2018 Managed Care Compliance Conference
Scottsdale, AZ, United StatesHandouts
SESSION |
SPEAKER |
P1: Reduce Your ACA 1557 Risks by Understanding How Cultural Sensitivity Can Add Value
Presentation (2 slides/page) |
Eric Christensen, Medicare Compliance Consultant, SelectHealth Andrea Share, Compliance Director, Kaiser Permanente |
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P2: Creating an Effective Vendor Management and Oversight Program
Presentation (2 slides/page) |
Kay Mesia, CEO/Chief Compliance Officer, Two International Andre Smith, Director of Vendor Compliance Oversight, Blue Cross Blue Shield of Michigan
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P3: Communicating Effectively with Your Key Stakeholders
Presentation (2 slides/page) |
Steve Bunde, Vice President of Integrity & Compliance and Internal Audit, HealthPartners Laurena Lockner, Senior Manager of Monitoring & Compliance, HealthPartners Cathy Bodnar, Chief Compliance and Privacy Officer, Cook County Health & Hospitals System |
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P4: Independent Auditor Validation Survival Guide: How to Prepare For and Manage Your IAV Vendor and Process — Lessons Learned from the Trenches
No presentation available |
Mitchel Harris, Partner, PricewaterhouseCoopers David Curé, Chief Audit Executive, WellCare Health Plans Renee Treberg, Vice President, Government Programs Compliance, Prime Therapeutics Melissa Koellner, Vice President, Compliance & Risk Management, Healthcare Services, Humana |
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P5: Risk, Ransomware, and Resilience: The Next Generation of Patient Safety
Presentation (2 slides/page) |
Reg Harnish, Chief Executive Officer, GreyCastle Security Sheetal Sood, Senior Executive Corporate Compliance Officer, New York City Health + Hospitals |
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P6: Finding and Fighting Fraud, Waste, and Abuse within Managed Care Programs: Strategies to Develop an Effective and Robust FWA Program within Your Health Plan while Ensuring Compliance with Federal and State Regulations
Presentation (2 slides/page) |
Ryan Lipinski, Compliance Officer, Cook County Health & Hospitals System, CountyCare Lynn O’Dea, Director of Government Programs, Health Care Service Corporation Catie Heindel, Vice President, Strategic Management Services |
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P7: It’s Risky Business: Medicare Risk Adjustment
Presentation (2 slides/page) |
Lauren Haley, Member, Strategic Health Law Dorothy DeAngelis, Managing Director, Navigant |
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P8: MACRA: Not Just for Providers
Presentation (2 slides/page) |
Todd Gower, Advisory Senior Manager, Healthcare & Risk, Ernst & Young Lisa Alfieri, Manager, Risk and Compliance, Ernst and Young |
SESSION |
SPEAKER |
GENERAL SESSION: Ethics and Compliance: Do You Need Both in Order to Operate an Effective Compliance Program? Yes!
Presentation (2 slides/page) |
Mark Chilson, Executive Vice President and General Counsel, CareSource Jeffrey McFadden, Partner, Stradley Ronon Stevens & Young, LLP Courtney Thiele, Instructor, Division of Bioethics, The Ohio State University College of Medicine |
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101: Mental Health Parity: Managing Compliance Across Commercial, Medicaid, and Duals Products
Presentation (2 slides/page) |
Helaine Fingold, Senior Counsel, Epstein Becker Green |
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102: Provider Networks: Renewed Scrutiny on Adequacy and Accurate Directories
Presentation (2 slides/page) |
Renee Kimm, Assistant Compliance Counsel, Central Health Plan of California Ryan Morgan, Attorney, Polsinelli PC |
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103: Compliance Training: Exploring New Frontiers for Better Learning Transfer
Presentation (2 slides/page) |
S. Leah Yoder, Ed.D., MSN, RN, Senior Advisor, UL |
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201: “Gimme a C, Gimme an A, Gimme a P… What’s That Spell? CAP!” — Does It Work for You? Effective Strategies for Managing Corrective Action Plan Process After Surviving a CMS Program Audit
Presentation (2 slides/page) |
Anne Crawford, Director, ATTAC Consulting Group LLC Clifton Schmidt, Medicare Compliance Officer, SelectHealth
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202: How to Effectively Work with Your PBM During a CMS Audit
Presentation (2 slides/page) |
Robert Thieling, Vice President of Internal Audit, MedImpact Healthcare
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203: Culture of Compliance: Why is Transparency the Best Medicine for Your Compliance Program?
Presentation (2 slides/page) |
Maria Phelps, Manager, Enterprise Risk, CareSource Margaux Frazee, Director of Corporate Compliance, CareSource
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301: Applying New Department of Justice Compliance Standards to the Managed Care Context
Presentation (2 slides/page) |
Ralph Caccia, Partner, Wiley Rein LLP Randolph S. Sergent, Vice President & Deputy General Counsel, CareFirst, Inc. |
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302: “Hear Ye! Hear Ye! Here Come the Regulators — Managed Care Organizations Getting Audit Ready!”
