Osato Chitou is the Founder and Principal Consultant of NMOC Healthcare Compliance Consulting, LLC, d/b/a Compli by Osato, where she provides legal and compliance services to the Payor, Provider, and Life Science Industries. Her prior roles include serving as the Chief Legal and Compliance Officer for a Private Equity backed MSO supporting Dermatology and Plastic Surgery practices across four states, in addition to serving as the Medicare Compliance Officer for several multi-state Payors that offered Medicaid, Medicare Advantage and Special Needs Plans. She has also served as the Compliance Officer for one of New Jersey’s largest urban teaching hospitals. Additionally, Ms. Chitou worked for the State of New Jersey, within the Department of Human Services, and was charged with overseeing Managed Care Organizations market entry and exit including MCO applications, close-out activities, and procurement cycles. Ms. Chitou started her legal career in private practice as an Associate in the Healthcare & Healthcare Privacy practice groups at Moses & Singer LLP. While there, her areas of concentration included state and federal health privacy issues and regulatory compliance with HIPAA and HITECH. Ms. Chitou is admitted to practice law in New York, New Jersey, and the Supreme Court of the United States.
HELAINE I. FINGOLD is a Senior Counsel in the Health Care and Life Sciences practice, in the Baltimore office of Epstein Becker Green. She has more than 28 years of broad health law and regulatory experience, including prior government experience in both the legislative and executive branches of the federal government.
Ms. Fingold advises on issues involving the Medicare Program Parts A, B, C, and D, Medicare Innovations, Dual Eligibles, and Medicaid; counsels on issues related to products offered on public and private health insurance exchanges and related health insurance reform issues; provides interpretative and practical advice regarding oversight and compliance requirements of the Medicare Advantage and Medicare Prescription Drug programs; and, assists with issues related to Mental Health Parity and confidentiality of medical and substance use disorder treatment records and information.
Prior to rejoining the firm, Ms. Fingold worked at the Centers for Medicare & Medicaid Services' ("CMS") Center for Consumer Information and Insurance Oversight (CCIIO) on issues involving qualified health plans and stand-alone dental plans in both state and federally-facilitated exchanges, plan oversight, essential health benefits, and market-wide cost sharing limitations.
From 2004 to 2012, Ms. Fingold worked in a range of capacities at CMS with responsibility for areas of the Medicare Advantage program, including plan application review and approval/denial, plan oversight, and marketing.
Ms. Fingold began her career as an attorney in the DHHS Office of the General Counsel addressing legal issues arising under Medicare Parts A and B and Medicaid. Ms. Fingold then worked within CMS's predecessor agency on Medicaid waiver and demonstration programs. She later spent two years as a health care attorney in the DC office of Epstein Becker Green. Ms. Fingold left the firm to serve as General Counsel for the Medicare Payment Advisory Commission before rejoining CMS in 2004.
Charmaine Gee, J.D.
Director of Appeals and Grievances, Medicare Advantage and MMP Plans, Amerihealth Caritas VIP Plans
Charmaine Gee, J.D. Director of Appeals and Grievances, Medicare Advantage and MMP Plans, Amerihealth Caritas VIP Plans
The AmeriHealth Caritas Family of Companies
Charmaine Gee is the Director of Appeals and Grievances for Keystone First VIP Choice, AmeriHealth Caritas VIP Care, First Choice VIP Care Plus and AmeriHealth Caritas VIP Care Plus.
She is responsible for the resolution of medical and prescription drug appeals and grievances from members, member representatives and Medicare providers. In addition, she provides operational oversight for the delegated entities responsible for delivering supplemental benefits to members.
Charmaine earned a Bachelor of Art in Human Services from Lincoln University in Pennsylvania. She earned a Juris Doctor from Widener University School of Law in Delaware.
Cindy Glennon, MPH, CIA has 15+ years of experience in health care and pharmaceutical industries. She has proven success in designing, implementing, managing and continuously enhancing value-added audit and risk programs designed specifically to meet the needs of the business in context of these highly-regulated industries. She currently serves as Director of Internal Audit at Commonwealth Care Alliance based on Boston, Massachusetts. You can reach her at firstname.lastname@example.org or 617-426-0600.
