2024 Agenda
Conference Program
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Day 1 - Thursday, May 2, 2024
Day 2 - Friday, May 3, 2024
7:45 |
Registration Opens and Continental Breakfast Served |
8:50 |
Co-Chairs’ Opening Remarks |
9:00 |
Fraud and Abuse: MCO Takeaways from Recent Investigations and Enforcement Activity in the Healthcare Industry |
10:00 |
A New Era of MHPAEA Enforcement: Litigation Risks and Compliance Considerations for MCOs |
10:30 |
Morning Coffee and Networking Break |
10:45 |
GC Perspectives on the Future of Payor-Provider Relationships |
11:30 |
Interactive Panel & Q&AAsk an Arbitrator About Managed Care Disputes: Everything You Ever Wanted to Know but Have Been Afraid to Ask |
12:30 |
Networking Lunch |
1:30 |
An MCO Guide to Navigating Mergers and Acquisitions Amid Heightened Antitrust Enforcement |
2:30 |
Afternoon Break |
3:00 |
Limiting Liability When a Data Breach Occurs: Lessons Learned from Recent Incidents Impacting Plans and Downstream Partners |
3:45 |
Top 5 Legal Considerations for MCOs when Dealing with Financially Distressed Providers |
4:15 |
Conference Concludes |
Day 1 - Thursday, May 2, 2024
7:45 |
Registration Opens and Continental Breakfast Served |
8:45 |
Co-Chairs’ Opening RemarksJoanna Allen Tim McMichael Adam Petitt |
9:00 |
15-Years of Managed Care: Reflections and Perspectives on How the Industry has Changed and Key Drivers in the Litigation LandscapeMarguerita Brunson Sims Gregory Russo Lou Patalano Moderator:Tim McMichael Join renown litigators and thought-leaders from the managed care industry for an interactive discussion examining the most notable cases and developments of the last 15 years. Perhaps more importantly, panelists will discuss current forces shaping the landscape and what MCO’s and their counsel should be on the lookout for in the years ahead. |
9:45 |
Examining the Latest Legal Challenges to the No Surprises Act and Key Takeaways for Payors from the IDR ProcessAlexandra M. Lucas Matthew S. Rozen Ray Walker The No Surprises Act came into effect in January of 2022. Two years later, it remains a moving target. The Texas Medical Association (TMA) successfully challenged several provisions in the regulations implementing the NSA. Most recently, and notably, they secured the TMA III decision that the QPA calculation requirements unfairly favored insurers. The Departments of Labor, and Health and Human Services have issued new proposed rules in response. This session will provide plans with insights on the impact of these decisions, how future rulemaking is shaping up, and trends in IDR provider strategies.
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10:45 |
Morning Coffee & Networking Break |
11:00 |
Special Focus on AIMCOs on the Cutting Edge: How to Limit Exposure Leveraging Artificial Intelligence, Algorithms and Emerging TechnologyArchana Rajendra Chris Petelle Kevin Feder Moderator:Lindsay Fetzer Artificial Intelligence holds the potential to generate critical insights and drive efficiencies across the healthcare system. As AI tools and related technologies become increasingly sophisticated, the MCOs and downstream entities that use them will need to develop a deep understanding of how to harness the power and the promise of these inventions—as well as the risks. Litigation is already starting to bubble up, making it important to examine the current regulatory environment, and exposure created by AI use.
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12:00 |
Special Focus on AIAntitrust Risks in an AI World: A Conversation with the DOJ and FTCBindi R. Bhagat Timothy Slattery Moderator:Barbara Reeves The FTC and DOJ recently shared concerns about the anticompetitive potential of AI. More specifically, the use of AI to aggregate data in a way that could result in collusion. This moderated discussion with enforcement agencies will flag areas of concern as it pertains to the use of AI/ML in managed care and the potential for anticompetitive outcomes. |
12:30 |
Networking Lunch |
1:30 |
Preparing for a Surge in Health Plan Fee LitigationEli Burriss Kara Petteway Wheatley Excessive fee claims are on the rise, targeting plans both big and small. It’s critical time to analyze causes of action and what plans/plan sponsors can do to protect themselves as they devise winning defense strategies.
