Register Now | 888 224 2480 | AmericanConference.com/ManagedCare a C5 Group CompanyBusiness Information in a Global Context

The only forum created specifically to address the needs of Managed Care Organizations and their counsel.

ACIAmerican Conference InstituteBusiness Information in a Global Context

MANAGED CARE DISPUTES AND LITIGATION

American Conference Institute’s 8th Annual Advanced Forum On

Bolstering defensive strategies in the face of growing litigation costs

May 2-3, 2017 | Hyatt at the Bellevue | Philadelphia, PA

EARN CLECREDITS

Network with Managed Care industry leaders from:

Aetna

Anthem, Inc.

CareSource Management Group

Cigna

Florida Blue

Humana Inc.

Kaiser Foundation Health Plan

Premera Blue Cross

Unity Health Insurance and Gundersen Health Plan

and many more…

In a time of real uncertainty for Managed Care Organizations meet with your peers and industry leaders to:

• PREPARE your organization or clients for the upcoming changes and create effective practices to stay ahead of the curve

• BECOME the source for developing winning risk adjustment strategies

• BUILD an unparalleled defense against the latest tactics from providers

• GAIN inside knowledge of the recent antitrust cases from the litigators who led them

• DISCOVER what in house counsel and your potential clients wish their outside counsel knew

Optimize your experience by attending this year’s NEW interactive and collaborative workshop:

Collaborative Affordable Care Act Strategy Session: An Interactive and In-Depth Discussion of Best Practices to Help You Prepare for ACA Changes Under the Trump Administration

Distinguished Co-Chairs:

Tim McMichaelAssistant General CounselPremera Blue Cross

Elizabeth MonohanAssistant General CounselHumana, Inc.

Sponsored by:

Join the Conversation @ACI_Health #ACIManagedCare ACI Healthcare: Legal, Regulatory, and Compliance Experts

2

Dear Colleague,

With a changing political spectrum this year and targeting healthcare legislation, Managed Care Organizations and their counsel need the most up to date information to protect their business from upcoming changes and avoid unnecessary legal hassle.

Be part of the only forum created specifically to address the needs of Managed Care Organizations and their counsel. Collaborate with your peers and gain the knowledge you need to overcome the uncertainty and survive the next year.

At this comprehensive conference, not only will our esteemed faculty share their updated winning strategies for risk corridor, antitrust, out-of-network provider, and qui-tam litigation, but you will also learn from the mistakes other facilities have made to create the best strategies for avoiding needless litigation altogether. Acquire inside knowledge from top in-house professionals about what they look for in their outside counsel that will land you your next big client.

Learn cutting edge tactics directly from leading MCO legal authorities from Anthem, CareSource Management Group, Cigna, Florida Blue, Humana, Kaiser Foundation Health Plan, Premera Blue Cross, and many more…

Add value to your experience by attending our NEW interactive workshop:

Collaborative Affordable Care Act Strategy Session: An Interactive and In-Depth Discussion of Best Practices to Help You Prepare for ACA Changes under the Trump Administration. Open to MCOs and their counsel only, be the source at your institution for cutting edge strategies MCOs should be implementing to prepare for the impending changes to this industry. Join forces with colleagues and create the best possible solutions for your organization.

With rising uncertainty for the healthcare industry, there is not a moment to lose. This conference provides intimate networking with top-notch professionals, masters level wisdom, and indomitable best practices that you can put into practice immediately. Don’t delay – register now by calling 1-888-224-2480 or logging on to www.americanconference.com/ManagedCare

I look forward to meeting you and discussing these forthcoming challenges and innovative solutions with you in May.

Very truly yours,

Megan E. Furino, Esq.Conference Producer

The C5 Group, comprising American Conference Institute, The Canadian Institute and C5 in Europe, is a leading global events and business intelligence company.

For over 30 years, C5 Group has provided the opportunities that bring together business leaders, professionals and international experts from around the world to learn, meet, network and make the contacts that create the opportunities.

Our conferences and related products connect the power of people with the power of information, a powerful combination for business growth and success.

ACIAmerican Conference InstituteBusiness Information in a Global Context Accreditation will be sought in those jurisdictions requested by the registrants

which have continuing education requirements. This course is identified as nontransitional for the purposes of CLE accreditation.

