With the Public Health Emergency (PHE) ending this past May, our panelists will discuss the impact of this change and highlight key areas where health plans should be focused as they transition to a post-PHE environment. Panelists will address some of the related challenges including: the focus on monitoring ordering patterns for behavioral health and telehealth services that increased during the pandemic and the impact on billing, coding, and quality; how comprehensive fraud, waste, and abuse (FWA) programs may need to shift or be redefined to ensure diligence; Medicaid redetermination and the importance of member engagement as millions transition to the ACO marketplace; and the effects on benefit determination and coordination with these shifts.

In this session, you will: 

1. Understand the impact of enrollment shifts due to the ending of PHE on benefit management and coordination of benefits 
2. Learn how a comprehensive FWA program can protect your members and your organization from inappropriate billings as care shifts between virtual and in-person visits 
3. Learn best practices and engagement strategies for member outreach, tactics for building trust, and how to approach member engagement from a whole person and socio-cultural perspective 

Moderator

Naomi Murphy
Senior Vice President, Coordination of Benefits
Cotiviti, Inc.

Panelists

Leah Dewey, MPH
Vice President, Clinical and Consumer Engagement
Cotiviti, Inc. 

Erin Rutzler, AHFI, CFE, CPC
Vice President, Fraud, Waste, and Abuse
Cotiviti, Inc.