Federal and state regulators are turning up the heat, especially in Medicaid and Medicare Advantage. From heightened audit activity to stricter diagnosis coding rules, payers are under growing pressure to get documentation, chart reviews and claims submission right the first time.
This session brings together payment integrity and legal experts to break down what CMS is scrutinizing now — and what payers must do to avoid penalties and prepare for evolving requirements.
Gain clarity on:
- CMS’ current enforcement priorities and how payers can adapt
- Real-world legal guidance on audit readiness, documentation and payment integrity
- How to operationalize compliance improvements across teams and technology
Speakers:
- Cereasa Horner | Director of Policy and Payment Integrity, CERIS
- Steven Hamilton | Partner, Crowell & Moring LLP
- Payal Nanavati | Counsel, Crowell & Moring LLP