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Monday, January 28, 2013
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Monday, January 28, 2013
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7:30 am -
8:15 am
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8:15 am -
11:00 am
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Workshop: Implementing Measures to Ensure you Remain Compliant |
- What compliance areas are likely targets for increased scrutiny by CMS and other oversight entities (OIG, Congress, OCR, etc.) and present the most risk?
- Appeals and Grievances - What data and measurements dyou need in place tassure compliance? How dyou manage "lumpy demand"?
- Delegated Entity Oversight - Recognizing the steps you need ttake tensure you implement and operate an effective oversight program
- 2012 CMS Compliance Program Guidance revisions – what are the most significant changes and what actions should your organization take tensure alignment with these changes?
- Learn more on what practical operational and governance measures can you take tminimize your risk of noncompliance and regulatory enforcement actions?
- What preventive strategies can you deploy tsupport an effective compliance program?
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Susan Roberts
President and Chief Executive Officer
The RobertsGroup, LLC
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Brenda Tranchida
Of Counsel, Venable LLP, Former Head of Audit, Enforcement and Compliance Programs
Centers for Medicare and Medicaid Services (CMS)
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11:30 am -
12:15 pm
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12:15 pm -
12:30 pm
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12:30 pm -
1:15 pm
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Medicare from Thirty Thousand Feet: Payment Trends And What This Means for Short-Term
and Long-Term Costs |
| Government health care programs are by far the fastest-growing portion of the federal budget. No one will know how successful ACA will be in slowing health
care costs but even if it meets optimistic expectations, the growth of governments will continue to outstrip the revenues available to fund them. So what are
some of the hurdles and obstacles that need to be removed? What initiatives can health plans adopt to take advantage of the aging population to increase the
number of members not entering traditional Medicare? |
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Brian Biles, MD, MPH
Professor of Health Policy
The George Washington University
School of Public Health and Health Services
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1:15 pm -
2:15 pm
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REACTOR PANEL: Leading Industry Experts Share Their Reactions and Thoughts on How Medicare
Advantage Will Move Forward and What This Will Mean for Reimbursement Rates |
- Listen to the biggest problems facing Medicare Advantage plans in the short, medium and long term given different the political outcomes of the
elections?
- Discuss the “biggest” opportunities for Medicare Advantage plans
- What are the prospects for people “aging in” to Medicare Advantage plans?
- Learn more about the types of changes we can expect from Medicare Advantage plans’ offerings over the next few years
- How will changes in the market climate and regulations impact medical loss ratios and the special need plans?
- Is the slow-down in the health care spending trend temporary due to the slow down in the economy or a permanent change that will continue when the
economy recovers, and employment increases substantially?
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| Moderator: |
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| Panelists: |
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Brian Biles, MD, MPH
Professor of Health Policy
The George Washington University
School of Public Health and Health Services
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2:15 pm -
2:45 pm
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2:45 pm -
3:30 pm
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3:30 pm -
4:15 pm
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KEYNOTE PRESENTATION: Harris Poll – Trends and Predictions |
- What will happen to health care reform and the health care system if the Republicans win the White House and both houses of Congress?
Or if they fail to do so?
- Recognize the prospects for the health insurance industry under either scenario?
- Hear the biggest opportunities and potential problems for the industry?
- How many changes could occur to the ways health care is delivered and paid for, with or without the ACA?
- Understand the prospects for state exchanges and private exchanges?
- Discuss the future of employer-provided insurance?
- What might “repeal and replace” look like in the real world?
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Debra Richman
Senior Vice President
Healthcare Business Development & Strategy
Harris Interactive
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4:15 pm -
5:15 pm
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CLOSING KEYNOTE PANEL: Market Consolidation: How Will This Impact the Future of Medicare Advantage |
- What strategies does an organization need in place if they are the buyer or the acquirer?
- As the market continues to consolidate what types of challenges and opportunities will this create for the large plan versus more regional plans?
- If the market consolidation continues to accelerate at the pace we have witness over the last year what will be implications in the short-term and in long
term for Medicare Advantage?
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Robert Fahlman
Formerly Chief Executive Officer
Arcadian Health
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Stephen Wood
Senior Vice President, Corporate Development
Universal American
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| Moderator: |
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Thomas Miller
Resident Fellow
Healthcare Policy and Regulation
The American Enterprise Institute for Public Policy Research
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5:15 pm -
5:30 pm
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5:30 pm -
6:30 pm
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