Sunday, January 29
SESSION |
SPEAKER |
P1: Compliance Program Makeover: From Good to Great
Presentation (2 slides/page) |
Deborah Johnson, Senior Director Compliance and Internal Audit, Peach State Health Plan Nicole Huff, Chief Compliance & Privacy Officer, St. Luke’s University Health Network |
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P2: How to Engage Your Business Partners to Embrace Compliance?
Presentation (2 slides/page) |
Jennifer Del Villar, Director of Medicare Compliance/Medicare Compliance Officer, Cambia Health Solutions
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P3: Going on the Offensive: Managed Care Strategies for Investigating, Combating, and Affirmatively Litigating Against Fraud
Presentation (2 slides/page) |
Jonathan Phillips, Attorney, Gibson, Dunn & Crutcher LLP Benton Curtis, Senior Counsel, Broad and Cassel |
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P4: Simplifying Healthcare Compliance: CareSource’s Experience with Integrated GRC
Presentation (2 slides/page) |
Kurt Lenhart, Vice President of Corporate Compliance, CareSource Margaux Frazee, Director, Corporate Compliance, CareSource Sean Woodson, GRC System Implementation Lead, CareSource |
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P5: Ensuring Your Vendors Are Ready When You Receive an Audit Notice
Presentation (2 slides/page) |
Jaima Binzer, External Audit and Delegated Oversight, DST Health Solutions Mary Menard, Compliance Solutions Executive, DST Health Solutions |
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P6: Connecting with Compliance: Creative Training and Education Methods
No Presentation Available |
Angela Keenan, Manager of Compliance, Network Health Jessica Vander Zanden, Director of Compliance and Culture, Network Health |
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P7: Managing a SIU in a Managed Care World
Presentation (2 slides/page) |
Christopher Horan, Vice President of Corporate Compliance Investigations, WellCare |
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P8: Star Wars: Avoiding the Dark Side — One Plan’s Approach to Legislative/Regulatory Oversight and Implementation
Presentation (2 slides/page) |
Michaela Monaghan, Director, Program Oversight - Government Programs, HCSC |
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Monday, January 30
SESSION |
SPEAKER |
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GENERAL SESSION: False Claims Act Enforcement in the Managed Care Space: Recent Trends and Proactive Compliance Tips
Presentation (2 slides/page) |
Scott Grubman, Partner, Chilivis, Cochran, Larkins & Bever Thomas Clarkson, Assistant U.S. Attorney, U.S. Attorney’s Office, Southern District of Georgia |
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GENERAL SESSION: “I am your Board Member. Please listen to me as to what Compliance education I need in order to serve as an effective Board Member.”
Presentation (2 slides/page) |
Mark Chilson, EVP General Counsel, CareSource Jeffrey McFadden, Partner, Stradley Ronon Stevens & Young, LLP Craig Brown, Board Member, CareSource |
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101: Medical Loss Ratio Audits: We Were Expecting You
Presentation (2 slides/page) |
Steve Bunde, Vice President - Integrity & Compliance and Internal Audit, HealthPartners Stephanie Moscetti, Program Manager - Integrity & Compliance, HealthPartners |
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102: |
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103: Fostering a Culture of Compliance
Presentation (2 slides/page) |
Maggie Perritt, Senior Director, Corporate Compliance: Delegation Oversight, WellCare Health Plans |
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201: Tools and Techniques for Effective Monitoring and Auditing of Sales Agents: Insights from a New Medicare Advantage Plan
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Thomas Wilson, Director Medicare Compliance, CareSource Megan Saunders, Manager, Corporate Compliance, CareSource
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202: Helpful Tips for Value Based Payment (VBP) Compliance Programs
Presentation (2 slides/page) Handout (.docx) |
Greg Radinsky, Vice President and Chief Corporate Compliance Officer, Northwell Health Aaron Lund, Director of Compliance and Privacy Officer, Northwell Health
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203: Mobile Health (mHealth) Applications in a Health Care Environment
Presentation (2 slides/page) |
Brandon Goulter, Facility Compliance Professional, Dignity Health Steven Baruch, Service Area Compliance Director, Dignity Health
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301: Surviving Your Managed Medicaid External Quality Review
Presentation (2 slides/page) |
Beau Colvin, Medicaid and Government Programs Compliance Manager, SelectHealth Greg Newton, Program Manager, Intermountain Healthcare |
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302: Managing the MCO-Provider Relationship: It’s More Than Just PHI
Presentation (2 slides/page) |
Scott Garnick, Transaction Contract Associate Manager, Accenture Polina Blinderman, LCSW, Northwestern Medicine Warren Wright Adolescent Program