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2:15 |
How to Strategically Manage Data and Analytics in Payor-Provider DisputesElizabeth Hutchins Adam Petitt |
2:45 |
Afternoon Refreshment Break |
3:15 |
Bid Protests: Takeaways from the Medicaid Managed Care Procurement LitigationBenjamin McCoy The stakes are high when it comes to locking in a Medicaid managed care contract. For plans, a winning bid, can mean billions in state dollars. This has resulted in an increased emphasis on developing a winning bid strategy, and examining the procurement process and opportunities to challenge awards.
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3:45 |
Unpacking AHA V. Becerra and CMS Final Rule on 340B: Implications for MA PlansMelissa Wong
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4:30 |
Navigating A New Risk Adjustment Landscape: Key Regulatory and Legal Considerations for Plans in 2024Tyler Marshall For MA plans, missteps when navigating the complexities of risk adjustment can be costly, making data accuracy and compliance of the utmost importance. In 2023 CMS introduced a new RA model and released the RADV final rule. This session will delve into these developments, compliance best practices and the implications for the legal landscape. |
5:00 |
Cocktail Reception
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Day 2 - Friday, May 3, 2024
7:45 |
Registration Opens and Continental Breakfast Served |
8:50 |
Co-Chairs’ Opening RemarksJoanna Allen Tim McMichael Adam Petitt |
9:00 |
Fraud and Abuse: MCO Takeaways from Recent Investigations and Enforcement Activity in the Healthcare IndustryKelly Hightower Hibbert Jared R. Ginsberg Nate Moore
|
10:00 |
A New Era of MHPAEA Enforcement: Litigation Risks and Compliance Considerations for MCOsAndrew Holmer Joseph E. Laska MHPAEA enforcement is ramping up and the Biden administration has proposed new rules that would strengthen federal laws on mental health parity requirements. The proposal would require health plans to collect data to assess the impact of “nonquantitative treatment limits” (NQTLs) on mental and behavioral health benefits and medical and surgical services. It’s a critical time for MCOs to examine what’s being proposed by regulators, as well as recent enforcement actions so that they can remove problematic provisions and ensure future compliance.
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10:30 |
Morning Coffee and Networking Break |
10:45 |
GC Perspectives on the Future of Payor-Provider RelationshipsTim McMichael Jon Rose Moderator:Jonathan Herman Hear from both sides of the aisle during this interactive discussion exploring payor provider perspectives. Panelists will offer insights on trends in the type of disputes that are arising in the MCO arena and best practices for building better relationships in an effort to avoid or at the very least efficiently manage what can often be protracted, costly matters for all involved. |
11:30 |
Interactive Panel & Q&AAsk an Arbitrator About Managed Care Disputes: Everything You Ever Wanted to Know but Have Been Afraid to AskHon. Myra C. Selby Kirstin Ives Christopher Keele, Esq. Moderator:Michelle Skipper
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12:30 |
Networking Lunch |
1:30 |
An MCO Guide to Navigating Mergers and Acquisitions Amid Heightened Antitrust EnforcementMike Cowie Dan Howley The Biden Administration is hyper focused on antitrust in healthcare. In the past few years the DOJ and have challenged several significant deals, with mixed success. New merger guidelines reflect a willingness to investigate or challenge more deals.
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2:30 |
Afternoon Break |
3:00 |
Limiting Liability When a Data Breach Occurs: Lessons Learned from Recent Incidents Impacting Plans and Downstream PartnersAdam A. Cooke
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3:45 |
Top 5 Legal Considerations for MCOs when Dealing with Financially Distressed ProvidersKen Thomas There has been an uptick in healthcare provider bankruptcies in the last couple year. Providers claim the roll back of COVID-19 funding and implementation of the No Surprises Act have contributed to the financial strain, and ultimately the decision to file for Chapter 11 bankruptcy. For payors, it’s a critical time to assess the impact on current business with providers and strategically approach ongoing legal matters.
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4:15 |
Conference Concludes |