Last Year's Agenda

October 29, 2020 

9:00AM – 9:10AM EDT

Welcome & Opening Remarks

Chairperson
David Reid, Senior Director, Operational Performance & Regulatory Support
Florida Blue

9:10AM – 10:00AM EDT

Keynote Panel Discussion: The Evolution of Compliance During the Pandemic and Examine the Future Implications

  • Discuss the impact of COVID-19 on compliance and how the future of compliance is forever changed
  • Examine compliance essentials to proactively build a bullet proof pandemic plan
  • Identify best practices and lessons learned from navigating compliance during the COVID-19 crisis

 

Moderator: 

David Reid, Senior Director, Operational Performance & Regulatory Support 
Florida Blue 

 

Panelists: 

Michelle O’Neill, Vice President, Corporate Compliance & Privacy
Summit Medical Group   

 

Angela M. Lloyd, MPH, CHC, Director, Medicare Audit & Corrective Action
Health Partners Plans

 

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

10:00AM – 10:15AM EDT
Break

10:15AM – 11:00AM EDT

Review and Implications of the 2021 CMS Revised Protocols

  • Assess CMS changes and revised protocols from COVID-19 and how compliance programs have been affected
  • Analyze new trends and potential changes coming for audits, including the recent changes to the ODAG/CDAG guidance
  • Evaluate lessons learned and best practices by health plans post COVID-19

 

Deborah Marine, Compliance Officer
SummaCare

11:00AM – 11:15AM EDT
Break

11:15AM – 12:00PM EDT

Business Continuity: Lessons Learned from COVID-19

  • Analyze how mandatory remote work permanently changed the compliance culture and lessons learned from operationalizing new CMS updates remotely
  • Discuss compliance challenges and best practices of vendor management during the pandemic
  • Learn strategies to safety proof business continuity plans during times of emergency

 

JoAnn McDaniel-Chinn, Medicaid Compliance Officer
Simply Healthcare Plans

12:00PM – 12:30PM EDT
Lunch

12:30PM – 1:15PM EDT

Panel Discussion: The Impact of Lifted Telehealth Restrictions and the Future of Telehealth

  • Examine the impact of lifted telehealth restrictions on privacy and data security and what implementation changes could limit or increase fraud, waste and abuse
  • Discuss the new telehealth accountability and standards post COVID-19 and the impact of a digital divide on vulnerable populations
  • Reflect on best practices and lessons learned from the telehealth restriction changes how it impacts the future of health care delivery

 

Moderator: 

David Reid, Senior Director, Operational Performance & Regulatory Support 
Florida Blue 

 

Panelists:  

Michelle O’Neill, Vice President, Corporate Compliance & Privacy
Summit Medical Group

 

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

 

Jessica Vander Zanden, CHC, Vice President, Compliance and Audit
Network Health Insurance Corporation

1:15PM – 1:30PM EDT
Break

1:30PM – 2:15PM EDT

Master the Audit Preparation Process

  • Understand the shift from one size fits all to personalized customized training models
  • Evaluate mock audits and other programs and tools for successful audit preparation
  • Learn tips and strategies for hosting a successful CMS audit onsite

 

Deborah Marine, Compliance Officer
SummaCare



Angela M. Lloyd, MPH, CHC, Director, Medicare Audit & Corrective Action
Health Partners Plans

2:15PM – 2:30PM EDT
Break

2:30PM – 3:15PM EDT

Effectively Manage a Successful Compliance Workflow

  • Identify tools to develop a quarterly work plan to successfully manage compliance issues
  • Understand the difference between an overall compliance plan compliance work plan and an overall compliance strategy
  • Discover effective strategies to build a successful compliance work plan

 

Jordan B. Muhlestein, Compliance & Ethics Director
Intermountain Healthcare

 

Gina Meili, Director of Compliance
Commonwealth Care Alliance

3:15PM – 3:30PM EDT
Break

3:30PM – 4:15PM EDT

Panel Discussion: Review of FDR Oversight & Effective Strategies to Partner with Delegates

  • Reflect on the essentials of a strong delegation oversight to withstand emergency or pandemic protocols to develop a strategic operational plan and effectively partner with delegates
  • Explore best practices and lessons learned for vendor classification and management during the COVID-19 crisis and throughout the audit process
  • Learn effective FDR risk management plans and identify contractual challenges before problems arise

 

Moderator: 

