AGENDA: DAY III
WEDNESDAY, MARCH 6, 2019
7:00 am
Registration Open; Networking Breakfast
MORNING CLOSING PLENARY SESSION — THE LATEST ON HIPAA ADMINISTRATIVE SIMPLIFICATION INITIATIVES; LEVERAGING HIPAA TO DECREASE ADMINISTRATIVE COSTS AND BURDENS
8:00 am
Welcome and Introductions
Robert M. Tennant, MA
Director, HIT Policy, Medical Group Management Association, Washington, DC (Co-Chair)
Director, HIT Policy, Medical Group Management Association, Washington, DC (Co-Chair)
Robert Tennant is Director of Health Information Technology Policy for the Medical Group Management Association (MGMA). Mr. Tennant focuses on federal legislative and regulatory health information technology issues including MACRA, HIPAA, administrative simplification, EHR policy, and other HIT topics. He currently participates with numerous industry organizations including his position on the executive committee of the Board of Directors of the Workgroup for Electronic Data Interchange (WEDI); and co-chair of the WEDI Virtual Clipboard Initiative, Secure Messaging Workgroup, and ePayments Taskforce. In addition, he serves as co-chair of the National HIPAA Summit and is a member of Board of Commissioners for the Electronic Healthcare Network Accreditation Commission (EHNAC), the Council for Affordable Quality Healthcare Index Advisory Panel, the United Healthcare Administrative Simplification Workgroup, CMS DRLS workgroup, the National Uniform Claim Committee, the Physicians EHR Coalition, and others.
8:15 am
Administrative Simplification: An Update from CMS
Madhusudhan Annadata
Director, Division of National Standards, Centers for Medicare and Medicaid Services, Baltimore, MD
Director, Division of National Standards, Centers for Medicare and Medicaid Services, Baltimore, MD
Madhu Annadata is the Director of the Division of National Standards (DNS) in the Program Management & National Standards Group (PMNSG) in the Office of Information Technology (OIT) at the Centers for Medicare & Medicaid Services (CMS). As Director of DNS, Madhu directs the national implementation and oversight of certain technical provisions of the Health Insurance Portability and Accountability Act (HIPAA), and related statutes and regulations, including transactions, code sets, and unique identifiers.
Madhu started his federal career with CMS where he held several leadership positions most recently as the Director of the Division of National Standards. Throughout his federal career Madhu has supported programs related to Medicaid Fraud, Waste and Abuse, Medicare Shared Savings Plan – Accountable Care Organizations, Physician Value, Quality Resource Use Reports, Open Payments, Healthcare Fraud Prevention Partnership initiative, and HIPAA Administrative Simplification. Before joining Federal service, Madhu worked for General Dynamics Information Technology, Lucent Technologies and Kennedy Krieger Institute.
Madhu started his federal career with CMS where he held several leadership positions most recently as the Director of the Division of National Standards. Throughout his federal career Madhu has supported programs related to Medicaid Fraud, Waste and Abuse, Medicare Shared Savings Plan – Accountable Care Organizations, Physician Value, Quality Resource Use Reports, Open Payments, Healthcare Fraud Prevention Partnership initiative, and HIPAA Administrative Simplification. Before joining Federal service, Madhu worked for General Dynamics Information Technology, Lucent Technologies and Kennedy Krieger Institute.
9:00 a.m.
Improving the HIPAA Transactions: An Update on ACA Operating Rules
Erin Weber
Director, Committee on Operating Rules for Information Exchange (CORE), CAQH – Streamlining the Business of Healthcare, Washington, DC
Director, Committee on Operating Rules for Information Exchange (CORE), CAQH – Streamlining the Business of Healthcare, Washington, DC
Erin Weber is the Director of CAQH CORE, a non-profit alliance of healthcare industry leaders whose mission is the creation and adoption of healthcare operating rules that support standards, accelerate interoperability, and align administrative and clinical activities among providers, payers and consumers. Erin has been with CAQH CORE for more than eight years. In this role, she oversees the CAQH CORE operating rule development process, education and outreach, and participant relations. Prior to joining CAQH, Erin served as a consultant with PricewaterhouseCoopers LLP (PwC) where she managed engagements for government clients and as the lead revenue cycle researcher at the Advisory Board Company.