Rhonda M. Glover was born in Annapolis, Maryland and raised in Washington, DC. She graduated from Old Dominion University in Norfolk, Virginia and received a Bachelor of Science degree in Criminal Justice. She subsequently received a Master of Science degree in Management from the Johns Hopkins University in Baltimore, Maryland. Ms. Glover is currently enrolled at the Grand Canyon University in Phoenix, Arizona pursuing a Doctor of Education in Organizational Leadership with an emphasis in Organizational Development. She also holds a certificate in Nonprofit Executive Management from the Georgetown University in Washington, DC.
She began her career with the Federal Bureau of Investigation (FBI) in August 1984 assigned to FBI Headquarters (FBIHQ) in the Technical Services Division. In 1985, she was promoted to the Laboratory Division as a Photographer. In January 1987, Ms. Glover was promoted to the New York Office as an Investigative Specialist assigned to the Special Surveillance Group working Foreign Counterintelligence matters. In September 1988, she was appointed to the position of Special Agent. Upon completion of training, she was assigned to the Newark Field Division investigating drug violations. While in the Newark Division, Ms. Glover was a member of its inaugural Evidence Response Team and worked major investigations such as TWA 800 and UNABOM. In July 1998, Ms. Glover transferred to the Washington Field Office and continued to investigate drug matters. In March 2000, Ms. Glover was promoted to Supervisory Special Agent assigned to FBIHQ, Criminal Investigative Division, Drug Section, Colombian/Caribbean Unit. She was subsequently assigned to the Inspection Management Unit, Inspection Division. In June 2005, she was promoted to the Newark Division to oversee traditional Organized Crime matters. In October 2006, she initiated an Intelligence Program squad of Special Agents focused on the development of human intelligence.
In September 2009, Ms. Glover was promoted to Assistant Special Agent in Charge (ASAC) of the New Haven Field Office overseeing the National Security Branch, which was comprised of the Counterintelligence, Counterterrorism, Cyber and Intelligence programs. From October 2011-March 2015, she served as the Criminal/Administrative Branch ASAC with program management responsibilities for Violent Crime, White Collar Crime, Violent Gangs, Public Corruption, Violent Crimes Against Children, Financial Management and Support Services. She also served as the New Haven Division’s Leadership Coordinator and Compliance Officer. In March 2015, Ms. Glover was assigned to the Human Resources Division, FBIHQ in Washington, DC where she served as the Acting Unit Chief with oversight of the Onboarding New Employees Program, a program to assist new employees in the navigation of their first year of employment with the FBI. Ms. Glover served as the Program Manager for the Professional Development Program in the FBI’s Human Resources Division where she was responsible for the delivery of professional development content. She also served as the Team Leader of the FBI’s Cross-Cultural Mentoring and Sponsorship Program which was developed to transform the landscape of the leadership within the FBI by encouraging inclusive and mentoring relationships and increase more diverse career development networks.
Ms. Glover is a Life member of the National Organization of Black Law Enforcement Executives (NOBLE) where, since 2002, she has served as the NOBLE National Youth Committee Chairperson. As the youth committee chairperson, Ms. Glover singlehandedly developed its acclaimed annual youth leadership conference which has impacted more than 2700 youth. She is also a charter member of the Connecticut Chapter of NOBLE which was initiated in 2010. She is a member of Women in Federal Law Enforcement and a member of the International Association of Chiefs of Police (IACP), where she served on the Human and Civil Rights Committee. In 2008, through the Human and Civil Rights Committee, she developed the IACP’s onsite community service and Explorers Project which is executed yearly during its annual conferences. As a result of her work with IACP, she was appointed to the National Law Enforcement Exploring Committee. She currently serves on the Board of Directors for the Public Safety Cadets. Ms. Glover attended Session 72 of the Law Enforcement Executive Development Seminar where she is a member of its association. Other membership organizations include being a Diamond Life member of Delta Sigma Theta Sorority, Incorporated, a Life member of the National Association of the Advancement of Colored People, and the National Council of Negro Women.