ACI certifies that the activity has been approved for CLE credit by the New York State Continuing Legal Education Board.

ACI certifies that this activity has been approved for CLE credit by the State Bar of California.

You are required to bring your state bar number to complete the appropriate state forms during the conference. CLE credits are processed in 4-8 weeks after a conference is held.

ACI has a dedicated team which processes requests for state approval. Please note that event accreditation varies by state and ACI will make every effort to process your request.

Questions about CLE credits for your state? Visit our online CLE Help Center at www.americanconference.com/CLE

Continuing Legal Education Credits

EARN CLECREDITS

Prepare for the healthcare industry’s most tumultuous year ever with leading Managed Care professionals and their counsel.

Register Now | 888 224 2480 | AmericanConference.com/ManagedCare a C5 Group CompanyBusiness Information in a Global Context 3

7:45 Registration and Continental Breakfast

8:30 Co-Chairs’ Welcoming Remarks

8:45 Year in Review 2016: Recent Trends and Updates in Managed CareJames J. McCarrie, IICounsel Aetna (Blue Bell, PA)

Matthew VarzallySenior Counsel-Litigation & InvestigationsHumana (Louisville, KY)

Ed BrooksPartnerMcGuireWoods LLP (Chicago, IL)

Tracy A. RomanPartnerCrowell & Moring (Washington, DC)

Greg ScottVice Chairman, US Leader, Health PlansDeloitte (Pittsburgh, PA)

• Impact of the election on the status of the ACA• Class actions for prescription co-pays• Consolidation of hospital systems

» Understanding red flags and when it becomes an anti-trust problem

» Negotiating with hospital systems and their exclusive provider groups

» Best practices for MCOs to protect themselves and their insureds

• Increasing wave of cases involving provider fraud schemes » UnitedHealth Group v. American Renal Associates » Referrals to out-of-network ambulatory surgery centers when the provider is part owner of the ASC

• Discrimination - 1557• New trends on the horizon

9:45 Morning Refreshment Break

10:00 Risk Corridor Litigation: Getting the Best Results from a Bad Situation• Overview of the risk corridor landscape today• Examination of the current suits in progress

» Analyzing whether to move forward with your own suit or hang back and wait

» Determining the realistic outcomes of this type of suit » Understanding when to settle

• What changes to expect under the Trump Administration

Risk Adjustment: Analysis, Opportunities and Best Practices

11:00 Successful Commercial Risk Adjustment StrategiesGabriel McGlamerySr. HCR Policy ConsultantFlorida Blue (Jacksonville, FL)

One of the biggest threats to MCOs under the ACA has been failing to understand commercial Risk Adjustment. In this session, learn about how commercial Risk Adjustment works from one of the policy experts at the company that has had the most success in navigating the Risk Adjustment-driven market. Learn how it changes everything your MCO does, from strategic planning, marketing, product development, member services, provider practices, and what happens when plans fail to adjust to a post-risk adjustment market. Find out what role risk adjustment could play in a post-ACA world.

11:45 Spotlight on Medicare Risk AdjustmentJulie Nielsen Managing DirectorBerkeley Research Group, LLC (Tampa, FL)

One of the biggest legal and financial threat to Medicare Advantage plans involves allegations of false submissions of risk adjustment data to CMS under Medicare Risk Adjustment. In this session, learn about the regulatory compliance and False Claims Act litigation risks that Medicare Advantage plans face, get an update on the current landscape of regulatory oversight and ongoing qui tam cases, and discuss best practices for ensuring data integrity and minimizing compliance risk.

Day One | Tuesday, May 2, 2017

Media Partner:

Join the Conversation @ACI_Health #ACIManagedCare ACI Healthcare: Legal, Regulatory, and Compliance Experts

4

12:15 Networking Lunch

1:15 A Day in the Life of In-House Counsel in 2017: The Ever Expanding Wheelhouse of Today’s In-House LitigatorTim McMichaelAssistant General CounselPremera Blue Cross (Mountlake, WA)

Caroline SchiffSenior CounselHumana, Inc. (Chicago, IL)

Jeffrey L. StredlerSenior Associate General CounselAnthem, Inc. (Virginia Beach, VA)

Viktoriya Torchinsky-FieldManaging Counsel, LitigationCigna (Philadelphia, PA)

Join a conversation amongst in-house counsel on stage and in the audience to gain first-hand insights into the daily challenges they face, including:

• Struggle of wearing many hats: » Litigator » PR Guru » Risk manager

• While also considering: » Budgets » Staffing » Reporting demands

Don’t miss this invaluable opportunity to learn what outside counsel can do to help their in-house counsel maintain this delicate balance.

