Agenda

Sunday, January 26

  • -
    Pre Conference Pre Conference
    100
  • 08:00 AM - 09:30 AM
    P01: Ethics and Compliance Work Plan Essentials that Effectively Mitigate Risk Andrea Share, Exec Director, Ethics/Compliance Strategy & Ops, Kaiser Permanente Chanelle Gamble, Compliance Manager, Kaiser Permanente
    • Explain the importance of conducting an ethics and compliance risk assessment and the relevance of risk assessments in an integrated care setting
    • Describe the key components of a risk assessment, how to conduct a risk assessment, and the role of work planning for effective mitigation
    • Introduce a "simple six step" approach to conducting a risk assessment, review a framework for defining risk, and discuss key takeaways for how the connection between risk assessment and work planning delivers business value
    General Compliance
  • 09:30 AM - 09:45 AM
    Networking Break Mingle with your peers in the foyer before your next session starts.
    Networking
  • 09:45 AM - 11:15 AM
    P02: Cyber Threats and Compliance Challenges: How to Manage Technology Risk Jennifer Griveas, Chief Human Resources Officer & General Counsel, Eliza Jennings Senior Care Network Michael Gray, Vice President of IT and Compliance Officer, Eliza Jennings
    • Identify biggest security threats to healthcare organizations
    • Identify the value of integration of knowledgeable IT personnel into high-level operations team as a means to ensure compliance and effective risk mitigation
    • Describe how best to implement technology solutions to enhance efficiency and productivity without sacrificing organizational security
    General Compliance
  • 12:30 PM - 02:00 PM
    Breakout Sessions
    #P03
    P03: The A to Zs of FDR, Delegate, and Subcontractor Oversight Steve Bunde, VP Integrity & Compliance & Internal Audit, HealthPartners Laurena Lockner, Director Monitoring & Compliance, HealthPartners Rebecca Fuller, Corporate Compliance Officer, PrimeWest Health
    • Prevent: Learn about CMS and state requirements for FDR, delegate, and subcontractor oversight and areas of audit focus
    • Detect: Understand due diligence, contracting, risk assessment, and auditing and monitoring strategies - including key partnerships
    • Correct: Discover what to do when issues are identified and how to incorporate those into the correct CMS Program Audit Universe
    General Compliance
    #P04
    P04: Compliance 2020: Compliance and Business Roles in Today’s Complex Regulatory Environment James Taylor, Manager, PricewaterhouseCoopers Christopher Schroeder, Director, PricewaterhouseCoopers Taline Avakian, Director of Compliance and Medicare Compliance Officer, Harvard Pilgrim Health Care
    • Key developments and trends across the healthcare industry related to the evolving role of compliance and the role of business units
    • How compliance has helped define the role of meeting regulatory requirements
    • An understanding of embedded compliance support and/or performance/program support teams/units, and how risk ownership is driving the role of business units
    General Compliance
  • 02:00 PM - 02:15 PM
    Networking Break Mingle with your peers in the foyer before your next session starts.
    Networking
  • 02:15 PM - 03:45 PM
    Breakout Sessions
    #P05
    P05: Effectively Managing Internal Investigations and Regulatory Disclosures Anne Crawford, Director, ATTAC Consulting Group LLC Annie Shieh, Sr Compliance Counsel, Central Health Plan of California Lori Benso, Member, Strategic Health Law
    • Methods to determine if communication infrastructure supports prompt identification of potential issues
    • Strategies for initiating timely investigations that determine beneficiary and organizational impacts
    • Common themes and regulatory disclosure approaches when deciding whether self-reporting to regulators is required or advisable
    • Attorney-client privilege and litigation risk-management strategies
    General Compliance
    #P06
    P06: Compliance Goals in Risk Adjustment Coding Dana Brown, President, Reimbursement Management Consultants, Inc. Dott Campo, Manager, Risk Adjustment Division, Reimbursement Mgmt Consultants, Inc. Rebecca Welling, Senior Director- Coding Compliance, Providence Health Plan Rebecca Welling, Senior Director- Coding Compliance, Providence Health Plan
    • Overview of Risk Adjustment reimbursement in the MA and ACA models
    • Review of Risk Adjustment coding, HCC code capture accuracy, review of coding guidelines, rules & regulations
    • In-depth review of most common compliance issues in coding in an RA environment, isolating the issues and giving tools to analyze them and make good compliant decisions
    General Compliance
  • 03:45 PM - 04:00 PM
    Networking Break Mingle with peers and between sessions.
    Networking
  • 04:00 PM - 05:30 PM
    Breakout Sessions
    #P07
    P07: Special Supplemental Benefits and the FDRs that Provide Them - Unique Monitoring Challenges They Pose Jennifer Del Villar, Dir Gov Pgms Compliance, Cambia Health Solutions, Inc. Gail Blacklock, Compliance Officer , Inter Valley Health Plan
    • Unique monitoring challenges with unique FDRs
    • Monitoring the member match - right member to the right supplemental benefit
    • Tracking & monitoring health outcomes
    General Compliance
    #P08
    P08: Establishing a Best-Practice Approach for Your Compliance, Privacy, and Security Programs Bret Bissey, Vice President, Chief Compliance Officer, Gateway Health Kelly McLendon, Managing Partner, CompliancePro Solutions