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Informa
May 21
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8:00am - 9:00am

Registration and Morning Coffee

9:00am - 9:45am

The Current Managed Care Landscape Nationwide



  • Speaker Alexander Shekhdar - Vice President, Federal and State Policy, Medicaid Health Plans of America (MHPA)
more
9:45am - 10:30am

Digital Communications and Your Members: 5 Myths Debunked

  • Neng Bing Doh - CEO, HealthCrowd
10:30am - 11:15am

Morning Networking Break

11:15am - 12:00pm

The Impact of Patient Reported Outcomes on Regulators and Payers

  • Speaker Christine McSherry - Executive Director, Jett Foundation
12:00pm - 12:45pm

Update on Regulatory Developments and Government Initiatives on the Hill Impacting Managed Care

  • Tonya Hales - Assistant Director Division of Medicaid and Health Financing, Utah Department of Health
  • Andrey Ostrovsky - CEO, Concerted Care Group
  • Kate McDonald - Partner, Health Industry Advisory Practice Group, McDermott, Will & Emery LLP
12:45pm - 1:30pm

Fraud, Waste & Abuse in Medicaid Managed Care

The National Health Care Anti-Fraud Association (NHCAA) will host this panel discussion on the topic of health care fraud, waste and abuse, specifically regarding Medicaid managed care. Join the NHCAA’s CEO and three key NHCAA member representatives and seasoned anti-fraud professionals who work for insurers that hold Medicaid managed care contracts as they address the leading issues and trends in the FWA space as it pertains to MC.

Moderator:

Louis Saccoccio, CEO, National Health Care Anti-Fraud Association

Panelists: 

Richard Munson, Vice President, Investigations, UnitedHealthcare

Nicholas Messuri, Vice President, Fraud Prevention & Recovery, DentaQuest

Katherine Leff, Director, Special Investigations Unit, CareSource

  • Moderator Louis Saccoccio - CEO, National Health Care Anti-Fraud Association
  • Panelist Richard Munson - Vice President, Investigations, UnitedHealthcare
  • Panelist Nicholas Messuri - Vice President, Fraud Prevention & Recovery, DentaQuest
  • Panelist Katherine Leff - Director, Special Investigations Unit, CareSource
more
1:30pm - 2:30pm

Networking Lunch

Showing of Streams
4:45pm - 5:45pm

Networking Reception

8:00am - 9:00am 60 mins
Registration and Morning Coffee
9:00am - 9:45am 45 mins
The Current Managed Care Landscape Nationwide
  • Speaker Alexander Shekhdar - Vice President, Federal and State Policy, Medicaid Health Plans of America (MHPA)
more



9:45am - 10:30am 45 mins
Digital Communications and Your Members: 5 Myths Debunked
  • Neng Bing Doh - CEO, HealthCrowd
10:30am - 11:15am 45 mins
Morning Networking Break
11:15am - 12:00pm 45 mins
The Impact of Patient Reported Outcomes on Regulators and Payers
  • Speaker Christine McSherry - Executive Director, Jett Foundation
12:00pm - 12:45pm 45 mins
Update on Regulatory Developments and Government Initiatives on the Hill Impacting Managed Care
  • Tonya Hales - Assistant Director Division of Medicaid and Health Financing, Utah Department of Health
  • Andrey Ostrovsky - CEO, Concerted Care Group
  • Kate McDonald - Partner, Health Industry Advisory Practice Group, McDermott, Will & Emery LLP
12:45pm - 1:30pm 45 mins
Fraud, Waste & Abuse in Medicaid Managed Care
  • Moderator Louis Saccoccio - CEO, National Health Care Anti-Fraud Association
  • Panelist Richard Munson - Vice President, Investigations, UnitedHealthcare
  • Panelist Nicholas Messuri - Vice President, Fraud Prevention & Recovery, DentaQuest
  • Panelist Katherine Leff - Director, Special Investigations Unit, CareSource
more

The National Health Care Anti-Fraud Association (NHCAA) will host this panel discussion on the topic of health care fraud, waste and abuse, specifically regarding Medicaid managed care. Join the NHCAA’s CEO and three key NHCAA member representatives and seasoned anti-fraud professionals who work for insurers that hold Medicaid managed care contracts as they address the leading issues and trends in the FWA space as it pertains to MC.

Moderator:

Louis Saccoccio, CEO, National Health Care Anti-Fraud Association

Panelists: 

Richard Munson, Vice President, Investigations, UnitedHealthcare

Nicholas Messuri, Vice President, Fraud Prevention & Recovery, DentaQuest

Katherine Leff, Director, Special Investigations Unit, CareSource

1:30pm - 2:30pm 60 mins
Networking Lunch
2:30pm - 3:15pm 45 mins
Track I: Specialty Populations and Programs
Monitoring EPSDT and Data Sharing with MCOs
  • Colleen Sonosky - Associate Director of Children's Health Services, DC Department of Health Care Finance
  • Serina Kavanaugh - Management Analyst, DC department of Health Care Finance
more
2:30pm - 3:15pm 45 mins
Track II: Addressing the Opioid Epidemic
Strategies to Manage the Opioid Crisis
  • John Lovelace - President Government Programs, UPMC Health Plan
more
3:15pm - 4:00pm 45 mins
Track I: Specialty Populations and Programs
How New Mexico Stakeholders Leveraged Technology to Facilitate Statewide Collaboration and Interventions for At-Risk Patients
  • Beth Landon - Policy Director, New Mexico Hospital Association
more

This session will focus on New Mexico stakeholders’ ability to drive collaboration, ease tensions around data sharing, and develop common, statewide goals. As part of the session, Landon will cover the following learning objectives:

  • How to implement a statewide process for sharing information;
  • How to identify and incorporate the right technology tools to detect high-utilizers of ED services;
  • How to work collaboratively with other organizations— payers, providers and other stakeholders— regardless of differences; 
  • How to address common implementation and collaboration challenges that may arise
3:15pm - 4:00pm 45 mins
Track II: Addressing the Opioid Epidemic
Effective Strategies for Engaging & Retaining People with an Opioid Use Disorder in Treatment
  • David Loveland - Senior Program Director, Community Care Behavioral Health Managed Care Organization (CCBH)
more

The workshop can provide an overview of strategies that can be implemented within a Medicaid funded system, including interventions that are cost effective.

4:00pm - 4:45pm 45 mins
Track I: Specialty Populations and Programs
Combating the Claims Payment Integrity Conundrum
  • Stanley Guilbaud - CEO, 360 Health Systems, Inc.
more

Today’s shifting and changing healthcare environment make managing and processing claims more complex than ever. Healthcare Organizations are increasingly under pressure to process claims effectively, at lightning speed and error-free. These ongoing challenges, including claim processing complexities and the health care reform often force health insurers to impose increased premiums and coverage limitations for patients.  According to the NHCAA between $68 billion and $156 billion is lost annually to FWA overpayments and does not include accidental coding inaccuracies and payment errors which can be comparable in numbers.

4:00pm - 4:45pm 45 mins
Track II: Addressing the Opioid Epidemic
Putting the Brakes On the Opioid Epidemic
  • Jason Winters, RPh, MBA - Senior Director, Government Programs, Express Scripts
more

Drug overdose is the leading cause of accidental deaths in the US -- more than 42,000 people fatally overdosed on opioids in 2016 and nearly 2 million are addicted. Research shows that with a 10 day supply of opioids, 1 in 5 become long term users. During this session we’ll reveal solutions to help curb the costs, combat the opioid epidemic and keep members healthier.

4:45pm - 5:45pm 60 mins
Networking Reception