Topics
- Sound compliance practices within the CMS quality initiatives: Stars, HEDIS
- Identifying and managing false claims act exposure in a Part C plan
- Moving the audit and compliance function upstream
- Best practices for clinic inspections: ferreting out bogus provider groups in your network
- MA chapter 13 appeals and grievances best practices
- RADV audits
- Procedures
- Fraud & abuse:
- Bundling
- Case Studies
Who should Attend
Health plan executives with responsibilities in Compliance, Accounting, Fraud Examination, Enrollment, Marketing, Fraud, Waste and Abuse, Quality, Network Operations, Risk Management, Risk Assessment, Utilization Management and Risk Adjustment.
