2024 Managed Care Compliance Conference

202 Building the Airplane as You Fly: FDR and Vendor Oversight at a MA Start-Up and What Happens after Wheels Go UP!

  • 202 Building the Airplane as You Fly: FDR and Vendor Oversight at a MA Start-Up and What Happens after Wheels Go UP!

    Kenneth Nuñez, Chief Compliance Officer, Provider Partners Health Plans.

    2024-01-30

    • Day 0: Navigate the intimidating world of identifying and negotiating with FDR and delegated vendors before launch date, including issues around contracting, pre-delegation audits, network adequacy, and compliance program effectiveness of partners

    • Implementation: The importance of involving compliance in each implementation stage including system configuration, CMS required mailings, call center operations and delegating or retaining A and G

    • Go Live and Hair on Fire! Determining who has ultimate responsibility over the FDR and delegate after go-live: Should it be Compliance, Procurement, Operations, or a team-based approach?

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The Society of Corporate Compliance and Ethics (SCCE) is a non-profit, member-based professional association. SCCE supports our members' work with education, news, and discussion forums. We are a community of leaders, defining and shaping the corporate compliance environment across a wide range of industries and geographic regions. In developing and maintaining effective ethics and compliance programs, our members strengthen and protect their companies.

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About HCCA

The Health Care Compliance Association (HCCA), is a 501(c)6 non-profit, member-based professional association. HCCA was established in 1996 and is headquartered in Minneapolis, MN. We provide training, certification, and other resources to over 10,000 members. Our members include compliance officers and staff from a wide range of organizations, including hospitals, research facilities, clinics and technology service providers.

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