In September 2012, she was selected to participate in the prestigious Masters Series for Distinguished Leaders through the Skinner Leadership Institute, a program designed to empower leaders in Washington, DC. In May 2016, she was selected to represent the FBI at the Harvard University, John F. Kennedy School of Government participating in “Women and Power: Leadership in the New World,” an intense, interactive experience designed to transform women as they advance to top positions of influence in public leadership. She is a member of the International Coach Federation and holds certifications from the World Coach Institute as a Career Coach, and a certification from the Youth Coaching Institute as a Youth Mentor Coach with a focus on ages 14-30. Ms. Glover is also certified to administer the EQi-2.0 and EQ 360 (Emotional Intelligence) assessments which supports individuals in becoming more self-aware to manage behaviors brought to relationships and the workplace.
In September 2007, Ms. Glover was presented with the FBI Director’s Award for Equal Employment Opportunity in recognition of her leadership, training, recruitment, and significant contributions to enhance employment opportunities for women and minorities within the FBI. The FBI Director’s Award is one of the highest forms of recognition received by an FBI employee. Ms. Glover is the recipient of the 2009 Women of Achievement Award presented by the Central Jersey Alumnae Chapter of the Delta Sigma Theta Sorority, Incorporated. She was also recognized by the Western Region, New Jersey of American Society for Industrial Security with the Leadership Award for her service to the community. In July 2013, she was the recipient of NOBLE’s Lloyd Sealy Award for outstanding accomplishments in the field of criminal justice. In May 2017, Ms. Glover received an Honorary Doctorate in Humanitarian Services from the Lincoln College of New England and was its first female commencement day in the 50-year history of the school. She is also the recipient of the Johns Hopkins University 2018 Woodrow Wilson Award for Distinguished Government Service and was recently nominated and selected to serve on the Johns Hopkins Alumni Council. Ms. Glover is a co-author in the best-selling book, “Dear Fear Volume 2:18 Powerful Lessons on Living Your Best Life on the Other Side of Fear.”
Ms. Glover retired from the FBI in September 2018 after 34 years of service. She is now the Chief Executive Officer of the Rhonda M. Glover Group LLC, a training, development and career coaching firm in Washington, DC where she impacts and shifts people throughout the U.S. and internationally.
Ana Handshuh Vice President, Managed Care Services
Ultimate Health Plans
Ana Handshuh, CHC, is a government programs executive with expertise in creating and implementing corporate programs for the healthcare industry. Ms. Handshuh is the Principal at CAT5 Strategies, a healthcare advisory practice specializing in Regulatory and Operational Compliance, Revenue Management, Communications, Quality, Care Management Programs, Benefit and Formulary Design, Program Bid Submission, Accreditation, and Technology Integration. She recently founded TRACSCOUT, a technology startup SaaS platform for managed care processes.
Her recent consultancy roles include conducting compliance risk assessments, performing Compliance Program Effectiveness audits, conducting FDR and PBM pre‐delegation audit, preparing for CMS program audit, and writing and implementing post‐audit corrective action plans. Ms. Handshuh has also assisted government program sponsors achieve higher Star ratings, create and implement care management programs, document their processes and procedures, achieve accreditation status, design and submit government program bids, institute corporate‐wide programs and create communications strategies and materials. She is a member of the Health Care Compliance Association and is Certified in Healthcare Compliance by the Compliance Certification Board. Ana currently serves on the Board of the Resource Initiative and Society for Education (RISE), the preeminent national professional association dedicated to managed and accountable care financing and delivery.
Ms. Handshuh previously served as the Vice President of Managed Care Services at Central Florida Inpatient Medicine (CFIM), providing leadership and strategy on CFIM projects with physicians, risk entities, hospital systems, and health plans. Prior to that assignment, she worked with Precision Healthcare Systems as their Vice President of Quality Improvement, leading the IPA’s collaborations with payers to implement Quality and Star Rating initiatives. Ms. Handshuh also served as the Director of Corporate Program Development at Physicians United Plan (PUP), leading the Medicare health plan’s Quality Management and Corporate Communications departments and spearheading the development of innovative integrated technology solutions to drive business excellence and Star Rating achievement. Prior to joining Physicians United Plan Ms. Handshuh was the founder of I-Six Creative. Under Ms. Handshuh’s vision and leadership, I-Six provided expertise in the areas of managed Medicare benefit design, MSO/IPA operations, provider network strategy, new market launches, technology integration, corporate communications and quality improvement.
