Hooper, Lundy & Bookman, P.C. & HFMA Present
2015 Provider Managed Care Update
Post ACA Changes to Government and Private Managed Care Markets
Registration & Breakfast Will Begin At 8:00am
April 28, 2015 – Oakland Marriott City Center
April 30, 2015 – The Westin Los Angeles Airport
The Affordable Care Act continues to impact the managed care marketplace in both anticipated and unanticipated ways. Health care providers and suppliers face an ongoing panoply of complex choices, many of which have a significant impact not only on patient care and relationships with other providers, but also on their own financial and operational health.
At the heart of many post-ACA changes is managed care. In this one-day seminar, Hooper, Lundy & Bookman (HLB) provides a comprehensive look at the current and future states of both the Government and Private Managed Care Marketplaces.
Because of the complexity and variety of issues providers are facing, we offer a choice of breakout sessions throughout the day designed to address the most pressing questions providers are asking today.
The seminar opens with a Plenary Session co-presented by Keith Fontenot, former top OMB budget official and currently the managing director of HLB’s Government Relations, and Public Policy practice, and Margaret Tatar, former acting deputy director of delivery systems for California DHCS and current principal with Health Management Associates.
Together they will provide regulatory updates from Washington, D.C. and Sacramento, addressing current issues influencing managed care, including:
- Changes in the insurance market
- Alignment of managed care and provider interests in new models
- Cost containment pressures and downstream affects
- Continuing managed care reforms, and
- Continued governmental enforcement and oversight of governmental plans
Following the plenary session, participants have an opportunity to choose among the following breakout sessions throughout the day:
10:10am - 11:00am
Medi-Cal Managed Care Update: Margaret Tatar and Mark Reagan (HLB-Oakland), Mark Johnson (HLB-Los Angeles) look at both the current and future regulatory states of Medi-Cal Managed Care, including MCO tax, plan inconsistency in PCP payments, handling special populations, and more... [Session 1]
Managed Care Litigation Update: Daron Tooch provides insight into the relevance of recent court decisions and ongoing litigation related to hot button issues including out-of-network disputes, contract disputes, current class actions, and more... [Session 2]
11:10am - 12:00pm
Medicare Advantage Reimbursement: Steven Lieberman (Lieberman Consulting) and Amanda Hayes-Kibreab (HLB) take a comprehensive look at the impact of sequestration, the Annual Call Letter, ACO changes, and more... [Session 3]
Contracting & Managing Relationships with Health Plans: Felicia Sze (HLB) explores recent trends in managed care contracting and managing issues that arise in everyday relationships with managed care plans, including narrow networks, charity care, options for self-disclosure in regulated managed care programs, and more... [Session 4]
1:10pm - 1:40pm
Veterans Administration/TRICARE: As a result of serious access problems for veterans through the VA system, Congress recently enacted the Veterans Choice Program. David Vernon (HLB) discusses the rollout of the VCP, the recent expansion of the VA's Center for Public-Private Partnerships (PC3), jurisdictional and compliance issues that could impact providers, and more... [Session 5]
ERISA Benefits & Pitfalls: Michael Houske and Peter Brachman address ERISA best practices and how providers can maximize collections on self-funded claims, recent case law that may have a large impact on how providers operate when dealing with plan administrators, recoupment efforts against providers, and more... [Session 6]
1:50pm - 2:40pm
Covered California Update: Brett Johnson (CMA) and Katrina Pagonis (HLB-Oakland), Felicia Sze (HLB-Los Angeles) provide an up-to-the minute update on the Covered California Program, including current demographics of Covered California and their potential impact on the commercially insured patient population; how Covered California seeks to be a catalyst for change in California's health care delivery system, and what participating providers should expect as a result of Covered California's efforts; operational issues that may arise in provider participation in Covered California, and more... [Session 7]
Innovative Models in Managed Care: Kevin Forster (ECG, Oakland), Darin Libby (ECG, Los Angeles) and Charles Oppenheim (HLB) present creative approaches that providers are taking with payors in regard to various models such as ACOs, Value-based purchasing, and provider-owned Knox-Keene plans. Presentation includes discussion of real world examples, strategic considerations, legal issues that impact which models may be best suited to different circumstances, and more... [Session 8]
Closing Session/General Q & A: 2:50pm - 3:30pm
***Following the program, please join Hooper, Lundy & Bookman for a complimentary wine and cheese event sponsored by the firm's Diversity Initiative.***
Organizations Affected: All health care providers
Who Should Attend: CEOs, CFOs, General Counsel, Director of Managed Care, Patient Financial Services Directors and other Financial Executives
The registration fee is $250 per person.
To register for Oakland, click here.
To register for Los Angeles, click here.
MCLE Credit and CPE Credit will be provided at the end of the program.
Please direct all registration questions to Sharon Lee at firstname.lastname@example.org.