Dr. Brady consulted with organizations in California, Southeast Asia & China. She has improved relations between business functions by analyzing the challenges effected by communication & business processes. Specializing in organizational development, strategic management & human resource strategies including stakeholder buy-in between constituents. In addition, Dr. Brady has taught at the graduate level in the United States & Asia with an emphasis on strategic planning & organizational development. To reflect the current & future state of organizational successes, she has continued research in recognizing paths to broader goals which requires flexibility in “how we do things around here’—cultural changes.
Osato F. Chitou, Esq., MPH
NMOC Healthcare Compliance Consulting, LLC d/b/a Compli by Osato
NMOC Healthcare Compliance Consulting, LLC d/b/a Compli by Osato
Osato F. Chitou, Esq., MPH is an attorney by training, however, prior to finding the law and compliance was both an educator and a social worker. These experiences have allowed her to bring incredibly complex topics into easy to understand form, for a variety of audiences. Ms. Chitou is also an aspiring stand-up comic, as Ms. Chitou is a firm believer that laughter is critical for survival. Ms. Chitou is the Founder and Principal Consultant of Compli by Osato, which provides legal and compliance advisory services to Payors and Providers in receipt of government healthcare funds. She is also the Founder of Omuwa Luxe - a wellness brand catering to the needs of Women of the African Diaspora. Ms. Chitou received her Bachelors in Biological Anthropology from Boston University, her Masters in Public Health from the University of North Carolina-Greensboro, and her Juris Doctor from Rutgers School of Law- Newark. Ms. Chitou is licensed to practice Law in New York, New Jersey, and the Supreme Court of the United States.
Laurie serves as the Vice President of Appeals & Grievances at Beacon Healthcare Systems. With more than 20 years of experience overseeing Medicare appeals and grievances for two of the nation’s largest and most highly respected health plans, she currently provides oversight of the company’s highly acclaimed Beacon’s Appeals Manager (BAM), the industry’s most intuitive and easy-to-use appeal and grievance tool.
Amy has worked in the Medicare Advantage industry since 2009. Over the course of her career Amy has helped several startup MA Plans stand up and manage departments such as, A&G, Compliance, Enrollment & Premium Billing, Sales & Marketing and Member Services. This includes development of technology platforms, creation of policies and procedures and training staff on day-to-day operations. Amy has extensive first-hand experience managing CMS Program Audits, Part C and D Annual Reporting and has successfully guided a Sales & Marketing department through CMS sanctions. Prior to joining CODY, Amy worked for a Medicare Advantage Health Plan where she was responsible for all Health Plan Operations.
Ever since I was little, I knew I wanted to work in Health Care. Now, with 16 years’ experience working in everything from Hospital Utilization Departments to the Bay Area’s top Level 1 trauma center. After I had my second child, I learned he had a hearing loss in his left ear. My desire to understand all aspects of hearing and how the brain processes sound into speech, grew by the minute. I decided to switch gears from Plastic Surgery and spent 7 years working with Hearing Aids and Sound Engineering. Perfecting formulas to allow even the most challenging hearing loss patients, be able to walk out of the office hearing whispers from across the room. For the past 4 years, I took lead on processing Appeals & Grievances at Brown & Toland Physicians. Gathering data that was appropriate for our reporting needs was imperative in finding where education might be needed. I am obsessed with clinical data and modernizing workflows to be more efficient. I am a mother of 2 and between kids, sports, our dog named Dino and work, I enjoy crafts, painting, gardening, learning, and implementing what I have learned into my day-to-day life.
Mark Dwinnells, CHC, has over a decade of experience in the operation of Part C, Part D, Medicaid, and other health insurance plans. He is one of two Compliance Managers for Health Plan Compliance at Commonwealth Care Alliance, Inc., with over 5 years compliance experience in CCA's dual eligible plans. Mark in the Health Plan Compliance role has overseen CCA through its expansion from Massachusetts to include Rhode Island, California, Michigan, and soon to be launch in Indiana, with lines of business including MAPD, D-SNP, FIDESNP, and an MMP plan. He has expertise in oversight of FDRs and Medicaid Material Subcontractors, while also building out systems, processes, and documentation to carry out effective Medicare and Medicaid Compliance activities.
A serial entrepreneur and senior leader with 20+ years as an operations, compliance and technology expert, Craig has designed best-in-class practices for health plans. Working alongside the best development team in the industry, he developed, and launched the top CRM and A&G compliance solutions for the payer market.
