4:00 PM 4:05 PM

3:00 PM 3:05 PM

2:00 PM 2:05 PM

Chairperson’s Day One Closing Remarks

John Tanner, Chief Compliance Officer
Beacon Healthcare Systems

Ana Handshuh, Principal
CAT5 Strategies

Friday - October 29, 2021

10:00 AM 10:10 AM

9:00 AM 9:10 AM

8:00 AM 8:10 AM

7:00 AM 7:10 AM

Chairperson’s Day Two Opening Remarks

John Tanner, Chief Compliance Officer
Beacon Healthcare Systems

Ana Handshuh, Principal
CAT5 Strategies

10:10 AM 10:55 AM

9:10 AM 9:55 AM

8:10 AM 8:55 AM

7:10 AM 7:55 AM

Creating a Universe File for CMS

• Learn how to test and dive into who to look for
• Explore common problems and programming logic

Vanessa Turner, Director, Medicare Compliance
Integra Managed Care

10:55 AM 11:10 AM

9:55 AM 10:10 AM

8:55 AM 9:10 AM

7:55 AM 8:10 AM

Break

11:10 AM 12:00 PM

10:10 AM 11:00 AM

9:10 AM 10:00 AM

8:10 AM 9:00 AM

Compliance to Accessibility Standards

• Delve into the particulars of Section 508 to ensure compliance to accessibility of government information
• Get clarity on what you truly need to do regarding disabilities, ESL and your grievance process to comply with Affordable Care Act’s Section 1557
• Shore up the two Star measures linked to Medicare marketing guidelines for interpretation and translation and for the hearing impaired
• Discuss best practices for call center monitoring and for your complaints management system, to provide meaningful access for people with disabilities

Osato Chitou, Principal
NMOC Heathcare Compliance Consulting d/b/a Compli by Osato

 

12:00 PM 12:15 PM

11:00 AM 11:15 AM

10:00 AM 10:15 AM

9:00 AM 9:15 AM

Break

12:15 PM 1:00 PM

11:15 AM 12:00 PM

10:15 AM 11:00 AM

9:15 AM 10:00 AM

A Breach in the Hull: Lessons Learned from a Successful Phishing Attack

• Learn about one plan’s approach in responding to a phishing attack resulting in a breach of over 500 individuals
• Hear about lessons learned during and after the investigation along with creative and effective post-breach training and communication strategies
• Review how they handled member communications, disclosures to the media, and related tasks that challenged compliance

Angela Keenan, CHC – Director of Privacy & Compliance
Network Health

1:00 PM 1:15 PM

12:00 PM 12:15 PM

11:00 AM 11:15 AM

10:00 AM 10:15 AM

Break

1:15 PM 2:00 PM

12:15 PM 1:00 PM

11:15 AM 12:00 PM

10:15 AM 11:00 AM

Choose Your Own Adventure Lunch-and-Learn

• The Interoperability and Transparency Rollout: Learn how plans are meeting the challenges of working with vendors and checking-off critical compliance milestones

 Facilitator: Gail Blacklock, Director Compliance/Compliance Officer
Inter Valley Health Plan 

• Top five skills a compliance professional should have and what distinguishes a great professional from a good one

 Facilitators: Sarah Peix, Director, Compliance and Janette Rojas, Compliance Manager
ChenMed

• Creating a universe file for CMS: how to test, what to look for, common problems, and programming logic

 Facilitator: Vanessa Turner, Director, Medicare Compliance
Integra Managed Care

• Information and the Challenges of Compliance with the Cures Act

Facilitator: Michelle O'Neill, Vice President, Corporate Compliance & Privacy
Summit Medical Group of New Jersey

• Offshoring of patient health information and managing stringent attestation requirements

 Facilitator: Joseph Piccolo, Vice President, Corporate Compliance & Ethics, Corporate Compliance and Privacy Officer
Inspira Health Network

• Patient Right of Access under HIPAA

 Facilitator: Beth Socoski, Chief Strategy Officer
Socoski Design & Consulting

 

2:00 PM 2:15 PM

1:00 PM 1:15 PM

12:00 PM 12:15 PM

11:00 AM 11:15 AM

Break

2:15 PM 3:00 PM

1:15 PM 2:00 PM

12:15 PM 1:00 PM

11:15 AM 12:00 PM

Effective Strategies to Partner with Delegates and FDR Oversight Best Practices

• Identify contractual vulnerabilities and effective FDR risk management strategies before problems arise
• Develop a strategic operational plan and effectively partner with delegates to withstand emergency or pandemic protocols
• Explore best practices and lessons learned for vendor classification and management during the COVID-19 crisis and throughout the audit process

Ana Handshuh, Principal
CAT5 Strategies

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

Karen Weintraub, Executive Vice President
Healthcare Fraud Shield

3:00 PM 3:15 PM

2:00 PM 2:15 PM

1:00 PM 1:15 PM

12:00 PM 12:15 PM

Break

3:15 PM 4:15 PM

2:15 PM 3:15 PM

1:15 PM 2:15 PM

12:15 PM 1:15 PM

Save Time and Resources – Program Audit Best Practices for Multi-Plan Organizations

• Brush up on best practices for pre-, during, and post-audit to stay agile and to be in the best position for the next one coming
• Survey organizational structures conducive to accurate of universes and effective mock audits

JoAnn McDaniel-Chinn, Medicaid Compliance Officer
Simply Healthcare Plans

Jennifer Del Villar, Director of Government Programs Compliance and Medicare Compliance Officer
Cambia Health Solutions

4:15 PM 4:20 PM

3:15 PM 3:20 PM

2:15 PM 2:20 PM

1:15 PM 1:20 PM

Chairperson’s Closing Remarks and Conference Concludes

John Tanner, Chief Compliance Officer
Beacon Healthcare Systems

Ana Handshuh, Principal
CAT5 Strategies