Metropolitan New York Chapter HFMA Fall Academy Wednesday, October 15th, 2014 Marriott Long Island 101 James Doolittle Boulevard, Uniondale Featuring keynote speakers & sessions covering topics in: • Healthcare Exchange • Requirements of the ACA-The State Perspective • Risk & Compliance Issues in Health Insurance Exchanges • Understanding the Impact of the new “Out of Network” Patient Billing Protections • New York State of Health: What to Expect in Plans and Enrollment for 2015 • and Other Important Issues 8:30 am – 5:00 pm (8.0 hours CPE) 8:00 AM – 8:30 AM Registration and Continental Breakfast This registration period will include a 1/2 hour presentation on the Benefits of HFMA Certification 8:30 AM – 10:30 AM Welcome and Opening Remarks / Keynote Speakers WENDY LEO, FHFMA, President, HFMA Metropolitan NY Chapter PAUL H. KECKELY, Ph.D., Navigant Consulting Managing Director Mr. Keckely will discuss the Health Care Exchanges, observations and data points to consider 10:30 AM – 10:45 AM Networking Break 10:45 AM – 12:15 PM Breakout Sessions Healthcare Exchange-The Finance Perspective Speaker: WAYNE CAFRAN, KPMG LLP, Principal Advisory Services Our speaker will discuss the shift from FFS, utilization factors, different payment rates, high deductible and coinsurance, and managing the bottom line.Practical Issues and Challenges in Exchange Plan Contracting. Speakers: DAVID EVANGELISTA, Director of Managed Care, Medisys Health Network RICHARD T. NAGY, FHFMA Vice President of Hospital Managed Care Contracting Mount Sinai Health System David Evangelista and Richard Nagy will team up with two leading health plan representatives to present a panel discussion on the practical problems of exchange plan contracting. How to frame out a contract with a health plan that never before offered a commercial product? How can the plan “partner up” in managing increased bad debt, member responsible collection problems, and the verification and eligibility issues that will confront providers? What significant issues can be anticipated in advance and be included in appropriate contract language? How can providers reach agreement on rates when everyone knows that exchange plans will be paying less than “traditional” plans? These and many other important issues will be presented and discussed in a practical and useful way. Requirements of the ACA-The State Perspective Speaker: LAURA DILLON, Supervising Insurance Examiner, New York State Department of Financial Services Ms. Dillon will discuss the requirements of the ACA including basics on the marketplace (individual vs. small group coverage), financial assistance that is available for consumers, information on the qualified health plans including the 10 essential health benefits and the 4 metals tiers of coverage, as well as challenges that we have seen with the implementation. 12:15 PM - 1:15 PM Lunch Break Includes 1/2 hour presentation on the benefits of HFMA membership 1:15 PM – 2:15 PM Welcome Back DAVID WOODS, VP of Education, HFMA Metropolitan NY Chapter Industry Update ELISABETH WYNN, Senior Vice President, Health Economics and Finance, Greater Hospital Association Risk & Compliance Issues in Health Insurance Exchanges Speakers: MITCHEL S. HARRIS, PricewaterhouseCoopers LAURIE G. RADLER, PricewaterhouseCoopers Participation in exchanges introduces new complexities for providers as well as for health plans accustomed to commercial product compliance oversight. Indications are that health insurance marketplace (HIM) or exchange (HIX) compliance will be driven by transitional government program oversight protocols and requirements. The speakers will discuss how organizations that have aligned their HIX operations around commercial product design have created a compliance imperative to review their current HIX compliance programs and enhance or expand them as needed. Understanding the Impact of the new “Out of Network” Patient Billing Protections Speaker: JAMES FOUASSIER, Esq., Associate Director Managed Care at Stony Brook University Hospital Do not think that the new law is only about “doctors’ bills”. While that is a part, the law also imposes significant duties, responsibilities and technical challenges on the hospitals in which those doctors work. This may mean you. Jim Fouassier will give a detailed analysis of the new law, discuss the affected constituencies and, most importantly, the relationship between physician billing and the obligations of the hospitals to disclose all of the specific kinds of network and cost information that the law requires now be made “transparent”. This program will be as valuable and important to representatives of physician practice plans as it will be to hospital personnel. What is your facility doing to implement the notification and disclosure requirements both in the office and on line? What are the consequences of non-compliance (or, even more importantly, of doing it wrong)? For physicians, just how is the new “independent dispute resolution” process supposed to be set up and how will it work? Should out of network physicians continue to accept assignments of benefits? Should hospitals solicit assignments of benefits on behalf of clinical providers as well as themselves? These and many other important questions will be addressed in this useful one-hour presentation New York State of Health: What to Expect in Plans and Enrollment for 2015 Speaker: WENDY D. DARWELL, Vice President and Chief Operating Officer, Nassau-Suffolk Hospital Council, Inc., A member of the Suburban Hospital Alliance of NYS, LLC Ms. Darwell will discuss plan offerings and changes to the enrollment procedures for consumers, Navigators and Certified Application Counselors for the health exchange’s second open season. 3:15 PM - 3:30 PM Networking Break 3:30 PM - 5:00 PM New York State of Health: What to Expect in Plans and Enrollment for 2015 Speaker: DON WRIGHT, Senior Vice President, Self-Pay Operations Parallon Business Solutions Hospitals have designed increasingly sophisticated and patient-centered collection practices over the last decade that include everything from charity care programs to advanced scoring, segmentation and analytical models. With the Affordable Care Act in full swing, collection recovery is going to change in significant ways. Hospitals will need more dynamic processes to prepare for the major shift in patient financial classes over the next 12 to 24 months. In this session, we reveal the four critical hospitals must take now to create new workflow strategies and expand existing programs to prepare for the new world of self-pay collections. 5:00 PM – 5:30 PM Closing Remarks CHRISTINA MILONE, Esq., Chair of General Education, HFMA Metropolitan NY Chapter ONLINE REGISTRATION NOW AVAILABLE FOR CREDIT CARDS For quick and easy registration Click: hfma.org/Content.aspx?id=24818
Posted on: Thu, 02 Oct 2014 16:52:40 +0000
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