In addition to a special presentation by Inspector General Christi A. Grimm, RISE National attendees will hear from Office of Inspector General (OIG) representatives about their current priorities in the managed care space.

RISE National 2023 attendees will have the opportunity to hear two presentations from OIG to learn the office’s vision for its oversight of Medicare Advantage plans as well as details about recent and future audit activity.

As previously announced, Grimm, the sixth inspector general of the U.S. Department of Health and Human Services (HHS), will take the main stage at 9:15 a.m. Tuesday, March 7, the first day of the main conference. She will provide an overview of OIG’s approach to understanding risks and opportunities associated with managed care and how that informs OIG’s oversight and enforcement associated with Medicare Advantage.  Grimm will also explain the importance of coordination between OIG and plans on key issues like combatting health care fraud, waste, and abuse. 

Later that morning at 11:15, three OIG representatives will offer a deep dive into risk adjustment data validation audits, denials of payments and services, and new work regarding health disparities.

RISE National 2023

The 2023 update from the OIG will take place as part of the compliance and regulatory updates track. Ana Handshuh, principal of Cat 5 Strategies and chair of the RISE Association’s Quality and Revenue Community, will moderate the discussion. Panelists (pictured below left to right) include the OIG’s Megan H. Tinker, chief of staff; Blaine Collins, regional inspector general; and Jacqualine Reid, social science research analyst, who both work for the Office of Evaluation and Inspections.






Handshuh (pictured right) considers the panel discussion one of the most important sessions of the conference. “They are going to be talking about an increased amount of audit activity and the breadth of the audit activity,” she said. “They appear to be broadening their scope of what they are looking at to include potential health disparities, prior authorization, and focusing on ensuring appropriate beneficiary care and the appropriate use of program funds.”

Attendees will leave the session armed with information on the highest areas of risk. “The takeaways are attendees can go back to their plans and say, ‘here are the areas of most risk the OIG has identified—let’s look under the hood of our own plans, determine if we have opportunities and figure out how to improve our own internal oversight processes to mitigate any risk within our own organization’,” Handshuh said. 

Don’t miss your chance to hear from OIG directly. RISE National 2023 will take place March 7-8, with preconference workshops on March 6, at The Broadmoor Resort, Colorado Springs. Click here to see the full agenda, roster of speakers, and how to register.