4th Annual CompliancePalooza

Oct 28, 2021 ‐ Oct 29, 2021

Standard: $500.00


CMS Audit Shakeup Part 1: Tackle the Enormity of Medicare Advantage and Part D Program Audit Changes to Protocols

Oct 28, 2021 10:15am ‐ Oct 28, 2021 11:00am

Identification: THURS02

•    Dive into CY 2022 protocols for Medicare Advantage and Part D program audits to understand what new programming and workflows are needed
•    Review an in-depth analysis of the changes from current protocols to better understand what CMS is looking for


CMS Audit Shakeup Part 2: Shore up Your Fraud, Waste and Abuse Activities with Integrity Audit Lessons Learned

Oct 28, 2021 11:15am ‐ Oct 28, 2021 12:00pm

Identification: THURS03

•    Gain insight from plans that went through the CY 2021 Program Integrity Audit to see where your gaps are and how to fill them
•    Better prepare your compliance team and ensure reporting mechanisms measure up
•    Ensure you have the right proactive activities as well as the right oversight structure in place to prevent and correct potential FWA


Get Ahead of the Changes in CMS’ One-Third Financial Audit

Oct 28, 2021 12:15pm ‐ Oct 28, 2021 1:00pm

Identification: THURS04

•    Learn directly from a health plan which underwent a recent One-Third Financial Audit unlike the previous ones they have experienced
•    Discover exactly how CMS financial audits have expanded in scope and better prepare your response
•    Understand what CMS is looking for, the areas of interest, and the depth, to plan ahead


Increasing Access to Care for Mental Health and Substance Use Disorder Treatment Amid Unclear Requirements

Oct 28, 2021 2:15pm ‐ Oct 28, 2021 3:00pm

Identification: THURS06

•    Discuss mitigation efforts for the disjointed guidance for compliance with mental health parity requirements and the need for uniformity between state and federal regulators
•    Gain clarity and understand why it is important that Part 2 aligns with HIPAA (Health Insurance Portability & Accountability Act) standards
•    Understand why eliminating or relaxing the X-waiver is critical to treating opioid addiction

  • Deepti Loharikar, Director, Regulatory Affairs, Association for Behavior Health and Wellness

The Changing Landscape for Compliance

Oct 28, 2021 3:15pm ‐ Oct 28, 2021 4:00pm

Identification: THURS07

•    Delve into best practices to manage relationships with a growing list of involved regulators to pivot successfully in the Biden Administration era of expanded scrutiny
•    Survey how other health plans are managing HIPAA compliance and related concerns as employees migrate back to the office

  • Osato F. Chitou, Principal Consultant, NMOC Healthcare Compliance Consulting d/b/a Compli by Osato
  • Beth Socoski, MBA, MSW, MSCL, CHC, CCEP, Chief Strategy Officer, Socoski Design Consulting
  • Michelle O’Neill, Vice President, Corporate Compliance & Privacy, Summit Medical Group
  • Joseph Piccolo, Vice President, Corporate Compliance & Ethics, Corporate Compliance and Privacy Officer, Inspira Health Network

The Value of AI, Rules, and SMEs for Compliance and Combating FWA

Oct 28, 2021 4:15pm ‐ Oct 28, 2021 5:00pm

Identification: THURS08

•    Understand the framework to leverage congruent use of Artificial Intelligence (AI) and traditional rules-based approach for best outcomes
•    Explore the importance of incorporating subject matter experts into your prevention program
•    Survey COVID-19 FWA, EEGs, and other case studies and learn why an integrated solution is the most efficient way to combat FWA


Chairperson’s Day Two Opening Remarks & Keynote Address: The Changed Landscape for Managed Care Compliance

Oct 29, 2021 10:00am ‐ Oct 29, 2021 10:55am

Identification: FRI001

Compliance to Accessibility Standards

Oct 29, 2021 11:10am ‐ Oct 29, 2021 12:00pm

Identification: FRI03

•    Delve into the particulars of Section 508 to ensure compliance to accessibility of government information
•    Get clarity on what you truly need to do regarding disabilities, ESL, and your grievance process to comply with Affordable Care Act’s Section 1557
•    Shore up the two Star measures linked to Medicare marketing guidelines for interpretation and translation and for the hearing impaired
•    Discuss best practices for call center monitoring and for your complaints management system, to provide meaningful access for people with disabilities

  • Osato F. Chitou, Principal Consultant, NMOC Healthcare Compliance Consulting d/b/a Compli by Osato

A Breach in the Hull: Lessons Learned from a Successful Phishing Attack

Oct 29, 2021 12:15pm ‐ Oct 29, 2021 1:00pm

Identification: FRI04

•    Learn about one plan’s approach in responding to a phishing attack resulting in a breach of over 500 individuals
•    Hear about lessons learned during and after the investigation along with creative and effective post-breach training and communication strategies
•    Review how they handled member communications, disclosures to the media, and related tasks that challenged compliance

  • Angela Keenan, CHC, Director of Privacy & Compliance, Network Health

Effective Strategies to Partner with Delegates and FDR Oversight Best Practices

Oct 29, 2021 2:15pm ‐ Oct 29, 2021 3:00pm

Identification: FRI06

•    Identify contractual vulnerabilities and effective FDR risk management strategies before problems arise
•    Develop a strategic operational plan and effectively partner with delegates to withstand emergency or pandemic protocols
•    Explore best practices and lessons learned for vendor classification and management during the COVID-19 crisis and throughout the audit process


Save Time and Resources – Program Audit Best Practices for Multi-Plan Organizations & Chairperson's Closing Remarks

Oct 29, 2021 3:15pm ‐ Oct 29, 2021 4:20pm

Identification: FRI002