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303: Managing Privacy and Security with a Mobile Workforce
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Frank Ruelas, Facility Compliance Professional, St. Joseph’s Hospital and Medical Center/Dignity Health
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401: How Narrow is Too Narrow? Regulators Respond to Narrow Network Health Plans
Presentation (2 slides/page) |
Michael Adelberg, Senior Director, Faegre Baker Daniels Deborah Schreiber, Network Compliance Officer, UnitedHealthcare Aaron Wesolowski, Senior Research Scientist, Health Care, NORC at the University of Chicago
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402: Mental Health Parity: Ensuring Compliance in the Era of a Rx Drug Abuse Epidemic
Presentation (2 slides/page) |
Kate Woods, Corporate and ACA Compliance Officer, Capital BlueCross Laura Gargiulo, Senior Counsel, Capital BlueCross
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403: Effectively Managing Corrective Actions
Presentation (2 slides/page) |
Jennifer Del Villar, Director of Medicare Compliance/Medicare Compliance Officer, Cambia Health Solutions Deneil Patterson, Director of Compliance, Cambia Health Solutions |
Tuesday, January 31
SESSION |
SPEAKER |
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GENERAL SESSION: CMS Audit Policy, Strategy, and EnforcementPresentation (2 slides/page) |
Vikki Ahern, Medicare Parts C and D Oversight and Enforcement Group, Centers for Medicare & Medicaid Services |
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GENERAL SESSION: What Every Leader Should Know About Compliance Officers and Compliance ProgramsPresentation (2 slides/page) |
Roy Snell, CEO, SCCE/HCCA |
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501: Lessons Learned and Insights Gained from Undergoing a CMS AuditNo presentation available |
Vikki Ahern, Medicare Parts C and D Oversight and Enforcement Group, Centers for Medicare & Medicaid Services Shirley Qual, Compliance Officer, UnitedHealthcare Gail Blacklock, Compliance Officer, Inter Valley Health Plan Michelle Coberly, Manager, Medicare Compliance & Quality,Priority Health
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502: Hospital Owned Health Plans: Tips for Effectively Managing Compliance in a Health Plan and Provider Environment
Presentation (2 slides/page) |
Catie Heindel, Vice President, Strategic Management Services Cathy Bodnar, Chief Compliance and Privacy Officer, Cook County Health & Hospitals System Ryan Lipinski, Compliance Officer, Cook County Health & Hospitals System, CountyCare |
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503: Value Added Compliance Program Effectiveness Review: A Health Plan’s Journey
Presentation (2 slides/page) Handout (.docx) |
Kelly Nueske, Executive Consultant, Pinnacle Healthcare Consulting Carolyn Barton, Carolyn Barton, Chief Compliance & Ethics Officer, Group Health Cooperative |
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601: Surviving a CMS-Mandated Independent Validation Audit (IVA): 150 Days and counting
Presentation (2 slides/page) |
Anne Crawford, Deputy Director, ATTAC Consulting Group Elizabeth Lippincott, Managing Member, Strategic Health Law
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602: Ethical Implications of Bundled Payments and Value Based Purchasing
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David N. Hoffman, Chief Compliance Officer, Physician Affiliate Group of New York, P.C.
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603: Putting It All Together: Integrating Procurement, Risk Management, and Compliance Oversight
Presentation (2 slides/page) |
Dan Roehler, Manager Regulatory Compliance, Blue Cross and Blue Shield of Kansas Christopher English, Regulatory Compliance Analyst, Blue Cross and Blue Shield of Kansas
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701: The Compliance Challenges Inherent in Risk Adjustment’s Continued Evolution and Expansion
Presentation (2 slides/page) |
Richard Lieberman, Chief Data Scientist, Mile High Healthcare Analytics, LLC
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702: Compliance with Managed Care Contracts: You Signed It — Now You Have to Live with It
Presentation (2 slides/page) |
George Eichhorn, General Counsel/Director of Compliance, ChildServe, Inc. |
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703: Root Cause Q&A: Complete and Consistent Resolution of Issues Causing Compliance Concerns
Presentation (2 slides/page) |
Erin Heckethorn, Director of Compliance, FirstCarolinaCare Insurance Company |
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801: Deep Dive on DIR: CMS’ 2017 Focus on Enforcement for One-Third Financial Audits and Your Rebates
Presentation (2 slides/page) |
Derek Frye, Audit & Technology Leader, Burchfield Group Sonya Henderson, Senior Vice President of Corporate Compliance & Government Programs, FirstCare Health Plans
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802: Ethics in the Age of The Affordable Care Act and SEPs
Presentation (2 slides/page) |
Kate Woods, Corporate and ACA Compliance Officer, Capital BlueCross Ras Sowers, Director, IT Audit and ERM, Capital BlueCross |