Presentation (2 slides/page) |
Deborah Johnson, Senior Director of Compliance and Internal Audit, Peach State Health Plan Nicole Huff, Chief Compliance & Privacy Officer, St. Luke’s University Health Network
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303: MRA Compliance: Navigating a Sea of Change
Presentation (2 slides/page) |
Aaron Vandervelde, Managing Director, Berkeley Research Group Stephen Sullivan, Partner, O’Melveny & Myers
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401: Top Proven Tips for Communicating with CMS to Improve Your Day-to-Day
Presentation (2 slides/page) |
Derek Frye, Audit & Technology Leader, Burchfield Group Wendy Richey, Chief Compliance Officer, Clover Health
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402: Role of Ethical Leadership
Presentation (2 slides/page) |
Timshel Tarbet, Director, Ethics & Integrated Strategy Management, Cambia Health Solutions Jory Chase, Ethics Consultant, Cambia Health Solutions
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403: Beyond the BAA: Don’t Forget About the White Elephant in the Room — Understand the Compliance Requirements of a Data Use Agreement
Presentation (2 slides/page) |
Aaron Lund, Director of Compliance and Privacy Officer, Northwell Health
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GENERAL SESSION: Health Policy Update from WashingtonPresentation (2 slides/page) |
Jonathan Morse, Deputy Director for the Center for Program Integrity, Centers for Medicare & Medicaid Services |
SESSION |
SPEAKER |
GENERAL SESSION: Insights from CMS on Program Audits and OversightPresentation (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: OIG UpdatePresentation (2 slides/page) |
Megan Tinker, Senior Advisor for Legal Review, U.S. Department of Health and Human Services, Office of Counsel to the Inspector General |
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501: Compliance Audit Transformation (from a Sponsor’s Perspective)Presentation (2 slides/page) |
Moderator: Vikki Ahern, Medicare Parts C and D Oversight and Enforcement Group, Centers for Medicare & Medicaid Services Peggy Fry, Director of Regulatory Compliance, Medicare Compliance Officer, BlueCross BlueShield of Tennessee Milagros Yzquierdo, Chief Compliance Officer, Healthsun Health Plans Kate Mihalevich, Vice President and Chief Compliance Officer, Express Scripts, Inc
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502: Effective Compliance Oversight: The Role of Compliance vs. The Role of Operations
Presentation (2 slides/page) |
Richard Merino, Managing Director, PricewaterhouseCoopers Sarah Lorance, Vice President of Complinace, Medicare, Anthem |
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503: Credentialing and Oversight of a Non-Clinical Provider: A Non-Emergency Medical Transportation Case Study
Presentation (2 slides/page) |
Mike Sawyer, Director of Corporate Compliance, Veyo Healthcare Logistics Cheyenne Ross, Vice President of Compliance & Regulatory Affairs, Centene Corp |
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601: Medicare-Medicaid InteGREATion: Compliance for Dual-Eligible Products
Presentation (2 slides/page) |
Anjenette Fenske, MMP Compliance Officer, UnitedHealthcare Community & State Deanna Simonds, Compliance Officer, UnitedHealthcare Community Plan of MA, UnitedHealthcare Community & State Alison Green, Director, Medicare Compliance, UnitedHealthcare Medicare & Retirement
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602: 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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603: Healing the Healer: How to Find Happiness in a High-Stress Profession
Presentation (2 slides/page) |
Saud Juman, President & CEO, PolicyMedical Inc Shawn DeGroot, President, Compliance Vitals
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701: Medicare Advantage and Medicaid Managed Care Compliance from the First Tier or Downstream Entity’s Perspective
Presentation (2 slides/page) |
Elizabeth Lippincott, Managing Member, Strategic Health Law Bruce Tavel, Senior Vice President, General Counsel, Chief Compliance Officer, Superior Vision
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702: Where the Rubber Hits the Road: Expert Tips and Techniques to Proactively Assess Your Organization’s Compliance with the New Encounter Data Reporting Requirements
Presentation (2 slides/page) |
Jennifer Tryder, Senior Program Manager, Integrity Management Services, Inc. John Hapchuk, Consultant, Integrity Management Services, Inc. |
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703: The Art of Accelerating Change
Presentation (2 slides/page) |
Vicki Nolen, Director, Project Deployment Office, Methodist Health System Katie Garms, Manager, The Improvement Academy, Methodist Health System |
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801: CMS Appeals Timeliness Monitoring: How to Prepare for the New Annual Reviews
Presentation (2 slides/page) |
Richard Merino, Managing Director, PricewaterhouseCoopers Jeffrey Smagula, Chief Compliance and Ethics Officer, Tufts Health Plan Chris Schroeder, Compliance Director, Cedars-Sinai
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802: Compliance Readiness: Beyond the CMS Compliance Program Effectiveness Audit
Presentation (2 slides/page) Presentation (2 slides/page) Presentation (2 slides/page) |
Ann U. Greenberg, Director of Compliance, Medicare Compliance Officer, Presbyterian Health Plan, Inc. Keith McRee, Chief Compliance Officer, Geisinger Health John Wells, Vice President of Medicare Compliance, Chief Medicare Compliance Officer, Aetna |