2:45 Afternoon Networking Break

3:00 Deep-Dive into Healthcare False Claims: Analysis of Current Trends in False Claims Cases for MCOsNicholas PaulSupervising Deputy Attorney GeneralCalifornia Attorney General’s Office (San Diego, CA)

Mark ChilsonExecutive Vice President and General CounselCareSource (Dayton, OH)

Dorothy DeAngelisManaging DirectorNavigant (New York, NY)

David J. LevissPartnerO’Melveny & Myers LLP (Washington, DC)

• Qui Tam cases against MCOs » Establishing plans to avoid Qui Tam cases against your MCO

» Discerning and avoiding the most Common pitfalls » Developing methods to win the case

• Qui Tam Cases against providers » Responsibilities of MCOs to report potential provider fraud - MCOs are uniquely situated to uncover fraud in investigations of billing practices

- Determining when you should speak up• Identifying your role in provider Qui Tam cases

4:30 The Future of Provider vs. Payor Disputes Elizabeth MonohanAssistant General CounselHumana, Inc. (Louisville, KY)

Tony RodriguezSenior CounselKaiser Foundation Hospitals / Health Plan (Oakland, CA)

Kevin FederCounselO’Melveny & Myers LLP (Washington, DC)

Jeffrey S. GleasonPartnerRobins Kaplan (Minneapolis, MN)

Moderator:Geoffrey SiglerPartnerGibson, Dunn & Crutcher LLP (Washington, DC)

• Lawsuits with out-of-network providers and the confusion over contracts

• Disputes between MCOs and third party payors• Hospital suits against MCOs

» Handling suits from hospitals who believe they were underpaid

» Fights over emergency room payments » Handling improper overnight stays and other types of overbilling

• Emerging trend of health plans being the plaintiff rather than the defendant

5:45 Conference Adjourns to Day Two

Register Now | 888 224 2480 | AmericanConference.com/ManagedCare a C5 Group CompanyBusiness Information in a Global Context 5

1:30 p.m. to 3:30 p.m. (1:00 Registration)

Collaborative Affordable Care Act Strategy Session: An Interactive and In-Depth Discussion of Best Practices to Help You Prepare for ACA Changes under the Trump AdministrationThis interactive workshop will give you the tools you need to overcome the uncertain future of the managed care industry under our country’s new administration. With the largest and most rapid changes taking place in the health insurance industry, hear from leading MCO professionals about the steps they are taking to prepare. Collaborate with colleagues to develop best practices to prepare for the uncertainty ahead and ensure your MCO or clients come out on top.

*Open to MCOs and their counsel only.

Day Two Wednesday, May 3, 2017

8:00 Registration and Continental Breakfast

8:30 Co-Chairs’ Welcoming Remarks

8:45 Antitrust Cases: How to Adjust Your Business Model in the Wake of the Anthem/Cigna and Humana/Aetna DecisionsRyan KantorAssistant Chief, Litigation I SectionAntitrust Division, Department of Justice (Washington, DC)

2016 brought the Managed Care industry two of the most impactful Antitrust cases in recent history. Our distinguished panel with insider knowledge will help you unbox these decisions and interpret the lasting effect they will have on your providers, MCOs, and the market as a whole.

