SPBA Fall Meeting 2022
September 19 – 20
In-Person and Online
Hyatt Regency Riverwalk – San Antonio, Texas
Meeting Time is Central Standard Time
Note: The agenda is subject to change to accommodate new developments.
All general sessions are in Regency ABC.
Monday, September 19
12:30 – 1:00 – Welcome, Opening Announcements - Chairman Dan Roslokken, President Anne Lennan.
Keynote
1:00 – 1:45 – The Great ‘Revision’ – How the pandemic has inspired a new way of working and why it could be a game-changer for business. The pandemic has informed changes in not only where we work and how we get our work done, but why we work. Businesses have a huge opportunity to meet the needs of this newly inspired workforce and unleash a tsunami of creativity and innovation. Teri will share researched-based strategies for tapping into the power of this new workforce. Teri Swope, CEO and Founder of SwopeLight Consulting, a leadership coaching/consulting firm.
1:45 – 2:00 – Table discussion with rotation. Online viewers take a break.
2:00 – 2:10 – Share table discussion thoughts with audience.
2:10 – 3:00 – MHPAEA NQTL Audits - The Department of Labor is actively auditing plans for compliance with non-quantitative treatment limitations (NQTLs) on mental health/substance abuse disorder benefits. Plans are required to perform and document their comparative analyses of the design and application of NQTLs. Hear the latest on how to prepare for these audits of your plans. Ashley Gillihan, Esq. Alston & Bird. Moderator: Jennifer Berman
3:00 – 3:15 – Break for in-person and online viewers.
3:15 – 3:45 – ADA Covers Gender Dysphoria – The Fourth Circuit Court held the ADA protects individuals with gender dysphoria. Ashley Gillihan, Esq. Alston & Bird.
3:45 – 3:55 – Table discussion. Online viewers take a break.
3:55 – 4:00 – Share table discussion thoughts with audience.
4:00 – 5:00 – The Impact of the Dobbs Decision on Health Plans – The Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization will have a significant impact on health plan administration. Ashley Gillihan, Esq. Alston & Bird.
5:00 – 5:15 – Table discussion with rotation. Online viewers take a break.
5:15 – 5:25 – Share table discussion thoughts with audience.
5:30 – 6:30 – Cocktail Reception - Garden Terrace Room
Tuesday, September 20
7:15 – 8:00 – Continental Breakfast - Regency East Foyer Room
8:00 – 9:00 – Supreme Court Ruling in Dialysis Coverage Case - The outcome will favorably affect employer group health plans. John J. Kulewicz, Esq. Vorys, Sater, Seymour and Pease LLP. Moderator: Caroline Fraker. Virtual
9:00 – 10:00 – Managing Risk and Ensuring Security & Privacy Protocols - This session will focus on the enterprise and organizational risk management that organizations need to have for a clear strategy, rigor, and planning to achieve effective and comprehensive security, privacy and cyber hygiene. Modern risk management is a highly collaborative exercise. Forward-thinking companies know that risk management cannot be confined to a single department or performed on an ad hoc basis inside operational silos -ownership of risk must be shared across the enterprise. Participants will gain an understanding of the following areas during this presentation:
>> How to categorize and assign responsibility to the four major types of corporate risk;
>> Review strategies, tactics and methodologies that should be considered by TPAs;
>> Third Party Risk Management (TPRM) that TPAs and organizations are requiring;
>> New Cyber Insurance requirements currently being implemented in underwriting considerations; and
>> How to assure stakeholder-trust.
Lee Barrett, Executive Director, CEO EHNAC
10:00 – 10:15 – Table discussion with rotation. Online viewers take a break.
10:15 – 10:25 – Share table discussion with audience.
10:25 – 10:45 – Legislative Update - Erin Reiter, SPBA’s Director of Federal Affairs.
10:45 – 11:00 – Break for in-person and online viewers
11:00 – 11:45 – Using Machine Learning to Personalize Member Engagement - Historical approaches for care management and population health are grounded in “hotspotting,” or targeting high past utilizers for outreach. This paradigm ignores the unique characteristics of each individual, resulting in one-size-fits-all care that often overlooks the needs of members who are newly rising in risk, and likely to become high utilizers in the future. This session will discuss the role of machine learning in driving proactive, personalized engagement based on a deep understanding of each member’s characteristics. The result is earlier identification of which patients in a population are likely to be emerging risk or rising risk, and what their specific risks are. This informs targeted and individualized outreach to get in front of adverse health events, rather than trying to claw back irreversible health deterioration after the fact. Zahoor Elahi + Laura Carlson, Health at Scale Technologies.
11:45 – 1:15 – Lunch-Garden Terrace
1:15 – 2:15 – Success Stories in Pharmacy Programs in the TPA Market – This session will summarize key trends facing the market for 2022 and explore case studies. Rx remains an area to help TPAs gain a competitive advantage. Learn about innovative tools to give your TPA firm the edge. Robert Shelley, Leaf Health.
2:15 – 2:30 – Break for in-person and online viewers
2:30 – 3:30 – Workshops
- Workshop A – TPA CEO/President/COO – Discussion Leaders: Kris Smith + Ben Frisch – Blanco Meeting Room.
- Workshop B – Creating Trust and Alignment between Client Management and Operations Teams. Teri Swope, SwopeLight, LLC - Regency ABC Meeting Room.
- Workshop C – Managing Risk and Ensuring Security Discussion – Discussion Leader: Lee Barrett, CEO, EHNAC - Llano/Pecos Meeting Room.
- Workshop D – Stop Loss Session – Navigating through difficult claims; Two-way communication between TPA and Stop Loss; Other than the network discount, have outside claim vendors been considered; partnerships based on price should not be the sole consideration. Discussion Leaders: Tap Power + Richard Mousty - Nueces/Frio Meeting Room.
3:30 – 3:45 – Break for in-person and online viewers
3:45 – 4:45 – Machine Readable Files are here! + IDR Final Rules – How did you do? Hear panelists discuss the highs and lows of implementing MRF. Mary Piecuch, Payer Compass + Stacey Karp, Zelis.
4:45 – 5:30 – TPA Service Agreements – What TPAs need to consider when constructing a new service agreement or revising an old one. Anne Tyler Hall + Phil Koehler, Hall Benefits Law. Virtual
5:30 – 5:35 – Closing Comments – Chairman Dan Roslokken
5:35 – 6:35 – Cocktail Reception – Garden Terrace Room