2019 Managed Care Compliance Conference
Orlando, FL, United StatesView all past conferences
Handouts
Managed Care Compliance Conference
January 27–30, 2019 | Lake Buena Vista, FL
P1: Compliance, Privacy, and Security Program Assessment Best PracticesBret Bissey, Vice President and Chief Compliance Officer, Gateway Health
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P2: Lessons Learned on the Frontlines of Network Compliance EnforcementDeborah Schreiber, Network Compliance Officer, UnitedHealthcare
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P3: Viewing Investigations from a Different Angle: Understanding the Varying Perspectives of Counsel, Compliance Officer, and Prosecutor to Improve Your Internal Investigation ProcessHeather Fields, Shareholder and Chair - Hospital / Health Systems Practice, Reinhart Boerner Van Deuren s.c.
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P4: Compliance 101Shawn DeGroot, President, Compliance Vitals
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P5: Building an SIU That’s Nimble, Effective, and Audit Ready!Marita Janiga, Executive Director of National Compliance, Ethics & Integrity Office - Investigations, Kaiser Permanente
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P6: Build a Managed Care Compliance Audit and Remediation PlanNicole Huff, Chief Compliance & Privacy Officer, St. Luke’s University Health Network
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P7: I Can Hear You — But Am I Listening?Jennifer Del Villar, Director of Medicare Compliance, Cambia Health Solutions, Inc
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P8: Let’s Talk Shop: Changes in MA and Part D Compliance Requirements for 2019Kate McDonald, Partner, McDermott Will & Emery
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SESSION |
SPEAKER |
GENERAL SESSION: Combating Fraud, Waste, and Abuse in Managed Care
Presentation (2 slides/page) |
Megan Tinker, Senior Advisor for Legal Affairs, U.S. Department of Health and Human Services, Office of Counsel to the Inspector General |
101: Managed Care Expansion in Medicaid and Medicare: Benefits, Challenges, and Compliance
Presentation (2 slides/page) |
Denise Leard, Attorney, Brown & Fortunato, PC Pam Felkins Colbert, Attorney, Brown & Fortunato, PC Angela Brice-Smith, Regional Administrator for Atlanta & Dallas Regional Offices, Deputy Consortium Administrator, CMS |
102: Detecting and Preventing Fraud, Waste, and Abuse
Presentation (2 slides/page) |
Christina Matsiga, Director of Compliance, HSC Health Care System |
103: Not for the Faint of Heart: Preparing CMS Tracer Case Summaries
Presentation (2 slides/page) |
Anne Crawford, Senior Vice President - Compliance Solutions, ATTAC Consulting Group LLC Thomas Wilson, Vice President and Compliance Officer, Health Team Advantage Mary Ann McLean, Vice President of Compliance, Baylor Scott & White Health Plan |
201: How Adequate Is Your Provider Network? Applying and Measuring Managed Care Provider Network Compliance Against the New 2018 Requirements
Presentation (2 slides/page) |
Jennifer Tryder, Program Director, Integrity Management Services, Inc Michael Walsh, Senior Auditor, Integrity Management Services, Inc Kimberly Hornik, Vice President of Compliance and Administration, Integrity Management Services, Inc
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202: Crisis Management for Really Busy People: Learn How to Implement an Efficient and Effective Crisis Management Program in Six Easy Steps
Presentation (2 slides/page) |
Lee Painter, Principal - CyberSecurity, CliftonLarsonAllen LLP Ahmed Salim, Regional Director of Compliance, Presence Health
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203: Hot Topics in Managed Care Compliance
Presentation (2 slides/page) |
Ann Beimdiek Kinsella, Compliance and Privacy Officer, Medica Health Plans Sarah J. Lorance, Senior Vice President & Chief Compliance Officer, Anthem, Inc Ann Greenberg, Medicare Compliance Officer, Presbyterian Health Plan, Presbyterian Insurance Company
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301: Engaging Members through Advocacy and Outreach: Addressing Social and Clinical Needs to Minimize Health Disparities
Presentation (2 slides/page) |
Joynicole Martinez, CEO, The Alchemist Agency |
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302: Risk Adjustment Compliance and Operations: Building Meaningful Communications
Presentation (2 slides/page) |
Nicole Martin, Senior Manager - Prospective Risk Adjustment / Physician Education Team / Prospective Field Chart Review Team Strategic Campaign Solutions (SCS), Florida Blue Dorothy DeAngelis, Senior Managing Director, Ankura Consulting
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303: Are You Ready for a Department of Labor Audit?
