The 2nd Annual

Medicare Advantage Compliance & Audit Readiness Forum

Regulatory & Audit Best Practices to Mitigate Compliance Risks

October 28-30, 2019
Embassy Suites by Hilton | Fort Lauderdale, FL
#CMSAuditIEN


Join us in Fort Lauderdale for the industry’s most robust regulatory, compliance and audit-readiness conference. Participate in engaging discussions on the latest changes to audit protocols and regulatory updates. Learn how other plans are working to minimize risks associated with implementing new supplemental benefits. Hear from plans subject to the latest round of CMS program audits. And, get best practices for ANOC, EOC and marketing compliance.

The Compliance Certification Board (CCB)® has approved this event for up to 19.2 live CCB CEUs (for the workshop and conference). Continuing Education Units are awarded based on individual attendance records. Granting of prior approval in no way constitutes endorsement by CCB of this event content or of the event sponsor.


Key topics will include


Keys to Successfully Navigating the Combination of Part C & D Appeals and Grievances Reporting
Universe Creation and Review: Adapting to New Data Challenges

CMS Informal Operational Reviews: Why Audit Readiness is Critical
Featured Panel: Lessons Learned from the Latest Round of Program Audits

Who Will You Meet?


  • Combining topics related to a CMS program audit, as well as more general regulatory compliance risks, this conference is most relevant to senior executives, directors and managers responsible for:
  • Medicare Advantage or Government Programs Compliance
  • Program Audit Management
  • Compliance Program Effectiveness
  • Regulatory Compliance and Ethics
  • FDR Oversight

How Will This Conference Help You?

Get candid lessons learned and practical insights from health plans who recently underwent a CMS program audit

Get expert analysis and insights from recent call letters and regulatory guidance
Learn how other health plans are operationalizing new strategies in response to regulatory updates
Build your professional network and earn CCB credits to earn or maintain your accreditation

Past Attendees Include:

Centene | Tufts Health Plan | Aetna | HealthSun Health Plan | Health Now | MetroPlus Health Plan | CareSource | Scan Health Plan | Independence Blue Cross Blue Shield | Priority Health | Blue Cross Blue Shield of Idaho | Humana | Health First | Harvard Pilgrim Health Care | WellCare

  • “Very informative. I feel like we learned a lot from other plans.”

    - C. Lewis with HEALTH ALLIANCE
  • "Content was on point. The attendees added incredible perspective to the discussion. The right people were in the room."

    - H. Hilty with CARESOURCE
  • "Very informative from a standpoint of a smaller plan, listening to the operations of bigger plans."

    - Z. Perez with VILLAGECAREMAX
  • "Extremely informative. Enjoyed the perspectives, lessons learned and best practices from many plans and consulting groups."

    – J. Donaghey with BMC HEALTHNET PLAN
  • “Great diversity of content and expert speakers. The schedule and setting allowed plenty of networking time.”

    - Alyson S. with IHeartMedia

Speakers

Maité Morales Martínez, Esq., LL.M., CHC

Chief Compliance Officer
Medical Card System, Inc.

Niejadd Evans, MBA, CHC

Chief Compliance Officer
MG Insurance Company

Gloria Yu

Medicare Compliance Officer
AmeriHealth Caritas

Nicole Britton, JD, CHC

Chief Compliance Officer
Independent Health

Robin Larmer, JD, MS

Chief Compliance and Regulatory Affairs Officer
Santa Clara Family Health Plan

Nicolle Mustafa

Director, Health Plan CMS Compliance
CHRISTUS Health

Jessica Vander Zanden

Vice President of Compliance & Audit
Network Health

Deborah Marine, JD, CHC

Compliance Officer
SummaCare

Darlene Black

Director, Medicare Compliance
SCAN Health Plan

Angela Lloyd

Director of Audit and Corrective Action
Health Partners Plan

Michelle Fogg

Manager of Operational Compliance
Health Partners Plan

Jacqueline Crews

Director, Government Programs & Regulatory Affairs
AvMed, Inc.

