2008 NATIONAL COB/TPL CONFERENCE AGENDA

“ALL FOR ONE – Uniting Best Practices for a Better COB World”

 

Sunday, September 28, 2008

 

Noon – 6:00 pm                      Registration Begins [Banquet level – Prefunction Hall]

 

2:00 pm – 3:15 pm                  COB/TPL Basics Training (Third Party Health Insurance and Medicare, Estate Recovery and Subrogation/Casualty) [Concourse Ballroom C & D]

 

                                                Coordinators: 

 

Keith Thompson, Director of Third Party Division, Alabama Medicaid Agency and COB/TPL TAG representative

 

David Lee, Audit Manager, New Hampshire Department of Health and Human Services and COB/TPL TAG representative

 

                                                Panel Members:

 

Andy Renggli, Office Chief of Coordination of Benefits for the Department of Social and Health Services, State of Washington and Vice Chair of the COB/TPL TAG

 

Sue Knefley, Health Insurance Specialist, Centers for Medicare and Medicaid Services and COB/TPL TAG member

 

Jon Hutcheson, Esq., Vice President of Case Management/Subrogation Services, HMS

 

Ben Chatman, Iowa Estate Recovery Program Director, HMS

 

Jane Bowman, Associate Director of Payment Review/Estate Recovery Section, Alabama Medicaid Agency

 

Stephanie McGee Azar, Deputy General Counsel, Alabama Medicaid Agency

 

This training is targeted for individuals who are new to the area of COB/TPL and for those who desire a refresher course.  Information to be presented will provide an overview of the basic requirements for state COB/TPL programs and will include discussion on operational functions and business practices within the 3 major areas of (1) health insurance and Medicare, (2) casualty/subrogation, and (3) estate recovery.

 

3:15 pm – 3:30 pm                  Sponsor Presentation – AIM

 

3:30 pm – 3:45 pm                  Break

 

3:45 pm – 5:00 pm                  Continue COB/TPL Basics Training [Concourse Ballroom C & D]

 

6:00 pm – 8:00 pm                  Welcome Reception (sponsored by AIM) [Concourse Ballroom A & B] – Meet John Corlett, new Chair of the COB/TPL TAG

 

 

Monday, September 29, 2008

 

7:30 am – 4:30 pm                  Registration and Conference Assistance [Banquet level – Prefunction Hall]

 

7:30 am – 8:30 am                   Breakfast – Visit Exhibits [Concourse Ballroom A & B]

 

8:30 am - 9:00 am                   Welcome [Concourse Ballroom C & D] – Gary Ashby, Manager of Benefits Coordination at the Colorado Department of Health Care Policy and Financing

 

9:00 am - 9:45 am                   Keynote Speaker – TBA (Invited - the Honorable Bill Ritter, Governor of Colorado)

 

9:45 am - 10:00 am                 Sponsor Presentation - Maximus

 

10:00 am - 10:30 am               Break (sponsored by Maximus) – Visit Exhibits

 

10:30 am - 11:45 am               Session 1: Third Party Health Insurance (Cost Avoidance and Containment)

 

                                                Coordinator:  Pat Tighe, Section Chief of the Benefit Coordination and Recovery Section in the Office of Ohio Health Plans and COB/TPL TAG representative

 

                                                Panel Members:

 

Jeff Flora, Deputy Director of the New York Office of the Medicaid Inspector General, Bureau of Revenue Initiatives

 

The third party health insurance cost avoidance and containment session will highlight the processes of New York and Ohio and how each tackles the cost avoidance process.  The presentations will demonstrate how the work can be performed either (1) in-house or (2) by a vendor and the pros and cons of each approach.  The session will end with a question and answer period for states to share experiences or ask questions.

 

11:45 am – 12:00 noon           Sponsor Presentation - HMS

 

12:00 noon – 1:00 pm             Lunch [Concourse Ballroom A & B] (sponsored by HMS)

 

1:00 pm – 2:15 pm                  Session 2:  HIPAA (Post-payment billing and electronic billing) [Concourse Ballroom C & D]

 

                                                Coordinators: 

 

Bob Pozniak, Director of the HIPAA Practice Group, New York Office of Health Insurance Programs

 

Jeff Flora, Deputy Director of the New York Office of the Medicaid Inspector General, Bureau of Revenue Initiatives

 

                                                Panel Members:

 

                                                            Renee Gundersen, Director of EDI, HMS

 

Annette Gabel, Executive Director for HIPAA Standard’s Compliance, Medco and member of the Board of Directors for NCPDP

 

                                                This session will discuss the challenges and successes in recovery billing as well as an overview of how the new X12 5010 versions accommodate Medicaid subrogation billing.  Panel members represent a state doing its own recovery billing, a vendor doing recovery billing on behalf of several states and someone from the Board of Trustees of NCPDP who works for a pharmacy benefits manager.