Presentation (2 slides/page) |
Amy Christen, Member, Dykema
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401: Managed Models: The Future of FDR Delegation— Service Delivery, Service Responsibility, and Service Ability
Presentation (2 slides/page) |
Richard Golfin III, Compliance Officer, CenCal Health
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402: Federally Facilitated Exchange (FFE) Audits: Do You Know the Risk Areas?
Presentation (2 slides/page) |
Steve Bunde, Vice President of Integrity & Compliance and Internal Audit, HealthPartners Dawn Guzik Stocker, Program Manager - Health Care Reform Compliance, Geisinger Health Plan
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403: A Phish Tale: Lessons Learned from a Successful Phishing Attack in a Managed Care Organization
Presentation (2 slides/page) |
Jessica Vander Zanden, Vice President of Administrative Services, Network Health Angela Keenan, Director, Privacy & Compliance, Network Health
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GENERAL SESSION: CMS Compliance and Enforcement UpdatePresentation (2 slides/page) |
Kimberly Brandt, Principal Deputy Administrator for Operations, CMS |
SESSION |
SPEAKER |
GENERAL SESSION: CMS Audit and Enforcement Update
Presentation (2 slides/page) |
John A. Scott, Acting Director, Medicare Parts C & D Oversight & Enforcement Group, Centers for Medicare & Medicaid Services |
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GENERAL SESSION: The Parity Challenge: Compliance with a Complex Law
Presentation (2 slides/page) |
Tim Clement, State Government Affairs - Northeast, American Psychiatric Association |
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501: Regulators Mount Up: How an Insurance Department Ensures Compliance with Managed Care Plans
Presentation (2 slides/page) |
Rachel Chandler, Senior Attorney, Life and Health Actuarial Division, Mississippi Insurance Department
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502: The WHO, WHY, and HOW of Delegation Oversight
Presentation (2 slides/page) |
Christian Puff, Attorney, Hall Render Killian Heath & Lyman, PC Hayley Ellington-Buckles, Chief Compliance Officer, Versant Health |
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503: Stress is Stressful
Presentation (2 slides/page) |
Cathy Bodnar, Chief Compliance and Privacy Officer, Cook County Health and Hospital System Lauren Tockey, Admissions Counselor, Gateway Foundation Alcohol & Drug Treatment Centers |
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601: Medicare Advantage Risk Adjustment Compliance DOs and DON’Ts: How to Effectively Deploy Limited Resources on Emerging Risk Areas
Presentation (2 slides/page) |
Jason Christ, Member, Epstein Becker & Green, PC Teresa Mason, Associate, Epstein Becker & Green, PC Julie Nielsen, Managing Director, Berkley Research Group, LLC |
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602: Don’t Freak Out! You Can Survive Multiple CMS Audits at the Same Time— Here’s How
Presentation (2 slides/page) |
Ryan Hayden, Partner, PricewaterhouseCoopers Rohit Gupta, Director, PricewaterhouseCoopers Rezarta Molla, Vice President of Corporate Compliance, Harvard Pilgrim Health Care
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603: Are You Just Checking the Box or Creating Effective Compliance Training?
Presentation (2 slides/page) |
S. Leah Yoder, Senior Advisor, UL PURE Learning Shelley Segal, Principal and Co-Founder, Medicare Compliance Solutions
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701: The State of Play for Mental Health Parity
Presentation 1 (2 slides/page) |
Tricia Beckmann, Director, Faegre Baker Daniels Consulting Amy Finley, Senior Counsel, Highmark, Inc
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702: How to Prepare for 2019 CMS Rule Change to Marketing Materials: ANOCs, EOCs, Summary of Benefits — Issues, Impact, Disclosures, and Audits
Presentation (2 slides/page) |
Debbie Mabari, CEO, CODY Hannah LaMere, Director - Special Projects, CODY Mike Turrell, CEO, Ultimate Health Plans |
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703: The Importance of Automating Your Monitoring and Auditing
Presentation 1 (2 slides/page) |
Pamela Cleveland, VP - Compliance Product Strategy, Beacon Healthcare Systems Megan Grifa, Director, Medicare Compliance, Medical Mutual of Ohio |
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801: Understanding Recent Legislative Changes to Coordination of Benefits Practices for Medicaid and CHIP Programs
Presentation (2 slides/page) |
Kristen Ballantine, Vice President of State and Federal Government Relations, HMS Deborah Grier, Vice President COB Product Strategy, HMS
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802: The Rise of the Virtual Workforce: Compliance Role in Robotic Automation Governance
Presentation (2 slides/page) |
Deana Rhoades, Principal - Automation, Health Plan Consulting, NTT DATA John Wells, Vice President, Aetna Medicare Compliance, Aetna Sherrie Ryder, Senior Advisor - Compliance & Security, NTT DATA |