Rise

Welcome & Opening Remarks

Moderator:

Vanessa Turner , md , TEST TITLE
Wilmington title 2 Rise

Chairperson:

Vanessa Turner , md , TEST TITLE
Wilmington title 2 Rise

Vanessa Turner , md , TEST TITLE
Wilmington title 2 Rise

Chairperson
David Reid, Senior Director, Operational Performance & Regulatory Support
Florida Blue

Keynote Panel Discussion: The Evolution of Compliance During the Pandemic and Examine the Future Implications

Chairperson:

Todd Boyer , MS , Mr
Rise

• Discuss the impact of COVID-19 on compliance and how the future of compliance is forever changed
• Examine compliance essentials to proactively build a bullet proof pandemic plan
• Identify best practices and lessons learned from navigating compliance during the COVID-19 crisis

Review and Implications of the 2021 CMS Revised Protocols

• Assess CMS changes and revised protocols from COVID-19 and how compliance programs have been affected
• Analyze new trends and potential changes coming for audits, including the recent changes to the ODAG/CDAG guidance
• Evaluate lessons learned and best practices by health plans post COVID-19

Deborah Marine, Compliance Officer
SummaCare

Break

Business Continuity: Lessons Learned from COVID-19

• Analyze how mandatory remote work permanently changed the compliance culture and lessons learned from operationalizing new CMS updates remotely
• Discuss compliance challenges and best practices of vendor management during the pandemic
• Learn strategies to safety proof business continuity plans during times of emergency

JoAnn McDaniel-Chinn, Medicaid Compliance Officer
Simply Healthcare Plans

Lunch

Panel Discussion: The Impact of Lifted Telehealth Restrictions and the Future of Telehealth

• Examine the impact of lifted telehealth restrictions on privacy and data security and what implementation changes could limit or increase fraud, waste and abuse
• Discuss the new telehealth accountability and standards post COVID-19 and the impact of a digital divide on vulnerable populations
• Reflect on best practices and lessons learned from the telehealth restriction changes how it impacts the future of health care delivery

Moderator: 

David Reid, Senior Director, Operational Performance & Regulatory Support 
Florida Blue 

Panelists:  

Michelle O’Neill, Vice President, Corporate Compliance & Privacy
Summit Medical Group

Joseph A. Piccolo, Vice President, Corporate Compliance & Ethics, Corporate Compliance and Privacy Officer
Inspira Health Network

Jessica Vander Zanden, CHC, Vice President, Compliance and Audit
Network Health Insurance Corporation

Break

Master the Audit Preparation Process

• Understand the shift from one size fits all to personalized customized training models
• Evaluate mock audits and other programs and tools for successful audit preparation
• Learn tips and strategies for hosting a successful CMS audit onsite

Deborah Marine, Compliance Officer
SummaCare

Angela M. Lloyd, MPH, CHC, Director, Medicare Audit & Corrective Action
Health Partners Plans

Break

Effectively Manage a Successful Compliance Workflow

• Identify tools to develop a quarterly work plan to successfully manage compliance issues
• Understand the difference between an overall compliance plan compliance work plan and an overall compliance strategy
• Discover effective strategies to build a successful compliance work plan

Jordan B. Muhlestein, Compliance & Ethics Director
Intermountain Healthcare

Gina Meili, Director of Compliance
Commonwealth Care Alliance

Break

Panel Discussion: Review of FDR Oversight & Effective Strategies to Partner with Delegates

• Reflect on the essentials of a strong delegation oversight to withstand emergency or pandemic protocols to develop a strategic operational plan and effectively partner with delegates
• Explore best practices and lessons learned for vendor classification and management during the COVID-19 crisis and throughout the audit process
• Learn effective FDR risk management plans and identify contractual challenges before problems arise

Moderator: 

David Reid, Senior Director, Operational Performance & Regulatory Support  
Florida Blue   

Panelists:  

Sarah Simmerson, CIA CRMA, FBM Optimization
Florida Blue  

Tracy Jones, Senior Compliance Coordinator
SummaCare

Break

Panel Discussion: Improve Your Appeals and Grievances Operations in a Time of Uncertainty

• Discuss best practices and lessons learned from A&G operations post COVID-19
• Explore why health plans continue to struggle and develop a game plan to successful managed the increase in expedited appeals
• Analyze the best way to identify misclassified appeals and best approaches for billing COVID-19 services

Deborah Marine, Compliance Officer 
SummaCare 

Tracy Jones, Senior Compliance Coordinator 
SummaCare 

Melissa Rusk, Director Claims & BPO Operations 
SummaCare 

Chairperson Closing Remarks

David Reid, Senior Director, Operational Performance & Regulatory Support
Florida Blue