 

2:15pm – 2:30 pm                   Sponsor Presentation - PCG

 

2:30 pm – 3:00 pm                  Break (sponsored by PCG) – Visit Exhibits

 

3:00 pm – 4:45 pm                  Session 3:  Managed Care and TPL – Different views and perceptions on the approach to cost containment within managed care.  State views on drivers and issues as well as the point of view from managed care plans and their issues and focus.

 

                                                Coordinator:  Lisa Gifford, Financial Resources Director for the Oklahoma Health Care Authority and COB/TPL TAG representative

 

                                                Panel Members:

 

Thomas L. Johnson, Executive Director of the Medicaid Health Plans of America

 

Anna Bransford, Financial Manager in the Program Administration Bureau of the New Mexico Human Services Department

 

Carrie Cunningham, MHP, Vice President of Business Development for Managed Care, HMS

 

Dr. Jeffrey Cianchetti, Medical Director, CareSource

 

This session will involve a robust discussion among varied panelists.  The panel includes someone from a Medicaid managed care plan, someone from a state Medicaid office, someone from a vendor dealing with managed care TPL issues, and the executive director of the group that represents Medicaid managed care plans with national issues.  The discussion should enlighten states regarding the managed care organizations’ approach and issues with cost containment.  The session will also look at state determinations made when deciding how to organize managed care models and states’ reasons for making those decisions.  The session will end with a question and answer period in which states and MCOs can compare game plans and best practices in cost containment within managed care populations.

 

 

 

Tuesday, September 30, 2008

 

7:30 am – 1:15 pm                  Conference Assistance [Banquet Level – Prefunction Hall]

 

7:30 am – 8:30 am                   Breakfast [Concourse Ballroom A & B] – Visit Exhibits

 

8:30 am –9:45 am                    Session 4: Subrogation/Casualty/Ahlborn [Concourse Ballroom C & D]

 

Coordinator:  Andy Renggli, Office Chief of Coordination of Benefits for the Department of Social and Health Services, State of Washington and Vice Chair of the COB/TPL TAG

 

                                                Panel Members:

 

Jon Hutcheson, Esq., Vice President of Case Management/Subrogation Services, HMS

 

Anne Baudino Holton, Senior Assistant Attorney General, Colorado Medicaid & Public Assistance Unit in the Colorado Department of Law

 

Erin Pohland, Assistant Attorney General, Human Services Section of the Alaska Attorney General’s Office

 

Whether you are new or experienced, you have undoubtedly heard attorneys in your state, judges or perhaps you own Attorneys General refer to the decision of the U.S. Supreme Court in the case of Arkansas Department of Health and Human Services v. Ahlborn, 547 U.S. 268, 126 S.Ct. 1752, 164 L.Ed. 2d 459 (5/1/2006), to justify their approach to settling a case.  This panel will be a lively interactive session between the panelists who will compare and contrast their own Ahlborn experiences with the information states recently provided for a website designed to exchange information on this subject.  State representatives attending the discussion will share their own state’s similar and different experiences.  After the conference, we will post every state’s experience on the website and update it as new cases or state procedures are developed.  In that way, we will develop a national state-to-state dialog that will be current.

 

9:45 am – 10:00 am                 Sponsor Presentation – UMMS

 

10:00 am – 10:30 am               Break (sponsored by UMMS) – Visit Exhibits

 

10:30 am – 11:45 am               State and CMS Staff Only Break-out Sessions by CMS Region (Opportunity to raise issues relevant to each state for later discussion at the conference)

 

                                                Coordinators: 

 

John Corlett, Deputy Director of the Ohio Department of Job and Family Services, Office of Ohio Health Plans and Chair of the COB/TPL TAG

 

Ginni Hain, Director of Division on Policies on Medicaid Eligibility for the Aged, Blind and Disabled as well as on Medicaid Coordination of Benefits and Dual Eligibles, Centers for Medicare and Medicaid Services and COB/TPL TAG member

 

                                                Regions:

 

Region I (Andy Renggli & Mark Brasher) – Meet in the Dulles Room on Banquet Level

 

Region II (Pat Tighe & Jan Taylor) – Meet in the Kennedy Room on Banquet Level

 

Region III (Keith Thompson & Lisa Gifford) – Meet in the O’Hare Room on Banquet Level

 

Region IV (David Lee & Richard Hurd) – Meet in the Orly Room on Banquet Level

 

11:45 am – 12:00 noon           Sponsor Presentation - HMS

 

12:00 noon – 1:00 pm             Lunch [Concourse Ballroom A & B] (Sponsored by HMS)

 

1:00 pm – 7:00 pm                  Networking Activity [Meet promptly in front of the hotel] (sponsored by HMS):  Visit one of four Denver sites (1) the State Capitol, (2) the Molly Brown House, (3) the U.S. Mint, or (4) the 16^th Street Mall – then tour and have dinner at the Colorado History Museum with guest speaker Tim Gard – Medicaid TPL Motivational Comic,  and awards presentation.

