Mastering Health Plan Third-Party Oversight

Best Practices to Ensure FDRs and Delegated Entities Remain Compliant & Audit-Ready

May 15-17, 2019
Hilton Mission Valley | San Diego, CA
#3rdPartyOversightIEN


Learn from health plan third-party oversight leaders how to improve monitoring and oversight of your FDRs and other delegated entities. Optimize your pre-delegation compliance assessments and due diligence efforts. Streamline the identification process and improve the development and implementation of audit plans. Get the latest CMS regulatory updates and get pragmatic tips and tools to enhance your compliance program effectiveness.


Key topics will include


Streamlining Pre-Delegation Compliance Assessments to Minimize Downstream Risk
Tips and Tools for Monitoring Often-Forgotten Delegated Entities
Best Practices for Third-Party Onboarding and Identification

Evaluating Changing Medicare Advantage Regulations and the Impact to FDR Oversight
Proven Methods to Ensure Compliance Program Effectiveness

Come a Day Early


Workshop: The Compliance Essentials of Third-Party Oversight

Gain unparalleled insights while working alongside colleagues and peers from other health plans in our optional full-day exercise-based workshop.

Taking place Wednesday from 10am-4pm, this workshop features a series of group-based exercises where you can roll up your sleeves and work through these challenging scenarios:

• Conducting risk assessments to develop risk profiles for your delegated entities

• Developing a monitoring & audit workplan

• Building a complete and accurate tracer

• Compiling and issuing notices of non-compliance

• Working with an FDR through common audit issues

Who will you meet?


  • Network with and learn alongside fellow health plan professionals spanning all lines of business with responsibilities in:
  • FDR or delegation oversight
  • Operational compliance
  • Health plan operations
  • Corporate compliance & legal
  • Internal and external audit
  • Vendor contracting and management
  • Fraud, waste and abuse
  • Program integrity & special investigations

How Will This Conference Help You?

Gain proven methods to better assess your third-parties’ compliance program effectiveness
Improve your plan’s third-party onboarding processes to minimize downstream risk
Enhance pre-delegation compliance assessment procedures to reduce instances of non-completion
Boost compliance and audit readiness, organization-wide, with tips and tools for often-forgotten delegated entities
Learn best practices and lessons learned from other health plans on issues ranging from organizational structures, ongoing monitoring practices, and FDR compliance training

 

Attendees from Previous IEN Health Plan Compliance Events

AllMed Healthcare Management | Blue Cross & Blue Shield of AL | Blue Cross & Blue Shield of MN | Blue Cross & Blue Shield of TN | Blue Cross & Blue Shield of TX | Blue Cross Blue Shield of FL | Blue Cross Blue Shield of IL | Blue Cross Blue Shield of RI | Blue Cross of Idaho | CareSource | Centene | Centers Plan for Healthy Living (CPHL) | Dean Health Plan | Delta Dental Plan of Michigan | Fallon Health | Gateway Health Plan | Health First | HealthNow New York | Healthsun | Humana | Medical Mutual | Meridian (WellCare) | Priority Health | Sanford Health Plan | Superior Health Plan | The Regence Group | VillageCareMAX

Speakers

Michelle Fogg

Manager of Operational Compliance

Health Partners Plan

Anne DeLomba

Manager of FDR/Delegation Oversight

Neighborhood Health Plan of Rhode Island

Ann Patel

Director of Audit

Virginia Premier Health Plan

Pamela Martin

Medicare Part D Consultant

MPD Compliance Specialists

Kristen Halsey

Director of Vendor Risk Management & Oversight

CareSource

Tucker Blair

Associate Counsel

Gateway Health

Sarah Herbert

Manager, Delegation Oversight Team

Virginia Premier Health Plan

Angela Lloyd

Director of Audit and Corrective Action

Health Partners Plan

Megan Grifa

Director, Medicare Compliance

Medical Mutual of Ohio

Kimberly Hughes

Manager Delegation Oversight

Passport Health Plans

Valerie Dubuc

Manager of Vendor Oversight

CareSource

Gail Blacklock

Director of Compliance & Compliance Officer

Inter Valley Health Plan

Lynne Civin

Medicare Part D Consultant

MPD Compliance Specialists

Schedule


Receive a full, detailed agenda via email

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15

May 2019

Wednesday

Optional Pre-Conference Workshop

  • 9:00 AM
    Pre-Conference Workshop Registration and Networking Meet & Greet
  • 10:00 AM

