August 26, 2020
1:30 – 3:00 p.m., Pacific Time
An LHPC members-only program

Registration is now closed.

Overview

Health plans must operate within the robust state and federal laws and regulatory requirements that govern managed care organizations. Plans are required by law to have compliance programs in place that are designed to keep them operating within a prescribed legal and regulatory framework, to reduce risk of non-compliance and ultimately improve patient care. This makes compliance central to health plan success and sustainability.

No matter your role or position, every individual plays an important part in ensuring the health plan achieves and maintains compliance. Join us for this introductory webinar and learn the fundamentals of health care compliance, including:

• What is compliance and why is it important?
• Who is responsible for compliance?
• Who makes the rules and how are they implemented?
• How does compliance impact me?

Who should attend:
Health plan staff at all levels and across all departments who are new to managed care. The webinar would also be valuable to staff who are interested in learning about how compliance works within the health plan and the role they play in helping to achieve and maintain compliance.

Agenda

What is Compliance?

• Role of compliance in managed care
• Essential (and required) elements of a compliance program

Why is Compliance Important?

• Purpose and core principles of compliance
• How compliance teams work to mitigate and prevent risk
• What happens when incidents occur or if there are compliance findings

Who’s Responsible for Compliance?

• Compliance organizational structure
• Roles and responsibilities of health plan compliance departments

Who Makes the Rules & How are They Implemented?

• Regulatory oversight authorities — DHCS, DMHC, CMS
• How new rules and requirements are received, relayed and complied with

How Does Compliance Impact Me?

• Real-world examples of risk and compliance in practice
• Compliance is a team effort

Faculty

Richard Golfin, III, JD, CHC
Chief Compliance Officer
Alameda Alliance for Health

Richard Golfin, III brings an extensive background in medical-legal compliance and academic expertise to the role of Chief Compliance Officer for Alameda Alliance for Health. Mr. Golfin previously served as the Compliance & Privacy Officer for CenCal Health, Director of Delegation Oversight for Molina Healthcare of California, Director of Compliance for Care 1st Health Plan and as Compliance Advisor to L.A. Care Health Plan. Through his career, Mr. Golfin has managed and directed the launch of multiple integrated care delivery programs across the state of California and led the resolution of complex medical-legal compliance issues to root out Fraud, Waste and Abuse within provider networks and delegated entities.

Jenifer Mandella
Compliance Officer
Central California Alliance for Health

Jenny Mandella is the Compliance Officer at Central California Alliance for Health. In this role, she is responsible for ensuring the health plan operates in compliance with requirements. She oversees the Alliance’s fraud waste and abuse prevention program, internal audit and monitoring program, and delegate oversight program, and ensures HIPAA compliance as the Privacy Officer. Jenny has worked at the Alliance for 10 years and has held a variety of management and leadership roles at the organization. Jenny holds a Master of Public Policy degree from University of California at Los Angeles and a Bachelor of Arts degree in Politics from University of California at Santa Cruz.

Lezlie Micheletti
Health Program Specialist
Health Policy and Stakeholder Engagement
Department of Managed Health Care

Lezlie Micheletti is the Health Program Specialist, Health Policy and Stakeholder Engagement, with the Department of Managed Health Care. In this role, she conducts outreach and education to consumers and stakeholders about the DMHC and the Help Center, promoting how the department can assist consumers with health care issues and ensure consumers receive services to which they are entitled. Lezlie previously served at Covered California as the Program Manager of the Navigator, Outreach and Education, and Provider Education Grant Programs. Prior to Covered California she worked at the Department of Public Health where she managed the Ryan White Care Grant Program.

Registration

This is an LHPC members-only program.

Fees     $30 (per connection)
*This special pricing is being offered while staff work remotely. Standard pricing will resume once staff return to work on-site. 

Registration Confirmation: Registrants will receive an email confirmation that will contain a link to the program participant information web page. The web page provides helpful instructions for accessing the program and any accompanying materials.

Participating in the Webinar: You will only need a computer with a web browser (Google Chrome or Mozilla Firefox is recommended) and a telephone. Audio for the program will be available via toll-free number or by using your computer speakers. 

Cancellation Policy: Cancellation notification must be submitted in writing to institute@lhpc.org seven or more days prior to the course date. Refunds will not be given after that date. Substitutions are encouraged. Payment will be due for registered individuals that do not attend the event and for which a cancellation notice is not received.