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Schedule
Wednesday, March 18, 2026
7:00 AM - 5:45 PM
Conference Attendee Assistance: Check-In and Badge Pick-Up
7:00 - 8:00 AM
Conference Breakfast
This event is included in the conference registration fee. Attendees, speakers, and registered guests are welcome. Interested in sponsoring this event? Sponsor.
8:00 - 9:30 AM
1. The A&Bs of Medicare Parts A & B (not repeated)
Sara Filipelli, Senior Associate Counsel, Parkland Health and Hospital System
Alison Hollender, Husch Blackwell
Erica Waxman, Chief Legal Officer, Eating Recovery Center and Pathlight Mood & Anxiety
2. Year in Review (not repeated)
3. The Changing Medicaid Program–A Panel of State Medicaid Directors
Michael H. Cook, Liles Parker PLLC
- How the Medicaid program is changing in a particular state and nationally
- How the HR1 is affecting their programs and how they are responding to it
- Innovative features of the particular State's Medicaid program potentially addressing such items as social determinants of health care (SODH), managed care organizations, the opioid crisis, behavioral health, APMs, long term care and home and community-based care, and 1332 and 1115 waivers
- If and how public health issues are affecting their various programs, e.g. staffing shortages, and potentially what lessons have they learned from the COVID pandemic and the actions the state is taking to prepare for future pandemics
10:00 AM - 12:00 PM
10:00-10:15 AM
Welcome and Introductions
Mark Kopson, AHLA President, Plunkett Cooney PC
Charles A. Luband, Dentons US LLP
10:15 AM-12:00 PM
General Session
12:00 - 1:15 PM
Lunch and Learn PRE-REGISTRATION REQUIRED
Topic: A Look at the Federal Health Policy Agenda for 2026
Eric Zimmerman, Managing Principal, McDermott+
This talk would focus on prominent health policy changes being considered by Congress and/or the Trump Administration with an eye toward identifying topics under discussion and predicting future directions. The purpose would be to help the audience plan future organizational direction in light of a shifting federal health policy landscape. The talk would focus on potential Medicare and Medicaid policy changes.
This event is included in the registration fee. Limited attendance and pre-registration is required. Continuing Education Credits are not available. Interested in sponsoring this event? Sponsor.
1:30 - 2:30 PM
7. Basics of Medicare Hospital Cost Reporting (not repeated)
Jowita Walkup, Dentons US LLP
Dave Yoder, Director | Reimbursement, Adventist Health, Roseville, CA
- Forms, filings, and deadlines: What is filed, by whom, when, and what happens next
- Report structure and flow: How the major schedules flow through the cost report
- Overhead step‑down and cost‑based reimbursement: Core concepts and calculations
- Key schedules and data points: Settlement, outlier reconciliations, financial statements, and related exhibits
- Protested Items, disputes, appeals, and litigation primer: How cost reporting issues translate into administrative appeals and federal court litigation
8. Medicare and Medicaid and Bankruptcy (not repeated)
Augustus "Augie" Curtis, Offit Kurman
Samuel R. Maizel, Dentons
9. Graduate Medical Education (GME) in the USA–Key Metrics and Opportunities for 2026
Scott Bezjak, Forvis Mazars
Bradley Cunningham, Lead Policy and Regulatory Analyst at the Association of American Medical Colleges (AAMC)
- The structure and purpose of DGME, IME, and GME caps
- The Need for Additional Graduate Medical Education and the Impact on the US Healthcare Delivery System
- Operational decision making that affects GME reimbursements and program funding
- Payment metrics associated with the current funding of US Graduate Medical Education programs that are favorable to Graduate Medical Education
- State-level strategies for expanding GME funding and capacity and geographic distributions of Medicare supported GME positions
10. Medical Necessity in Medicare Advantage
Timothy P. Blanchard, "Blanchard Manning LLP
Kathy Roe, Health Law Consultancy
11. Best Practices for Legal Oversight of 340B Programs in Turbulent Times
Trevor Coe, Senior Associate Counsel, University of Maryland Medical System
Emily J. Cook, McDermott Will & Schulte
- Recent material 340B developments
- Myths and truths about 340B Program compliance and oversight obligations
- Examples of recent federal and state enforcement priorities
- Best practices for in-house legal teams to support 340B Program operations
- Examples of hypothetical 340B scenarios and practical guidance for in-house responses
3:00 - 4:00 PM
12. Advanced Cost Reporting (not repeated)
Gregory N. Etzel, Morgan Lewis & Bockius LLP
Eric Lucas, Moss Adams X Baker Tilly
13. Medicare Compliance: Continued Concerns (not repeated)
Marti Arvin, Chief Compliance and Privacy Officer, Erlanger Health
14. Medicare Reimbursement for Hospital-Based Nursing and Allied Health Programs
Alek Pivec, King & Spalding, LLP
Ann Showers, Director-Finance & Regulatory, TPR Solutions, LLC
- Overview of Medicare’s payment rules for nursing and allied health programs
- The provider-operated criteria and the friction with hospital operations and accreditation standards
- Common audit requirements and expectations
- Statutory and regulatory exceptions to the provider-operated rules
- Litigation implicating nursing and allied health reimbursement, including pending and recently decided cases.