9:30 a.m.
Using and Improving the HIPAA Transactions: The Health Plan Perspective
Gail Kocher, MPA
Director, National Standards, Blue Cross Blue Shield Association, Chicago, IL
Director, National Standards, Blue Cross Blue Shield Association, Chicago, IL
Gail Kocher joined is the Director, National Standards at Blue Cross Blue Shield Association (BCBSA). Prior to joining BCBSA, she was at Highmark, Inc. in a variety of roles, including the HIPAA Knowledge Center and was also in the Provider Business division. Gail spent 10 years in the clinical laboratory field, including managing a physician’s office laboratory. She currently represents BCBSA on the Workgroup for Electronic Data Interchange Board of Directors and serves on several WEDI workgroups and committees. She also currently serves as Policy & Procedures Secretary for the ASC X12N Insurance Subcommittee and Co- Chair for the Regulation Advisory/Collaboration Work Group. Gail is a member of the Health Information Management Systems Society. She is currently serving a two-year term on the HIMSS Global Conference Education Committee. She also participates in the HIMSS Blockchain Work Group. Gail was selected as the 1995 Pennsylvania Blue Shield Health Care Management Fellow.
10:00 a.m.
Break
10:15 a.m.
Using and Improving the HIPAA Transactions: The Hospital Perspective
Suzanne Lestina
Director, Administrative Simplification, American Hospital Association, Washington, DC
Director, Administrative Simplification, American Hospital Association, Washington, DC
Suzanne Lestina is the Director, Administrative Simplification Policy at the American Hospital Association. She was previously the Vice President Revenue Cycle Innovation at Avadyne Health and Director Revenue Cycle MAP with HFMA.
10:45 a.m.
Using and Improving the HIPAA Transactions: The Physician Perspective
Heather McComas, PharmD
Director, Administrative Simplification Initiatives, American Medical Association; Former Professional Affairs Manager, National Association of Boards of Pharmacy (NABP), Chicago, IL
Director, Administrative Simplification Initiatives, American Medical Association; Former Professional Affairs Manager, National Association of Boards of Pharmacy (NABP), Chicago, IL
Heather McComas is Director, of the American Medical Association’s (AMA’s) Administrative Simplification Initiatives division. In her role at the AMA, Heather focuses on reducing practice administrative burdens and streamlining manual processes such as prior authorization so that physicians can focus on what matters most — patient care. She regularly participates in standards development organizations, including X12 and NCPDP, and is co-chair of WEDI’s Prior Authorization Subworkgroup. She has testified on behalf of the AMA before the National Committee on Vital and Health Statistics on various administrative simplification issues. Heather is a pharmacist by training and received a PharmD from the University of Wisconsin-Madison.
11:15 a.m.
FHIR Based API’s: A New Approach to Administrative Transactions
John Kelly, MHA
Principal Business Advisor, Edifecs; Managing Director, HealthIT LLC, Boston, MA
Principal Business Advisor, Edifecs; Managing Director, HealthIT LLC, Boston, MA
John Kelly, Principal Business Advisor for Edifecs, a nationally recognized health information exchange expert. Kelly’s focus is on information exchange and applying the principles of supply chain integration to the healthcare delivery lifecycle. His wide-ranging experience includes serving as CIO of healthcare network provider NaviNet, director of eBusiness Architecture at Harvard Pilgrim Health Care and managing director of his own health IT consulting firm. John also served as the architect and technical lead for the Commonwealth of Massachusetts’ statewide HIE project, developing a shared infrastructure for the Commonwealth, which supported both the health information and health insurance exchanges. He is on the Board of Directors for the Workgroup for Electronic Data Interchange (WEDI).