9:45 2017: The Year of Change for Medicare and MedicaidKimberly J. DonovanPartnerSquire Patton Boggs (Miami, FL)

Abby SalzerSenior Corporate CounselWellCare Health Plans, Inc. (Tampa, FL)

• Review of the final Medicaid rules going into effect this year » Find out how other MCOs are adapting to meet these requirements

• Medicare/Medicaid litigation and enforcement risks » Identifying potential risks of Medicare and Medicaid plans » Weighing these risks against the prospective benefits for your company

• Understanding the Trump Administration’s effect on the Medicare Program

• How will Trump’s changes to the ACA affect Medicaid » Analyzing the fate of state expansion programs » Addressing the potential federal changes and their impact on MCOs

10:45 Morning Networking Refreshment Break

11:05 Cybersecurity and Service Providers: Strategies for Keeping Compliant when Dealing with Outside VendorsElliot R. GoldingPartner (Privacy and Cybersecurity)Squire Patton Boggs (US) LLP (Washington, DC)

David WintersPartnerButler Rubin Saltarelli & Boyd LLP (Chicago, IL)

Jonathan WitteAssociate Chief CounselCigna (Philadelphia, PA)

• Analysis of New State and Federal Information Security Regulations

• Vendor Management Best Practices » Developing information security plans to keep information protected when you have little oversight

» Explaining HIPAA to third parties who handle your information

12:00 Conference Adjourns Lunch for workshop attendees only

POST-CONFERENCE WORKSHOP: Wednesday, May 3, 2017

Join the Conversation @ACI_Health #ACIManagedCare ACI Healthcare: Legal, Regulatory, and Compliance Experts

6

With more than 300 conferences in the United States, Europe, Asia Pacific, and Latin America, American Conference Institute (ACI) provides a diverse portfolio devoted to providing business intelligence to senior decision makers who need to respond to challenges spanning various industries in the US and around the world.

As a member of our sponsorship faculty, your organization will be deemed as a partner. We will work closely with your organization to create the perfect business development solution catered exclusively to the needs of your practice group, business line or corporation.

For more information about this program or our global portfolio of events, please contact:

Wendy Tyler Director of Sales, American Conference Institute

Tel: 212-352-3220 x5242w.tyler@AmericanConference.com

Global Sponsorship Opportunities

Who You Will Meet:• In-House Counsel and Business Executives from Managed Care

Organizations, HMOs, and Insurance Companies specializing in: » Litigation » Risk management » Claims/Strategic payments » Payor relations disputes

• Outside Counsel specializing in: » Health plans » Health litigation » Managed care litigation » Managed care contracting » Payor disputes

“I enjoyed every panel… Both antitrust panels were good – very relevant topics and PRACTICAL ADVICE.” – Courtney Cox, VP Litigation, WellCare Health Care

“The level of expertise of both the speakers and attendees results in meaningful discussions and practical advice.” – Mary Jean Miller, Associate General Counsel, CareSource Management Group

“Great conference and good networking opportunity! Outstanding speakers – prepared and informative!” – Leo Nouhan, Attorney, Leo Nouhan & Associates

a C5 Group CompanyBusiness Information in a Global Context

o I would like to receive CLE accreditation for the following states: . See CLE details inside.

© American Conference Institute, 2017

Complete Payment Details 4

Bringing a Team?

3 - 4 10% Conference Discount

5 - 6 15% Conference Discount

7 20% Conference Discount

8 or more Call 888-224-2480

Payment Policy

Payment must be received in full by the program date to ensure admittance. All discounts will be applied to the Program Only fee (excluding add-ons), cannot be combined with any other offer, and must be paid in full at time of order. Group discounts available to 3 or more individuals employed by the same organization, who register at the same time.

Delegate Substitutions and Cancellations

You must notify us by email at least 48 hrs in advance of the conference if you wish to send a substitute participant. If you are unable to find a substitute, please notify us in writing no later than 10 days prior to the conference date. All cancellations received will be subject to a cancellation fee of $350. Delegates opting to receive a credit voucher will receive a credit for the full amount paid, redeemable against any other American Conference Institute conference in the next 12 months.

No credits or refunds will be given for cancellations received within 10 days of the conference start date. Delegates may not “share” a pass between multiple attendees without prior authorization. No liability is assumed by American Conference Institute for changes in program date, content, speakers or venue. American Conference Institute reserves the right to cancel any conference it deems necessary and will, in such event, make a full refund of any registration fee, but will not be responsible for airfare, hotel or other costs incurred by registrants.

Terms and Conditions

Fill in your Profile

SALUTATION NAME

JOB TITLE ORGANIZATION

ADDRESS CITY

STATE/PROVINCE ZIP CODE COUNTRY TEL.

