2019 Agenda

CompliancePalooza 2019 featured a jam-packed conference agenda with 20+ esteemed speakers, two tracks, 17+ top-notch sessions, and 6+ hours of networking.

October 21, 2019

8:00AM – 9:00AM
Registration and Networking Breakfast

9:00AM – 9:05AM

Welcome Remarks

David Reid,  Sr. Director, Operational Performance & Regulatory Support 

Florida Blue 

9:05AM – 9:55AM

PANEL: Review and Implications of the 2019 CMS Season

  • Distinguish of the focus areas of CMS for each audit area 
  • Review the trends of the 2019 audit season and the commonalities of the audit findings and how have they changed your compliance programs 
  • Discuss the potential changes on the horizon 

 

Moderator: 

Joann Chinn, Compliance Officer -FL  

Simply Healthcare Plans 

 

Panelists:

Helaine FingoldSenior Counsel 

Epstein, Becker and Green 

 

James Moran, Chief Compliance Officer 

Commonwealth Care Alliance 

9:55AM - 10:45AM

PANEL: Tales from the Front Lines: The Survivor's Guide to Recent CMS Audits

  • Gain insights from Health Plans who have been recently audited and hear lessons learned  
  • Learn how and why your peers would improve audit preparation 
  • Interpret audit outcomes and changes you can make and identify audit successes and potential hiccups  

 

Moderator: 

 

James Moran, Chief Compliance Officer  

Commonwealth Care Alliance

 

Panelists:  

 

Osato Chitou, Founder and Principal Consultant 

Compli by Osato 

 

Cindy Glennon, Director of Internal Audit 

Commonwealth Care Alliance  

10:45 AM – 11:15AM
Networking Break

11:15AM - 12:05PM

Tackling Managed Care Fraud, Waste and Abuse

  • Learn new methods to successfully combating Fraud, Waste and Abuse 
  • Examine best models for special investigation units 
  • Evaluate how to best manage the special investigation units 

 

Joann Chinn, Compliance Officer -FL 

Simply Healthcare Plans 

 

Sarah Peix, Director of Compliance 

ChenMed 

12:05PM – 12:45PM

Keynote: Leading Teams to Success

  • Best practices to elevate your team from non-compliant to compliant. 
  • Strategies to successfully lead teams and encourage compliance buy-in among the workforce and third-party entities. 
  • Discover how taking steps to understanding your culture and your WHY will cause a shift in your workforce, and the way you do business in the compliance space.

 

Rhonda Glover, Former FBI Agent and CEO 

The Rhonda M. Glover Group LLC

12:45PM – 1:45PM
Networking Lunch

1:45PM – 2:35PM

Concurrent Tracks

Track A: CMS Program Audits

Track B: FDR Oversight & Provider Monitoring

1:45PM – 2:35PM

Track A: Mastering Universe Preparation for Program Audits

  • Discuss best practices on FDR data integration into universes 
  • Learn key techniques on how to maximize your time and resources when preparing universes for program audits 
  • Gain quality assurance evaluation tips and tricks 

 

Melissa Rusk, Director Claims and BPO Operations 

SummaCare 

 

Osato Chitou, Founder and Principal Consultant 

Compli by Osato 

1:45PM – 2:35PM

Track B: Efficient FDR Monitoring Program Execution

  • Discuss strategies to build an effective and accurate risk assessment process 
  • Design impactful corrective action plans for FDRs 
  • Apply methods to confirm FDRs adhere to operational requirements 

 

Ana Handshuh, Vice President, Managed Care Services 

Ultimate Health Plans 

 

2:35 PM – 3:25PM

Concurrent Tracks

Track A: CMS Program Audits

Track B: FDR Oversight & Provider Monitoring

2:35 PM – 3:25PM

Track A: Improving Your Appeals & Grievances Operations

  • Improve processes and staff organization all things A&G 
  • Learn keys in the implementation of effective monitoring 
  • Apply new methods to enhance compliance team collaboration 

 

Charmaine Gee, Director of Appeals and Grievances, Medicare Advantage and MMP Plans, Amerihealth Caritas VIP Plans 

The AmeriHealth Caritas Family of Companies 

 

Ashley ToalMedicare Appeals & Grievances Team Lead 

The AmeriHealth Caritas Family of Companies  

2:35 PM – 3:25PM

Track B: FDR Oversight: Compliance Objectives and Contract Requirements

  • Improve FDR communications to increase participation
  • Further your comprehension of difficulties that lie ahead of fulfilling contractual requirements
  • Discover effective FDR risk management plans

 

Melissa Rusk, Director Claims and BPO Operations 

SummaCare 

 

3:25PM – 3:55PM
Networking Break

3:55PM – 4:50PM

Concurrent Tracks

Track A: CMS Program Audits

Track B: FDR Oversight & Provider Monitoring

3:55PM – 4:50PM

Track A: Examining Successful CAPs: Identifying the Root Cause

  • Discuss the best tools to test your CAP 
  • Gain strategies to guarantee root cause identification 
  • Learn how to maintain a compliance culture through innovative CAP approaches 

 

Heather Metz, Director of Compliance
AllyAlign Health

 