 

 

Wednesday, October 1, 2008

 

7:30 am – 4:45 pm                  Conference Assistance [Banquet Level – Prefunction Hall]

 

7:30 am – 8:30 am                   Breakfast [Concourse Ballroom A & B] – Visit Exhibits

 

8:30 am – 9:45 am                   Session 5:  Special Needs Trusts and Estate Recovery – Current Litigation and Best Practices [Concourse Ballroom C & D]

 

                                                Coordinator:  Jan Taylor, TPL Manager for the Minnesota Department of Human Services and COB/TPL TAG representative

 

                                                Panel Members:

 

Jennifer L. Weaver, Assistant Attorney General, Colorado Medicaid & Public Assistance Unit in the Colorado Department of Law

 

Dale B. Klitzke, Staff Attorney for the Minnesota Department of Human Services

 

Carole Procope, Recovery Section Manager for the Pennsylvania TPL Division

 

This session will focus on current litigation in the estate recovery and special needs trusts areas, in addition to practices that states have used to improve Medicaid estate and trust recoveries.  Discussion will focus on states that have successfully passed legislation to monitor and recover exempt resources.

 

9:45 am – 10:00 am                 Sponsor Presentation – Garretson Law Firm

 

10:00 am – 10:30 am               Break (sponsored by Garretson Law Firm) – Visit Exhibits

 

10:30 am – 11:45 am               Session 6:  TPL and Medical Support Enforcement - Are you working together?

 

                                                Coordinator:  Mark Brasher, Director, Office of Recovery Services, State of Utah and COB/TPL TAG representative

 

                                                Panel Members:

 

Dan McDonald, Director of the Arkansas Consortium and Arkansas IV-D program

 

Barb Saunders, Vice President of Child Support Services, HMS

 

Medicaid and child support caseloads share dual eligible children and have similar goals and federal mandates.  Hear how the DRA impacts child support agencies which in turn impacts Medicaid agencies.  Learn what innovative solutions child support agencies across the nation have implemented to increase the number of children with health care coverage and have provided in cost savings for Medicaid agencies.

 

11:45 am – 12:00 noon           Sponsor Presentation - ACS

 

12:00 noon – 1:00 pm             Lunch [Concourse Ballroom A & B] (sponsored by ACS)

 

1:00 pm – 2:15 pm                  Session 7:  Medicare, Program Integrity MIC Audits and CMS Program Information Updates [Concourse Ballroom C & D]

 

                                                Coordinator:  Betty Strecker, Health Insurance Specialist, CMS, Region VIII

 

                                                Panel Members:

 

                                                            Michael Fierberg, CMS Public Affairs, Region VIII

 

Zach Ramsey,  Vice President, Program Integrity Development, HMS

 

Tom Dougherty, Vice President, Federal Markets, HMS

 

This session will focus on Medicare and issues involving Medicaid and Medicare.  In addition, the panel will discuss the CMS Medicaid Integrity Program (MIP) and provide an update on the Audit MICs.

 

2:15 pm – 2:30 pm                  Sponsor Presentation – RelayHealth

 

2:30 pm – 3:00 pm                  Break (sponsored by RelayHealth) – Visit Exhibits

 

3:00 pm – 4:30 pm                  CMS/TAG Panel Discussion regarding state issues raised during earlier sessions and the state/CMS break-out discussions

 

                                                Coordinators: 

 

John Corlett, Deputy Director of the Ohio Department of Job and Family Services, Office of Ohio Health Plans and Chair of the COB/TPL TAG

 

Ginni Hain, Director of Division on Policies on Medicaid Eligibility for the Aged, Blind and Disabled as well as on Medicaid Coordination of Benefits and Dual Eligibles, Centers for Medicare and Medicaid Services and COB/TPL TAG member

 

                                                Panel Members:

 

Betty Strecker, Betty Strecker, Health Insurance Specialist, CMS, Region VIII

 

Andy Renggli, Office Chief of Coordination of Benefits for the Department of Social and Health Services, State of Washington and Vice Chair of the COB/TPL TAG

 

 

Lisa Gifford, Financial Resources Director for the Oklahoma Health Authority and COB/TPL TAG representative

 

Pat Tighe, Section Chief of the Benefit Coordination and Recovery Section in the Office of Ohio Health Plans and COB/TPL TAG representative

 

Jeff Flora, Deputy Director of the New York Office of the Medicaid Inspector General, Bureau of Revenue Initiatives

 

Keith Thompson, Director of Third Party Division, Alabama Medicaid Agency and COB/TPL TAG representative

 

 

Jan Taylor, TPL Manager for the Minnesota Department of Human Services and COB/TPL TAG representative

 

Mark Brasher, Director, Office of Recovery Services, State of Utah and COB/TPL TAG representative

 

 

4:30 pm – 4:45 pm                  Closing – John Corlett, Deputy Director of the Ohio Department of Job and Family Services, Office of Ohio Health Plans and Chair of the COB/TPL TAG