FAX EMAIL

TYPE OF BUSINESS NO. OF EMPLOYEES

APPROVING MANAGER JOB TITLE

3

Select your Level of Engagement Register & Pay by March 24, 2017 Register & Pay after March 24, 2017

o Conference Only $2095 $2295

o ELITEPASS*: Conference + Workshop $2495 $2695

o SPECIAL RATE FOR IN-HOUSE** $1395 $1595

All program participants will receive an online link to access the conference materials as part of their registration fee.

o Please reserve ___ additional copies of the Conference Materials at $199 per copy.

2

5 Accept the Terms and Conditions to Register I confirm I have read and understood the terms and conditions of registering for this event

898L17-PHIConference Code

1PHONE:1-888-224-2480

EMAIL:CustomerService@AmericanConference.com

MAIL:American Conference Institute45 West 25th Street, 11th Floor New York, NY 10010

ONLINE:www.AmericanConference.com/ManagedCare

FAX: 1-877-927-1563

Choose your Registration Method

Fee IncludesThe program, all program materials, refreshment breaks and lunches.

Please charge my o VISA o MasterCard o AMEX o Discover Card o Please invoice me

NUMBER EXP. DATE

CARDHOLDER

o I have enclosed my cheque for $_______________ _including applicable taxes made

payable to American Conference Institute (T.I.N.—98-0116207)

o ACH PAYMENT ($USD)

Please quote the name of the attendee(s) and the event code 898L17 as a reference.

For US registrants:Bank Name: HSBC USAAddress: 800 6th Avenue, New York, NY 10001Account Name: American Conference InstituteUPIC Routing and Transit Number: 021-05205-3UPIC Account Number: 74952405Non-US residents please contact Customer Service for Wire Payment information

Special DiscountACI offers financial scholarships for government employees, judges, law students, non-profit entities and others. For more information, please email or call customer service.

Exclusive Room Rates!American Conference Institute is pleased to offer our delegates a limited number of hotel rooms at a preferential rate. To book a room at the discounted rate please contact the hotel directly and mention “ACI’s Managed Care Litigation”

Venue: Hyatt at the Bellevue

Address: 200 South Broad St, Philadelphia, PA 19102

Telephone: (888) 421-1442

Venue Information at a Glance

Venue: Hyatt at the BellevueAddress: 200 South Broad St, Philadelphia, PA 19102TEL.: (888) 421-1442

Book your AccommodationAmerican Conference Institute is pleased to offer our delegates a limited number of hotel rooms at a preferential rate. To book a room at the discounted rate please contact the hotel directly and mention “ACI’s Managed Care Litigation”

*ELITEPASS is recommended for maximum learning and networking value.**SPECIAL IN-HOUSE RATE – call (888) 224-2480 or visit www.americanconference.com/ManagedCare for details

REGISTRATION CODE

Attention MailroomIf undeliverable to addressee, please forward to: Litigation Counsel, Health Law, General Counsel, Managed Care

Incorrect Mailing InformationIf you would like us to change any of your details, please email Data@AmericanConference.com or fax the label on this brochure to 1-877-927-1563.

American Conference Institute45 West 25th Street, 11th FloorNew York, NY 10010

New for 2017: Special Rate for In-House Counsel!ACIAmerican Conference InstituteBusiness Information in a Global Context

MANAGED CARE DISPUTES AND LITIGATION

MANAGED CARE DISPUTES AND LITIGATION

American Conference Institute’s 8th Annual Advanced Forum On

American Conference Institute’s 8th Annual Advanced Forum On

Bolstering defensive strategies in the face of growing litigation costs

May 2-3, 2017 | Hyatt at the Bellevue | Philadelphia, PA

May 2-3, 2017 | Hyatt at the Bellevue | Philadelphia, PA

EARN CLECREDITS

EARN CLECREDITS

Brand new sessions at this year’s program include:• The Future of Provider vs. Payor

Disputes

• Anti-Trust Cases: How to Adjust Your Business Model in the Wake of the Anthem/Cigna and Humana/Aetna Litigation

• Risk Corridor Litigation: Getting the Best Results from a Bad Situation

• Cybersecurity and Service Providers: Strategies for Keeping Compliant when Dealing with Outside Vendors

• Spotlight on Successful Risk Adjustment Strategies

B00-898-898L17.E