LaTasha Jones is the Manager of Medicare Compliance for Virginia Premier Health Plan, Inc. She is responsible for regulatory reporting of Medicare Advantage Plans and well as Medicaid Government reporting. Along with the team of analysts she manages, LaTasha also provides contract interpretation and departmental oversight monitoring to ensure Compliance. She began in the Healthcare industry in 2005 working in the area of Quality with Original Medicare. Since 2014 she has focused on Medicare Compliance and Medicare-Managed Care. LaTasha has a degree in Business Administration from the University of Phoenix. She resides in Prince George, VA along with her husband and 2 sons that keep her life very busy with sports and various other activities. She loves traveling to warm locations and spending time at the beach.
Deborah joined SummaCare as the Medicare Compliance Officer in January 2015, and became the Chief Compliance Officer for the insurance arm of Summa Health (SummaCare and Summa Insurance Company) later that year. She is responsible for the health plan compliance program, encompassing all lines of business with an emphasis on Medicare Advantage, Part D, and Marketplace products. Deborah became the health plan Privacy Officer in 2017.
Prior to joining SummaCare, Deborah served as the Compliance & Privacy Officer for Health Alliance Plan in Detroit, Michigan for 12 years. She was in-house counsel, focusing on regulatory compliance, for Univera Healthcare in Buffalo, NY from 1996 to July 2002.
Qualifications and Credentials
Deborah earned a law degree from Case Western Reserve University in Cleveland Ohio in 1995 and is licensed to practice in Ohio (inactive status), New York (retired status), and Michigan (active status). She received her certification in healthcare compliance (CHC) in 2009.
Heather Metz is the Director of Compliance at AllyAlign Health, where she is responsible for leading organizational compliance initiatives.
With 12 years of industry experience, Heather has played an integral role in the expansion of organizational compliance programs, specializing in internal and external compliance auditing and monitoring activities, comprehensive compliance risk assessments, audit workplans, root cause analysis and corrective actions.
Heather is certified in health care compliance with the Health Care Compliance Association (HCCA) and holds degrees in Social Work and Law and Public Policy.
Extensive experience (20+ years) working as a Healthcare Consulting Leader and Chief Compliance & Privacy Officer specializing in Government Programs Compliance with leading payers, hospital systems, and providers. Includes consultation at the highest levels of management and Boards of Directors in the areas of enterprise risk and healthcare compliance to achieve improved compliance program effectiveness and risk remediation. Jim’s approach has been to not merely provide regulatory expertise but rather to marry that expertise with a deep understand of payer and provider operations. Coupling that knowledge with consulting has allowed Jim to help organizations “build-in” regulatory expectations to achieve higher quality results, measure key performance indicators and achieve regulatory, operational and customer / regulator satisfaction improvements.
Ms. Sarah Peix is the Director of Compliance for the ChenMed Family of Companies, a Florida-based, integrated primary care practice focused on serving Medicare Advantage beneficiaries. ChenMed has a unique physician-led culture that provides coordinated care to moderate- to low-income seniors.
Before joining ChenMed in 2015, Ms. Peix served as the Medicare Compliance Officer at Health New England, an HMO in Springfield, Massachusetts. Ms. Peix oversaw Medicare Compliance when HNE was a 5-star plan and CMS conducted a Best Practice Review to develop its audit protocol in 2012.
Ms. Peix has 11 years’ experience in Medicare compliance and 16 years in health care compliance. Ms. Peix has her BA from Mount Holyoke College and MBA from the Isenberg School of Management at UMASS, Amherst.
David Reid Sr. Director, Operational Performance & Regulatory Support
David Reid is the Senior Director of Operational Performance & Regulatory Support at Florida Blue with over 16 years of experience in the insurance industry. A Certified Information Systems Auditor (CISA), he is accountable for ensuring business processes across multiple divisions are operationally effective and adhere to regulatory and industry requirements for both Commercial and Government market segments. David’s background is in systems development, database administration, internal auditing, process improvement, operations management and regulatory/accreditation compliance.
