4th Annual CompliancePalooza

Oct 28, 2021 ‐ Oct 29, 2021


Standard: $500.00

Sessions

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

Speaker(s):

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

Speaker(s):

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

Speaker(s):

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

Speaker(s):
  • 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

Speaker(s):
  • 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

Speaker(s):

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

Speaker(s):
  • 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

Speaker(s):
  • 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

Speaker(s):

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