Ana Handshuh, Principal at CAT5 Strategies, is a government programs executive with expertise in creating and implementing corporate programs for the healthcare industry. Her background includes Quality, Core Measures, Care Management, Benefit Design and Bid Submission, Accreditation, Regulatory Compliance, Revenue Management, Communications, Community-based Care Management Programs and Technology Integration. Ms. Handshuh currently serves on the Board of the Resource Initiative and Society for Education (RISE), the preeminent national professional association dedicated to managed and accountable care financing and delivery. She is a sought after speaker on the national healthcare circuit in the areas of Quality, Star Ratings, Care Management, Member and Provider Engagement, and Revenue Management. Her recent consultancy roles have included assisting organizations create programs to address the unmet care management needs in the highest risk strata of membership, document their processes and procedures, achieve accreditation status, design and submit government program bids, institute corporate-wide programs and create communications strategies and materials. She possesses sophisticated business acumen with the ability to build consensus with cross-functional groups to accomplish corporate goals. Ms. Handshuh served as the Vice President of Managed Care Services at Central Florida Inpatient Medicine (CFIM). In this role, she provided leadership and strategy on CFIM projects and collaborations with physicians, risk entities, hospital health care systems, and health plans. CFIM is the largest Hospitalist group in Central Florida, with 70 providers discharging over 50,000 patients annually from multiple hospitals across two health care delivery systems and 24 skilled nursing facilities. At CFIM Ms. Handshuh previously served as the Vice President of Operations. Prior to those assignments, she worked with Precision Healthcare Systems as their Vice President of Quality Improvement. In that capacity, she led the IPA’s Quality efforts and collaborated with payers on implementing programs to move the needle on Quality and Star Rating initiatives. Ms. Handshuh also served as the Director of Corporate Program Development at Physicians United Plan. In this role, she led the Quality Management and Corporate Communications departments and spearheaded the development of innovative integrated technology solutions to drive business excellence and Star Rating achievement initiatives. For the past fifteen years Ms. Handshuh has taken an active role in redefining and implementing changes that have led to improvements and greater efficiency within Government programs and healthcare delivery. Prior to joining Physicians United Plan Ms. Handshuh was the founder of I-Six Creative. Under Ms. Handshuh’s vision and leadership, I-Six Creative provided expertise in the areas of managed Medicare benefit design, MSO/IPA operations, provider network strategy, new market launches, technology integration, corporate communications and quality improvement.
Director II, Government Business Division Grievances and Appeals
Tracy is a Senior Compliance Coordinator at SummaCare Health Plan, where she has worked for the past 20 years. Tracy specializes in the development and creation of compliance tools to better assist in the over-sight of the Compliance program. A strong believer in the power of curiosity in the workplace, Tracy campaigns to assists employees with the art of questioning and leadership influence skills.
Dr. Legut has extensive experience as an Organizational Consultant providing leadership development, change management and strategic planning at Gap Inc, Humana and Northwestern Mutual Financial Services. In his current role at LeaderImage.com, he provides leadership development coaching to seasoned and emerging leaders. The post-pandemic work environment has presented many challenges to management and employees, and he has focused his practice to support leaders who must now manage the post-pandemic changes and lead within more formalized hybrid and remote work environments.
Deborah joined SummaCare as the Medicare Compliance Officer in January 2015, and became the Chief Compliance Officer for the insurance arm of Summa Health (SummaCare and Summa Insurance Company) later that year. She is responsible for the health plan compliance program, encompassing all lines of business with an emphasis on Medicare Advantage, Part D, and Marketplace products. Deborah became the health plan Privacy Officer in 2017.
Prior to joining SummaCare, Deborah served as the Compliance & Privacy Officer for Health Alliance Plan in Detroit, Michigan for 12 years. She was in-house counsel, focusing on regulatory compliance, for Univera Healthcare in Buffalo, NY from 1996 to July 2002.
Qualifications and Credentials
Deborah earned a law degree from Case Western Reserve University in Cleveland Ohio in 1995 and is licensed to practice in Ohio (inactive status), New York (retired status), and Michigan (active status). She received her certification in healthcare compliance (CHC) in 2009.
JoAnn has more than 10 years of experience in healthcare and human services. Prior to joining Community Care Plan, JoAnn served as Corporate Compliance and Privacy Administrator for MDLIVE, as well as Corporate Compliance Manager for MDLIVE, based in Sunrise, FL, and Corporate Compliance Analyst for Gateway Health Plan, in Pittsburgh, PA. JoAnn received her Master of Science in Criminal Justice Administration and her Bachelor of Science in Criminal Justice from Point Park University. JoAnn is a member of the Healthcare Compliance Association. She has demonstrated her commitment as a volunteer for South Florida Cares Mentoring Movement for Broward Public Schools.
Dana Renicker Senior Medicare Education Specialist
Dana is the Senior Medicare Education Specialist at SummaCare. Her responsibilities include development and facilitation of new employee and annual Compliance training as well as development of tools to assist SummaCare’s front line staff to better serve their members. Participating in triage of Grievance and Appeals cases and monthly monitoring of Call Center logs provides Dana with real life examples for proper categorization and documentation of member issues used in staff training.
Dana earned her certification in health care compliance (CHC) in 2016.
Melissa Rusk, CLSSBB, CPC Director Claims and BPO Operations
Melissa Rusk CLSSBB, CPC is the Director Claims and BPO Operations at SummaCare in Akron Ohio. In this role, Melissa is responsible for leading Claims, Claims Recovery, and Document Management Services. She leads and oversees multiple internal efforts to ensure compliance with federal and state regulatory requirements and plan performance guarantees. This includes: Fraud Waste and Abuse, FDR management, payment integrity, implementation of new plans and plan changes, weekly and monthly performance monitoring, system upgrades and new system implementation, encounter submissions, and plan audits. She oversees business decisions associated with coverage and payment policies.
