2021 Managed Care Compliance Conference

26. Another Look at Building a DSNP Compliance Program

    2021 Managed Care Compliance Conference  | Presenter(s): Kimulet Winzer, Nicole Larson, Thomas Tutaj  | February 01, 2021 

    • How to move from building to implementing a DSNP Compliance program --compliance professionals will share pitfalls and best practices

    • Components and concepts to create an effective program

    • How compliance professionals engage stakeholders as partners in building and creating an effective DSNP program

27. Building a Cybersecurity Auditing and Monitoring Plan

    2021 Managed Care Compliance Conference  | Presenter(s): Jennifer Griveas, Michael Gray  | February 01, 2021 

    • Upon completion, participants will be able to understand the biggest security threats to health care organizations and highlight most vulnerable systems and populations

    • Learn to assess compliance risk related to common technologies and equipment, with focus on developing an auditing and monitoring plan for meeting the mandates of the HIPAA Security Rule and other applicable substantive cybersecurity requirements

    • Speakers will review how to take results of auditing and monitoring activity to build a strong work plan to mitigate risks associated with technology

28. Covid-19 and Lessons Learned for Flexible Care Management Approaches

    2021 Managed Care Compliance Conference  | Presenter(s): Rob Parker, Valerie DeBoe, Gretchen Wagner, Rohit Gupta  | February 01, 2021 

    • A panel discussion on lessons learned from the Coronavirus pandemic and how health plans redeployed staff, adjusted processes, prioritized member outreach, and lessons learned for future emergencies and disruptions.

    • How were plans able to successfully deploy employees, including FDR staff, to provide remote care management services while proactively providing accommodations to high risk members?

    • What processes and organizational responses will your organization retain for future national or local emergencies (e.g., natural disasters)? What areas of improvement have been highlighted throughout this experience?

29. How to Build a CPE Tracer: Best Practices to Focus on Prevention, Detection, and Correction Using Misclassified Grievances

    2021 Managed Care Compliance Conference  | Presenter(s): Michelle Larson, Milly Koranteng, Hannah LaMere  | February 01, 2021 

    • Prevention: Apply prevention methods to avoid misclassified grievances, identify training needs, review of regulations, guidance and audit protocols, updating policies and procedures

    • Detection: Provide suggestions on how to add rigor to compliance staff oversight of call routing and classification of inquiries, grievances, organization determinations, coverage determinations

    • Correction: Learn the critical questions to consider when building Corrective Action Plans. A template will be reviewed

30. Corrective Action Plans & Root Causes: Why It's Important to Get Both Right

    2021 Managed Care Compliance Conference  | Presenter(s): Alexander Henrichs  | February 01, 2021 

    • Best Practices and Unique Perspectives on Root Causes and Developing Corrective Action Plans

    • Why CAPS rely so heavily on Root Causes, and how to help ensure, as Compliance, that you get it right the first time through

    • After the CAP: Measuring and Monitoring results to ensure the Corrective Action is truly Corrective

31. Risks and Audit Readiness for Non-Quantitative Treatment Limits (NQTLs) of the Mental Health Parity Addiction Equity Act (MHPAEA)

    2021 Managed Care Compliance Conference  | Presenter(s): Jon Swanson, Maggie Russillo  | February 01, 2021 

    • Understand the unique health plan challenges posed by MHPAEA non-quantitative treatment limits (NQTLs) in order to facilitate operational engagement

    • Address regulator, purchaser, and member expectations of NQTLs

    • Learn to build a toolkit to complete meaningful assessments and evaluate compliance for audit readiness

32. The Ever-Evolving Landscape of Privacy and Security Compliance

    2021 Managed Care Compliance Conference  | Presenter(s): Jonathan Friesen, Adam Greene  | February 01, 2021 

    • Update on recent changes to health information privacy laws

    • Recent privacy and security enforcement trends

    • Third party risk assessment