    Workshop Sessions:
    - Exercise A: Conducting Risk Assessments to Develop Risk Profiles for Your Delegated Entities
    - Exercise B: Developing a Monitoring and Audit Workplan

  • 12:00 PM
    Networking Luncheon for Workshop Participants
  • 1:00 PM

    Workshop Sessions:
    - Exercise C: Building a Complete and Accurate Tracer
    - Exercise D: Compiling and Issuing Notices of Non-Compliance
    - Exercise E: Working with an FDR Through Common Audit Issues

  • 4:00 PM
    End of Day

16

May 2019

Thursday

  • 7:00 AM
    Conference Registration and Networking Breakfast
  • 8:00 AM

    Conference Sessions

    • - Welcome and Opening Remarks
    • Panel Discussion: Innovative Delegate Oversight Practices and Tools
    • - Streamlining Pre-Delegation Compliance Assessments to Minimize Downstream Risks
  • 10:00 AM
    Morning Networking Break
  • 10:15 AM

    Conference Sessions

    • - Tips and Tools for Monitoring Often-Forgotten Delegated Entities
    • - Compliance Program Effectiveness: Addressing the Seven Elements
  • 12:00 PM

    Networking Luncheon

  • 1:00 PM

    Conference Sessions

    • - Panel Discussion: Evaluating Organizational Structures and Alignments to Improve Efficiency Across Lines of Business While Minimizing Risk
    • - Case Study: How We Built Our Risk Assessment Tool and Use it Develop Audit Plans
  • 3:00 PM
    Afternoon Networking Break
  • 3:30 PM

    Conference Sessions

    • - Proven Methods for Improving Your PBM Oversight and Audits
    • - Networking Roundtables
  • 5:00 PM
    Networking Reception
  • 6:00 PM

    End of Day

17

May 2019

Friday

  • 7:00 AM
    Networking Breakfast
  • 8:00 AM

    Conference Sessions

    • - Chairperson’s Recap of Day One
    • - Evaluating Changing Medicare Advantage Regulations and the Impact to FDR Oversight
    • - Best Practices for Third-Party Onboarding and FDR Identification
  • 10:00 AM

    Networking Break

  • 10:15 AM

    Conference Sessions

    • - A Focus on Ongoing Monitoring: Addressing Issues of Non-Compliance
    • - Best Practices and Preventative Measures to Avoid Fraud, Waste and Abuse
  • 12:00 PM

    Networking Luncheon

  • 1:00 PM

    Conference Sessions

    • - Practical Tips to Ensure Downstream Entities Have Robust Data Security
  • 2:00 PM

    Summit Conclusion

Location


Hilton San Diego Mission Valley

901 Camino Del Rio South
San Diego, CA 92108
(800) 682-6099

Located in the center of sunny San Diego, the Hilton San Diego Mission Valley hotel is minutes away from San Diego International Airport, the San Diego Zoo, Balboa Park, Mission Bay and Beaches, SeaWorld® San Diego, Old Town, iconic craft breweries and many other popular destinations.

Indulge in great amenities, including modern rooms and suites with relaxing walk-in showers, and an inviting outdoor pool.

Hotel MdR

IEN has negotiated a special room rate of $129/night. The venue is only offering this rate until April 23, 2019, so please book early.  Once the room block sells out pricing and availability will be at the venue’s discretion.  
 
Call 800-682-6099 or book your room here and use group code IN1 when reserving your room.

  • “Great topics and panelists”

    – Phong N. from Dean Health Plan
  • “Excellent—atmosphere, the discussions held, the takeaways from other health plans on how to implement CPE. Very knowledgeable speakers and networking among the attendees was amazing”

    - David P. with Indiana University Health
  • “Very informative. I feel like we learned a lot from other plans”

    - Chelsea L. with Health Alliance
  • “Excellent information related to compliance efforts”

    – Deborah S. with Blue Cross Blue Shield of Western New York
  • “Broad range of presentations with specific and applicable recommendations”

    - Karl W. with United Health

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