PYA is pleased to again sponsor and participate in the 7th Annual Polsinelli Health Care Reimbursement Summit, April 18-19, 2023. The in-person summit in Denver, Colorado, focuses on Medicare, Medicaid, and commercial reimbursement issues and will explore innovation as an enabler in the future of health care. PYA has supported the event since its inception in 2016.
Martie Ross, PYA Kansas City office managing principal, along with Julius Hobson, Polsinelli senior policy advisor, will present “Federal Public Policy – Thinking Outside the Box as Part of Reimbursement Strategy” on April 19. The presentation reviews the President’s fiscal year 2024 budget and healthcare priorities and discusses how to improve reimbursement frameworks through the use of advocacy.
Attendees can earn up to 10 CPE* credits, provided by PYA. CLE credits are also available.
Registration is open for the two-day event, and PYA attendees should use the sponsor code, PYA, when registering.
Agenda
Kimpton Hotel Born
1600 Wewatta St.
Denver, CO 80202
Tuesday, April 18, 2023
Registration |
1:00 pm – 1:30 pm |
Welcome |
1:30 pm – 1:35 pm |
Navigating Provider Reimbursement from Medicare Advantage Plans Presenters will discuss recent trends in provider arrangements with Medicare Advantage (“MA”) Plans, including key terms for negotiation, the movement toward value-based models, and common reimbursement issues that arise with MA Plans.
Panel: Jonathan Buck, Polsinelli |
1:35 pm – 2:35 pm
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Litigation Against Medicare Advantage Plans for 340(b) Drugs Presenters will discuss recent developments and opportunities for providers and reimbursement of 340(b) drugs from MA Plans.
Panel: David King, Polsinelli; Kyle Vasquez, Polsinelli |
2:35 pm – 3:35 pm |
BREAK |
3:35 pm – 4:05 pm |
Risk Adjustment Data Validation – Impacts on Reimbursement and Audits Presenters will discuss the process for risk adjustment data validation audits performed by MA Plans as well as reimbursement opportunities available for providers. Presenters will also discuss legal risks with collection of and reimbursement related to risk adjusted diagnosis.
Panel: Ryan Morgan, Polsinelli |
4:05 pm – 5:05 pm
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Program Concludes |
5:05 pm |
Reception – office |
5:30 pm |
Wednesday, April 19, 2023
Registration and Breakfast |
8:00am – 8:30am |
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Welcome |
8:30am – 8:35am |
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What is the Value of A Good Audit Plan? An experienced panel of reimbursement audits and disputes lawyers and consultants will discuss the value of a good audit plan for internal auditing, as well as outside inquiries, such as Covid-19 related inquiries by OIG, behavioral health audits by managed care organizations, and statistical samplings by recovery audit contractors.
Panel: Kelly Loya, Pinnacle; Ross Burris, Polsinelli; Colleen Faddick, Polsinelli |
8:35am – 9:35am |
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Homecoming: The Growth of Home-Based Clinical Care The COVID-19 Pandemic accelerated a pre-existing trend in health care towards the utilization of home-based treatment to promote access and efficiency for all types of populations. Join leaders in home-based care for a discussion of the future of home-based care and the clinical, operational, and legal challenges these providers face as they navigate this expanding frontier.
Looking to the future – what will home-based care look like in 5 or 10 years, and how will the legal landscape and environment change to accommodate this new world? Panel: Bill Dombi, President, National Association for Home Care & Hospice; Phil Mitchell, CMO, DispatchHealth; Ryan Thurber, Polsinelli; Kathleen Snow Sutton, Polsinelli |
9:35am – 10:35am |
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Break |
10:35am – 10:50am |
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Hospital and Health System Regulatory Update A panel of experts will join Danielle Adams, a Nursing Consultant with the Centers for Medicare and Medicaid Services (CMS), to explore recent regulatory developments and future considerations as the Public Health Emergency (PHE) winds down that may impact hospital and health system operations and influence reimbursement decisions. Topics will include matters involving hospital survey, certification and compliance, including, for example, the following:
Panel: Danielle Adams, Nursing Consultant, Centers for Medicare and Medicaid Services (CMS); Colleen Faddick, Polsinelli; Ross Sallade, Polsinelli |
10:50am – 11:50am |
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Lunch |
11:50am – 12:50pm |
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Is it time for a Payor Engagement Audit? In the ever-changing landscape of payor strategies and tactics, are providers optimizing reimbursement through effective revenue cycle and contracting strategies? A payor engagement audit may be in order. In this presentation, we will discuss:
Panel: Meri Gordon, Polsinelli; Jonathan Buck, Polsinelli |
12:50pm – 1:50pm |
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State Policy Issues: Are Providers Losing Ground?
Panel: Jennifer Evans, Polsinelli; David King, Polsinelli; Sasha Boghosian, Revive HealthCare; Jeffrey Gold, Hospital Association of NY State (HANYS); Katherine Blair Mulready, Colorado Hospital Association (CHA) |
1:50pm – 2:50pm |
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Break |
2:50pm – 3:05pm |
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Reimbursement for Behavioral Health: Changing Landscape in the Midst of a Mental Health Crisis Behavioral Health has experienced a tremendous period of growth and attention. The reimbursement framework for government and commercial payers continues to evolve as the models of care change. Keeping current on reimbursement methodologies for behavioral health, whether integrated or freestanding, will help you protect and grow your behavioral health revenue. This experienced panel will discuss reimbursement trends across the behavioral health industry and provide key areas of focus to incorporate into your reimbursement strategy. Topics will include the following:
Panel: Bragg Hemme, Polsinelli; Joelle Wilson, Polsinelli |
3:05pm –4:05pm |
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Federal Public Policy – Thinking Outside the Box as Part of Reimbursement Strategy President’s FY24 Budget
How to plan for the upcoming year in light of President’s budget
Given pressures on providers to live within packaged or bundled payments, consider advocacy as a tool to improve reimbursement framework
Panel: Julius Hobson, Polsinelli, Martie Ross, PYA, P.C. |
4:05pm – 5:05pm |
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Program Concludes |
5:05pm |
For assistance related to reimbursement, visit PYA’s reimbursement services page. If you would like additional guidance in these areas or with any matter related to strategy and integration, compliance, or valuation, one of our executive contacts would be happy to assist. You may email them below, or call (800) 270-9629.
*About Educational Credits
CPE:
Participants can earn up to 10 CPE credits in Specialized Knowledge. Program Level: Intermediate. Delivery Method: Group Live. Advanced Preparation: None. Prerequisites: None. No fee. PYA, P.C. is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website: www.NASBARegistry.org.
CLE credits will be provided by Polsinelli.