Kate Romanow joined the Association for Behavioral Health and Wellness (ABHW) in 2019 as the Director of Regulatory Affairs. Prior to joining ABHW, Kate was the Director of Medicaid Policy at the Blue Cross Blue Shield Association. She also held policy positions at Regence Blue Shield and the American Speech-Language-Hearing Association, working on issues such as ACA implementation, Medicare and Medicaid. Before moving to policy, Kate worked as a lawyer for a number of years on various health care issues. Prior to law school, Kate worked as a speech-language pathologist for three years. Kate received her B.S. and M.A. from the State University of New York at Geneseo and her J.D. from Boston University School of Law, with a concentration in health care law.
Melissa Rusk is the Director Claims and BPO Operations at SummaCare in Akron Ohio. In this role, Melissa is responsible for leading Claims, Claims Recovery, and Document Management Services. She leads and oversees multiple internal efforts to ensure compliance with federal and state regulatory requirements and plan performance guarantees. This includes: Fraud Waste and Abuse, FDR management, payment integrity, implementation of new plans and plan changes, weekly and monthly performance monitoring, system upgrades and new system implementation, encounter submissions, and plan audits. She oversees business decisions associated with coverage and payment policies.
Melissa has over 30 years’ experience working within the insurance industry in customer service, compliance and operations.
She is a Lean Six Sigma Green Belt and is certified in Lean by the University of Akron.
Beth is the Chief Strategy Officer of Socoski Design & Consulting and the host of TEDxWestshore in 2020. She serves on the board of the American Lung Association. She has served as Medicare Compliance Officer and Director of Compliance for health plans.
Beth started her career as an oncology social worker with the University of Pittsburgh Medical Center, and later helped build and develop care and Disease Management programs to support member outcomes and STARs measure. These experiences help her bring a unique perspective to the world of compliance.
Senior Manager, Operational Performance & Regulatory Support
Delores Stewart Senior Manager, Operational Performance & Regulatory Support
Delores Stewart (MAcc) is a Senior Manager within Operational Performance & Regulatory Support at Florida Blue. She is accountable for the CMS Mock Audit Program and vendor oversight activities. An experienced Senior Auditor from Deloitte & Touche, Delores is a licensed CPA, former Finance Manager at UF Health (First Coast Advantage, LLC) and worked for Florida’s Office of the Attorney General as a Medicaid Fraud Auditor prior to joining Florida Blue.
Patricia Suffern is the Associate Vice President and Medicare Compliance Officer for Virginia Premier Health Plan, Inc. Her areas of responsibility include Medicare Advantage Plans-including a Dual Eligible Special Needs Plan, Qualified Health Plans and Medicare and Medicaid Government Reporting.
She is a Registered Nurse and received her Masters of Public Management at Carnegie Mellon University (Phi Kappa Phi). She also received her Juris Doctorate degree from Duquesne University. As a Registered Nurse she worked in the Operating Room, Emergency Room and Cardiothoracic/Trauma Intensive Care Units. She has worked in various areas in the Healthcare Insurance Industry including care management, quality, and provider relations. Since 2005 she has focused on Medicare Compliance and Medicare-Medicaid Managed Care. Her home is in Pittsburgh, PA and she enjoys spending time with her family as well as reading, travelling and exercising.
Ashley Toal Medicare Appeals & Grievances Team Lead
The AmeriHealth Caritas Family of Companies
Ashley Toal is a Team Lead in the Appeals and Grievances department for Keystone First VIP Choice, AmeriHealth Caritas VIP Care, First Choice VIP Care Plus and AmeriHealth Caritas VIP Care Plus.
She is responsible for the investigation and resolution of member grievances, in addition to reviewing appeals for denied prescription drugs, services, and claims. She also assists with daily operational oversight of delegated entities for supplemental benefits.
Ashley received a Bachelor of Art in Communication Studies from West Chester University of Pennsylvania. Ashley has worked with Amerihealth Caritas VIP Plans since 2015. When she’s not geeking out over all things Medicare Compliance, you can find her running in Philadelphia while befriending every cat and dog she meets.