Vicki Mikels, CHC

Corporate Medicare Compliance Officer
Beacon Health Options

Ken Nuñez, MBA, CHC

Vice President, Compliance Solutions
ATTAC Consulting

Darlene Dulac, MBA, CHC

Senior Consultant
ATTAC Consulting

Melissa Whitley, MBA

Vice President, Client Services
BluePeak Advisors

Pamela Cleveland

Chief Compliance Officer & VP, Compliance Product Strategy
Beacon Healthcare Systems

Jon Swisher

Manager, Solution Development
Kiriworks

Jennifer MacFarlane

Director, Complaints, Grievances & Appeals
Health Partners Plan

Rocio Kirchner

Medicare Compliance Officer
Cigna-Healthspring

Jason Kaylor

Director of Strategic Accounts
MHK

Schedule


Receive a full, detailed agenda via email

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28

October 2019

Monday

Optional Pre-Conference Workshop

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

    Workshop: Mastering FDR Oversight for Optimal Compliance and Audit Readiness

    Come a day early to participate in this invaluable workshop. Get proven best practices, audit-based lessons learned and strategies to enhance your oversight and collaboration with FDRs. This workshop will address:

    • - Keys to operating a successful FDR identification and determination process
    • - How to conduct effective FDR risk assessments from bottom to top
    • - Tips and best practices for completing pre-delegation compliance assessments (PDCA)
    • - Proven methods for monitoring and auditing your high-risk FDRs
    • - Successful strategies and techniques to mitigate and resolve FDR corrective actions
  • 5:00 PM
    End of Day

29

October 2019

Tuesday

  • 8:00 AM
    Conference Registration and Networking Breakfast
  • 9:00 AM

    Conference Sessions

    • - Welcome and Opening Remarks
    • The Big Picture: Analyzing the Latest Regulatory Changes
    • - Informal Operational Reviews: Why Audit Readiness is Critical
  • 10:45 AM
    Networking Break
  • 11:15 AM

    Conference Sessions

    • - Ensuring Your ANOC, EOC and Marketing Efforts Remain Compliant
  • 12:00 PM

    Networking Luncheon

  • 1:00 PM

    Conference Sessions

    • - Successful Strategies to Ensure Your Appeals & Grievances are Audit-Ready
    • - Identifying and Mitigating Emerging Risks While Implementing New Supplemental Benefits
  • 2:45 PM
    Networking Break
  • 3:15 PM

    Conference Sessions

    • - Panel Discussion: Organizational Compliance Best Practices & Lessons Learned
    • - Networking Roundtables
  • 5:00 PM
    Networking Reception
  • 6:00 PM

    End of Day

30

October 2019

Wednesday

  • 7:30AM
    Networking Breakfast
  • 8:15 AM

    Conference Sessions

    • - Chairperson’s Recap of Day One
    • - Examining the Latest Changes to Audit Protocols
    • - Featured Panel: Lessons Learned from the Most Recent Round of Program Audits
  • 10:30 AM

    Networking Break

  • 10:45 AM

    Conference Sessions

    • - Building Consensus in Light of Vague Provider Preclusion List Guidance
    • - Universe Creation and Review: Adapting to New Data Challenges
  • 12:30 PM

    Networking Luncheon

  • 1:30 PM

    Conference Sessions

    • - Optimizing Compliance Oversight of Member Services
  • 2:30 PM

    Summit Wrap-Up & Conclusion

Sponsors


Location


Embassy Suites by Hilton

1100 SE 17th Street
Fort Lauderdale, FL 33316
(954) 527-2700

Enjoy a welcoming stay at the Embassy Suites by Hilton Fort Lauderdale 17th Street hotel, an oasis on Causeway. Their all-suite hotel is surrounded by shopping and dining options, and is close to Fort Lauderdale attractions including Port Everglades and Fort Lauderdale Beach. Rest in a two-room suite and experience more living area and work space to catch up on business. Expect a number of great amenities, including a heated outdoor pool and a modern fitness center.

We have secured a special room rate of $179/night. To book at this price, call (954) 527-2700 and mention "IEX" or book online. This rate expires October 7th.

Hotel MdR

Sponsor Or Exhibit At This Event


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