Melissa has over 30 years’ experience working within the insurance industry in customer service, compliance and operations.
She is a Lean Six Sigma Black Belt and is certified in Lean by the University of Akron and earned her CPC designation in November 2020.
Catlin Scheppler MBA, BSN, RN
Manager, Business Operations Recovery Audit and Appeals Department
Catlin Scheppler MBA, BSN, RN Manager, Business Operations Recovery Audit and Appeals Department
Catlin Scheppler is the Business Operations Manager for the Recovery Audit and Appeal Department at Ascension Wisconsin. She began her career as a registered nurse in the Operating Room and later in the Emergency Department. Recognizing her growing passion for the business aspect of healthcare, Catlin changed gears and joined the newly created Recovery Audit and Appeal Department at Ministry Health Care in 2010. Catlin obtained her Masters in Business degree from Viterbo University in 2016 and took a leadership role within the Recovery Audit Department. She became the Business Operations Manager for the newly-formed state audit and appeal team in 2017. The formation of Ascension Wisconsin Recovery Audit Department brought together three denial management teams: Wheaton Franciscan, Columbia Saint Mary's and Affinity Health Care. The Ascension Wisconsin Recovery Audit Department is comprised of four database coordinators and thirteen registered nurses who manage all federal (FFS Medicare/Medicaid) and commercial (Medicare Advantage, Medicaid HMO and Commercial) insurance denials for Ascension Wisconsin. In her leadership role Catlin manages all clinical denial information, reports trends and develops denial management solutions (including regulatory communications and educational materials for providers and senior leadership). Additionally, she participates in system-wide denial reduction initiatives, communicates with senior leadership and relevant clinical departments as well as coding, compliance and quality regarding federal and non-federal audit and denial trends. Catlin is an innovative, respected leader with documented success in appeal strategy and systemic collaboration. She has in-depth knowledge and experience in FFS Medicare/Medicaid regulations, commercial payor policies and strategies as well as organizational compliance practices.
Beth is the Chief Strategy Officer at Socoski Design & Consulting. She has worked in the healthcare industry for over 20 years, focusing on compliance, patient outcomes, quality improvement, and innovation.
Beth believes that we all have the ability to make a difference, and that everyone should. She is the curator and host of TEDxWestshore, the Board Vice President of Tampa Crossroads, the Board Chair of the American Lung Association in Tampa Bay, author of the #1 best-selling book collaboration "Living Kindly", and runs her own small non-profit helping bring awareness to other organizations doing good in the world.
Beth has an MSW from the University of Pittsburgh, an MBA from Waynesburg University, and an MSCL from Duquesne University.
As a senior compliance professional with over 15 years of progressive leadership experience in healthcare management and regulatory compliance, Brenda brings unparalleled expertise to the table and a consultative approach to CMS and state-level regulations that clients deeply value.
Ian Wayton helps health plans utilize technology to transform service delivery.
Having spent five years on the services side of the house, Ian brings his implementation experience and thoughtful approach to problem solving to his role as an account executive on the Kiriworks sales team.
While Ian started his professional career in accounting, he shifted to technology, serving as a sales solution engineer for Hyland Software and as a technical sales engineer for Xerox before joining Kiriworks in 2018.
Ian earned his undergraduate degree in Accounting and his MBA from Baldwin Wallace College.
Ashby Wolfe, MD, MPP, MPH
Regional Chief Medical Officer CMS San Francisco, Denver and Seattle Offices
Ashby Wolfe, MD, MPP, MPH Regional Chief Medical Officer CMS San Francisco, Denver and Seattle Offices
Centers for Medicare & Medicaid Service
Dr. Ashby Wolfe is a board-certified family physician and serves as co-Chief Medical Officer for the Centers for Medicare & Medicaid Services (CMS) offices in Denver, San Francisco and Seattle. Dr. Wolfe has been based at CMS San Francisco since 2015, and now also supports the Denver and Seattle regional locationsin her focus on the implementation of Medicare and Medicaid policy across the Western States and the Pacific Territories (AK, ID, OR, WA, AZ, CA, HI, NV, CO, MT, ND, SD, UT, WY, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands). As a senior medical advisor for CMS programs in the Western United States, she provides clinical expertise to the divisions of Medicare and Medicaid payment policy, quality improvement, survey operations, contracted health plans and serves as the principle liaison with the clinical community.
Dr. Wolfe completed her medical degree at Stony Brook School of Medicine in New York, and her residency training at the UC Davis Medical Center in Sacramento, California. She also holds a Masters of Public Policy and a Masters of Public Health from the University of California, Berkeley. Dr. Wolfe has practiced broad-scope family medicine in academic, integrated and community clinical settings over the course of her career and holds medical licenses in both the State of California and the State of Washington. She holds a particular interest in improving the quality and equity of care for underserved and low-income populations. She has published multiple articles on Medicare and Medicaid policy, and is a contributing author of the public health text, Prevention is Primary (Jossey-Bass).