Cindy Glennon, Director of Internal Audit 

Commonwealth Care Alliance 

3:45PM – 4:40PM

Track B: Navigating 42 CFR Part 2

  • Learn about Part 2 and its effect on disclosure of substance use disorder records
  • Review changes to the regulations over the past few years
  • Discuss the Part 2 proposed rule and the impact on compliance

 

Helaine FingoldSenior Counsel 

Epstein, Becker and Green 

 

Kate Romanow, JD, Director of Regulatory Affairs 

Association for Behavioral Health and Wellness 

4:40PM – 4:45 PM

Closing Session

David Reid, Sr. Director, Operational Performance & Regulatory Support 

Florida Blue

4:45PM – 5:45 PM
Cocktail Reception

Mix and mingle with fellow peers in the compliance industry through a structured networking opportunity 

October 22, 2019

7:30AM – 8:30 AM

Leadership Breakfast

Join other leaders in the healthcare compliance sector as they discuss common challenges faced by women in breaking through the glass ceiling.  

 

Moderator:

Ana Handshuh, Vice President, Managed Care Services 

Ultimate Health Plans

 

Panelists:

Deborah Marine, Compliance Officer

SummaCare 

  

James Moran, Chief Compliance Officer 

Commonwealth Care Alliance 

 

David Reid, Sr. Director, Operational Performance & Regulatory Support 

Florida Blue 

 

8:30AM – 8:35AM

Opening Remarks

David Reid, Sr. Director, Operational Performance & Regulatory Support 

Florida Blue 

8:35AM – 9:20AM

Panel: Enhance Workplace Audit Engagement

  • Learn effective ways to help engage your organization’s business leaders and board members with an audit 
  • Improve your relationship with the board  
  • Discover new methods to motivate people outside of the compliance team to align on deadlines 

 

Moderator:

Patricia Suffern, AVP, Medicare-Medicaid Program 

Virginia Premier 

 

Panelists:

Heather Metz, Director of Compliance

AllyAlign Health

 

Beth Socoski, Chief Strategy Officer 

Socoski Design Consulting 

 

LaTasha Jones, Medicare Compliance Manager 

Virginia Premier 

9:20AM – 10:05AM

Using Your Mock Audit Process as a Mitigation Control

  • How to demonstrate your oversight process to CMS
  • Set the standards for your internal controls and who owns them 
  • Make your mock audits the back-bone of your internal controls 

 

David Reid, Sr. Director, Operational Performance & Regulatory Support 

Florida Blue 

 

Delores Stewart, Senior Manager, Operational Performance & Regulatory Support 

Florida Blue 

10:05AM - 10:25AM
Networking Break

10:25AM – 10:55AM

Hands-On Workshop: Deep Dive into Delegate Training

  • Discuss methods to build a trust and collaborative relationship with your delegates 
  • Share best practices for training your delegates 
  • Learn how to further engage your delegates to help participate in successful audit

 

David Reid, Sr. Director, Operational Performance & Regulatory Support 

Florida Blue 

 

Delores Stewart, Senior Manager, Operational Performance & Regulatory Support 

Florida Blue 

11:1AM – 11:55AM

What's in Your Compliance Tool Kit?

  • Identify the most effective audit tools 
  • Discover new templates to make your day to day life easier 
  • Gain insights on the must have tools  

 

Ana HandshuhVice President, Managed Care Services 

Ultimate Health Plans 

 

Deborah Marine, Compliance Officer 

SummaCare 

11:55AM - 12:45PM
Networking Lunch

12:45 PM – 1:25PM

Mock Audit Best Practices: Maximizing Processes for Tracer Integration

  • Identify what data and documentation to sample
  • Learn how to integrate tracers into your mock audit process to find gaps and report results internally
  • Develop and implement your improvement plans from your results

 

Deborah Marine, Compliance Officer,

SummaCare

1:25PM – 2:05PM

Universe Creation and Review: Managing New Data Challenges

  • Learn how to better analyze the data universes for operational compliance success 
  • Build controls to reduce risk  
  • Discuss how to best prepare immaculate universe data  

 

LaTasha Jones, Medicare Compliance Manager 

Virginia Premier 

 

Patricia Suffern, AVP, Medicare-Medicaid Program 

Virginia Premier 

2:05PM – 2:50PM

Ways to Improve Your Effective Compliance Program

  • Determine strategies to keep your team engaged 
  • Discuss how to structure compliance at your organization 
  • Analyze best practices for the seven elements of an effective program 

 

Sarah PeixDirector of Compliance 

ChenMed  

  

Beth Socoski, Chief Strategy Officer 

Socoski Design Consulting 

2:50PM - 3:35 PM

Data Collection and Organization: Efficient Data Utilization

  • Learn new ways to further evaluate your data to improve accuracy  
  • Develop new methods on how share and validate your data? 
  • Share best practices on how to validate your data 

 

Ana Handshuh, Vice President, Managed Care Services 

Ultimate Health Plans 

 

Deborah Marine, Compliance Officer 

SummaCare 

 

3:35PM – 3:45PM

Closing Session

David Reid, Sr. Director, Operational Performance & Regulatory Support 

Florida Blue