David Reid, Senior Director, Operational Performance & Regulatory Support  
Florida Blue   

 

Panelists:  

Sarah Simmerson, CIA CRMA, FBM Optimization
Florida Blue  

 

Tracy Jones, Senior Compliance Coordinator
SummaCare

4:15PM – 4:30PM EDT
Break

4:30PM – 5:15PM EDT

Panel Discussion: Improve Your Appeals and Grievances Operations in a Time of Uncertainty

  • Discuss best practices and lessons learned from A&G operations post COVID-19
  • Explore why health plans continue to struggle and develop a game plan to successful managed the increase in expedited appeals
  • Analyze the best way to identify misclassified appeals and best approaches for billing COVID-19 services

 

Deborah Marine, Compliance Officer 
SummaCare 

 

Tracy Jones, Senior Compliance Coordinator 
SummaCare 

 

Melissa Rusk, Director Claims & BPO Operations 
SummaCare 

5:15PM – 5:25PM EDT

Chairperson Closing Remarks

David Reid, Senior Director, Operational Performance & Regulatory Support
Florida Blue

October 30, 2020

9:00AM – 9:45AM EDT

Let's Talk: An Interactive Session with Compliance Professionals

Grab a coffee, turn on your video camera and join other compliance experts to kick off day two with an engaging discussion about operational issues that can cause access to care challenges for members. 

 

Separate registration required. Participation included in conference fee.  

 

Moderators: 

David Reid, Senior Director, Operational Performance & Regulatory Support  
Florida Blue   
 
Michelle O’Neill, Vice President, Corporate Compliance & Privacy  
Summit Medical Group 

 

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

 

Deborah Marine, Compliance Officer 
SummaCare 

 

9:45AM – 10:00AM EDT
Break

10:00AM – 10:10AM EDT

Welcome Remarks and Day One Takeaways

Chairperson


David Reid, Senior Director, Operational Performance & Regulatory Support
Florida Blue

10:10AM – 10:55AM EDT

Understand the Fundamentals of the Evolving 42 CFR Part 2

  • Review the fundamentals of the Part 2 rule and the impact on compliance
  • Gain clarity and understand why it is important that Part 2 aligns with HIPAA standards
  • Discuss the implications and impact of 42 CFR Part 2 post COVID-19

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

10:55AM – 11:10AM EDT
Break

11:10AM – 11:55AM EDT

A Closer Look at Provider Director Accuracy Using the NPPES

  • Evaluate compliance challenges and concerns with the NPPES as CMS’s proposed single source of truth solution
  • 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 director accuracy

 

Moderator: 
David Reid, Senior Director, Operational Performance & Regulatory Support  
Florida Blue   

 

Panelists:  

Sarah Ernst, Lead – Enterprise Integration 

Florida Blue

 

Tracy Jones, Senior Compliance Coordinator
SummaCare

 

11:55AM – 12:30PM EDT
Lunch

12:30PM – 1:15PM EDT

Build an Effective Compliance Tool Kit

  • Learn which audit tools are the most effective to ensure compliance success
  • Discover new “must have” tools that emerged during the COVID-19 crisis
  • Gain insights from compliance professionals on success tips and strategies

 

JoAnn McDaniel-Chinn, Medicaid Compliance Officer
Simply Healthcare Plans

1:15PM – 1:30PM EDT
Break

1:30PM – 2:15PM EDT

Managed Care Fraud, Waste and Abuse in a Time of Disaster Recovery

  • Examine how special investigation units managed fraud investigations during the pandemic
  • Discuss lessons learned from increased fraud during the pandemic
  • Learn new strategies and best practices to combat Fraud, Waste and Abuse post COVID-19

 

Melissa Rusk, Director Claims & BPO Operations
SummaCare

2:15PM – 2:30PM EDT
Break

2:30PM – 3:15PM EDT

Best Practices for Efficient Data Utilization

  • Explore best practices to evaluate and validate data and improve accuracy
  • Discuss lessons learned from data collection and management during the COVID-19 crisis
  • Identify effective compliance metrics and discuss effective implementation strategies

 

Jordan B. Muhlestein, Compliance & Ethics Director
Intermountain Healthcare

 

Melissa Rusk, Director Claims & BPO Operations
SummaCare

3:15PM – 3:25PM EDT

Chairperson’s Closing Remarks

David Reid, Senior Director, Operational Performance & Regulatory Support
Florida Blue