Our annual conference will be livestreamed September 3-4. Sessions are designed to help you successfully navigate Centers for Medicare & Medicaid Services (CMS) audits, prepare for increased scrutiny from the Office of Inspector General (OIG), and evaluate the impact of the latest regulatory changes.
This year’s event will feature insights on the 2025 Medicare Advantage Final Rule, audit readiness techniques, health equity analysis of utilization management, and network adequacy. The agenda is jam-packed with hot topic sessions. Here are four you definitely do not want to miss:
Keynote presentation by the Deputy Inspector General for Evaluation and Inspections
Ann Maxwell, deputy inspector general for evaluation and inspections for the Department of Health and Human Services (HHS) OIG, will kick off the conference with a keynote at 10:05 a.m. EST, Tuesday, Sept. 3. She’ll offer a perspective on recent audits the office has conducted related to Medicare Advantage.
As the head of the Office of Evaluation and Inspections, Maxwell leads more than 150 professionals who provide objective, reliable, data-driven evidence to HHS, Congress, and the public on significant issues. She leads the office in producing results-oriented evaluations that provide valuable insights into the efficiency and effectiveness of HHS programs as well as offer actionable recommendations to drive positive change in HHS programs so that they can better serve and protect the American people.
Mastering CMS program audits
Angela Lloyd, associate compliance officer, Jefferson Health Plans, and Jennifer (Jen) Del Villar, CHC, director of government programs compliance/Medicare compliance officer, Cambia Health Solutions, will lead this session that explains how to prepare for and execute a CMS program audit.
The 50-minute session will take place at 11 a.m. EST, Tuesday, September 3. Attendees will learn how to prepare for a CMS program audit by understanding the audit process, required documentation, and key areas of focus. Speakers will explain how to execute the audit effectively by coordinating internal teams, responding promptly to auditor requests, and providing accurate and complete information. They’ll also offer tips on how to implement corrective actions and continuous improvement strategies based on audit findings to address deficiencies, enhance compliance, and improve overall plan performance.
Navigating the 2025 Medicare Advantage Final Rule
There were so many changes included in the 1,327-page 2025 Medicare Advantage Final Rule, Ana Handshuh, principal, CAT5 Strategies, and Annie Shieh, AVP, compliance, Molina Healthcare, will analyze the major changes and their implications for Medicare Advantage plans.
Attendees will learn how to develop comprehensive strategies to ensure compliance with the new regulations, including adjustments to operational, marketing, and network adequacy practices. Handshuh and Shieh will also explain how to implement effective communication and training programs to educate staff, agents, and beneficiaries about the new requirements and compliance expectations. The session will take place at 10:10 a.m. EST, Wednesday, September 4.
Understanding RADV updates and the new appeals process
This session, which will be held at 12:05 p.m. Wednesday, September 4, will focus on the revised RADV appeals process, including the separation of medical record review determination appeals and payment error calculation appeals. Speakers Colleen Gianatasio, director clinical documentation integrity and coding compliance, Capital District Physician’s Health Plan, and Donna Malone, CPC, CRC, AAPC approved Instructor, AHCCA, RAP, director risk capture, population health management, Mass General Brigham, will provide strategies to manage the initiating a payment error calculation appeal. They’ll also go over the timelines and procedural requirements for RADV appeals, including the issuance of revised audit reports.
CompliancePalooza 2024 will take place 10 a.m. to 4 p.m. EST, Tuesday, September 3 and Wednesday, September 4. Click here for the full agenda, list of speakers, and how to register.