Recording

California Health Benefit Exchange Webinar CD
Key deadlines, health plan networks, impact on hospitals

Webinar Recorded Live November 9, 2012
Program Rated 4.22 out of 5 by participants

Overview

The state of California has been active creating a brand new marketplace for health care — the California Health Benefit Exchange (CHBE).

Health plans have been busy too, filing certification applications, creating products for CHBE and developing networks of providers to support the products. With all this activity, providers and purchasers are asking questions — lots of them.

This webinar addresses the latest developments at CHBE and explores your most pressing concerns, including:

  • Defining the players and roles — plans, providers, purchasers
  • Critical timelines — what you need to do, and by when
  • How the enrollment process will work
  • Anticipated changes in patient demographics, marketplace
  • What happens to existing health plan relationships and contracts
  • On the horizon — how care delivery and payment be will impacted

Expert faculty include: Bruce Fried, partner at SNR Denton; David Panush, California Health Benefit Exchange director of government relations; and from the California Department of Managed Health Care, Maureen McKennan, deputy director of plan and provider relations, and Amy Krause, assistant chief counsel for the Division of Licensing, Office of Health Plan Oversight.

Recommended for:

Chief executive officers, chief operating officers, chief financial officers, and managed care executives.

Agenda

The California Health Benefit Exchange

  • Key players and roles
  • Deadlines — what to do by when, process, activities
  • Qualified health plans — who regulates
  • Network and plan design
  • Affordability and quality — goals of CHBE
  • Benefit options, design
  • Handling out-of-network issues
  • Health plan products — implications for hospitals
  • Post-election impact — what now?

Role of the California Department of Managed Health Care

  • Health plan deadlines for filing license applications
  • Process and review of product applications
  • Standards for determining network adequacy

Enrollment goals of CHBE

  • Enrollment goals — meeting the needs of Californians
  • Key timelines and responsibilities
  • “No Wrong Door” philosophy — how this works
  • Grants to support enrollment, outreach activity

Faculty

Bruce Merlin Fried is a partner in SNR Denton’s Health Care practice and managing partner of the firm’s Washington DC office. Mr. Fried, a 30-year health care law and policy expert, counsels and represents health plans, physician organizations, hospital groups, consumer organizations, health care information technology companies, pharmaceutical and biotech companies and other health care organizations with regard to federal health care programs and policies. Previously, Mr. Fried served as the Health Care Financing Administration’s (HCFA, now CMS) Director of the Center for Health Plans and Providers where he was responsible for policy and operations for the Medicare program.

Mark Hamelburg is a member of SNR Denton’s Health and Life Sciences sector team and a 20-year health law veteran with experience in a variety settings and specialties. Mr. Hamelburg’s primary focus at SNR Denton is on a broad range of matters relating to the Medicare Prescription Drug and Medicare Advantage programs. He also counsels clients on evolving areas of payment and health delivery reform, particularly areas in which CMS plays a key role, such as Accountable Care Organizations (ACOs). Prior to joining SNR Denton, Mr. Hamelburg held senior roles at the Centers for Medicare & Medicaid Services and in the US Department of Health and Human Services.

David Panush is the director of government relations with the California Health Benefit Exchange. Prior to joining the California Health Benefit Exchange in 2011, David Panush was the Health Policy Advisor to California Senate President Pro Tempore Darrell Steinberg. He has been a key policy consultant in the Office of the President Pro Tempore since 1986, and has advised the past five State Senate leaders on a variety of policy and fiscal issues. Panush holds a Bachelor of Arts from the University of California at Berkeley. As director of government relations, Panush will work with federal and state policy makers to ensure Exchange perspectives are reflected in federal and state regulations, guidances and legislative proposals.

Maureen McKennan is the deputy director, Plan and Provider Relations, at the California Department of Managed Health Care (DMHC). Ms. McKennan is responsible for fostering proactive and effective relations between the DMHC and its licensed health plans, while serving as primary advisor to the Director on critical plan and provider issues and providing strategic planning and policy direction on emerging issues and industry trends. Ms. McKennan is uniquely qualified to work in the health care field, having extensive experience as both an attorney and a nurse. She came to the DMHC from the Office of the Attorney General, where she had worked as an attorney in both the correctional law section and the licensing section.

Amy Krause, JD, is assistant chief counsel in the Division of Licensing, Health Plan Oversight at the California Department of Managed Health Care (DMHC).  Ms. Krause has over a decade of experience with health care law, regulation and policy, both in the public and private sectors.  She began her career in the Legal and Public Affairs Department at WellPoint Health Networks, Inc., and after relocating with her family, transitioned to the DMHC where she serves as a counsel, manager, and executive resource. 

Commands