- Proposed legislative and regulatory changes to the nursing and allied health payment rules
15. Current Issues with Provider-Based Status
Andrew D. Ruskin, K&L Gates
- Provider-Based Status Fundamentals
- Protecting Bipartisan Budget Act excepted status
- Using provider-based status to protect 340B eligibility
- Implications of CMS’s site neutrality rule for provider-based statute
- Updates on the drug acquisition cost survey
- Implications of provider-based status in commercial payer arrangements
16. Staying the Course: Civil Rights Compliance and Health Equity
Margia Corner, Sheppard Mullin Richter & Hampton
Aaron Schuham, University of California Office of the President
- The major shift since 2025 in policy priorities related to health equity for federal government funding and changes in the federal and state legal and regulatory landscape, including the anti-discrimination provisions in Section 1557 of the Affordable Care Act and their related regulations, the US Department of Health and Human Services Assurance of Compliance, and other federal certification requirements
- Notwithstanding these changes, many health care organizations and professionals remain deeply committed to identifying disparities in health outcomes and access to care, understanding the systemic barriers and other factors that may contribute to those disparities, and developing innovative solutions (such as digital health or community-based services) to eliminate them
- This session will give real-life examples of how ongoing initiatives to improve health equity can be aligned with the evolving federal policy and legal landscape and other practical tips for health care organizations seeking to ensure compliance in an ever-changing environment
4:30 - 5:45 PM
17. Medicaid Unpacked: Fundamentals for a Rapidly Evolving Era (not repeated)
Caroline L. Farrell, Foley Hoag
Jeff J. Wurzburg, Norton Rose Fulbright US LLP
- Brief overview of Medicaid, the largest US health coverage program
- The background on Medicaid’s structure, history, evolution, and current legal landscape
- Assess recent federal legislative and administrative developments shaping the future of Medicaid and how to navigate these changes, including the changes made by the One Big Beautiful Bill Act
- Understand other significant Medicaid changes, including major CMS policy announcements and the recent Medina Supreme Court decision
18. Administrative Enforcement (not repeated)
19. Medicaid Litigation Update
Garrett F. Mannchen, Office of the General Counsel, US Department of Health and Human Services
Felicia Y. Sze, Athene Law, LLP
20. Hospital Inpatient Prospective Payment System Update
Marc Hartstein, Health Policy Alternatives Inc
Katrina A. Pagonis, Hooper Lundy & Bookman PC
21. The Underpinnings of Overpayments
Susan Banks, Holland & Knight
B. Scott McBride, Morgan Lewis & Bockius LLP
- Frame the report-and-return requirement and analyze self-audit obligations under the federal Overpayment Statute, including when an overpayment is “identified”
- The Overpayment Statute’s intersection with the False Claims Act
- Address critical distinctions and considerations for overpayments in the Medicare FFS versus Medicare Advantage contexts
- Consider the role and relative weight of statutory, regulatory, and subregulatory agency guidelines, reflecting on the significance of Loper Bright and the current deregulatory environment
- Discuss several compliance and overpayment scenarios to assess likely conditions of payment, evaluate available deference and rulemaking related defenses, and consider implications for scienter arguments
- Distill practical takeaways for providers conducting internal investigations and defending false claims allegations
5:45 - 6:45 PM
Networking Reception
This event is included in the conference registration. Attendees, speakers, and registered guests are welcome. Interested in sponsoring this event? Sponsor.
Thursday, March 19, 2026
7:00 AM - 5:30 PM
Conference Attendee Assistance: Check-In and Badge Pick-Up
7:00 - 8:00 AM
Conference Breakfast
This event is included in the conference registration. Attendees, speakers, and registered guests are welcome. Interested in sponsoring this event? Sponsor.
8:00 - 9:00 AM
22. PRRB Appeals–The View from the Board Chair (not repeated)
Kevin D. Smith, Board Chair, Provider Reimbursement Review Board, Centers for Medicare and Medicaid Services
- Introduction of Board members
- Board decisions
- Jurisdiction
- Hearings
- Case inventory
- Board initiatives
- Board Rules and mandatory electronic filing
- Evaluation of decision process
- Observations from the Board
23. Medicare and Medicaid Behavioral Health Coverage and Payment: Promising Developments and Challenges (not repeated)
Matthew W. Bergeron, Larkin Hoffman
Susannah Vance Gopalan, UNC Health Pardee
- A survey of promising developments and challenges in behavioral health coverage and payment in Medicare and Medicaid. We will discuss how these trends impact various provider sectors, and how medical providers and practices may partner with behavioral health providers in their communities to make these new or expanded services more widely available
- The impact of budgetary issues on the expanded behavioral health services under Medicare and Medicaid, including the status of 1115 demonstration projects, and the potential impact of the community engagement requirements included in the One Big Beautiful Bill Act (Pub. L. No. 119-21)
- Services and payment methodologies covered will include Medicaid CCBHC services; Medicare intensive outpatient program (IOP) services; Medicare opioid treatment program (OTP) services; the expansion of Medicare Part B-covered behavioral health clinician services; school-based mental health services; and medication-assisted treatment (MAT) for opioid use disorder in Medicaid
24. Pennies or Payments: Physician Fee Schedule & Part B in 2026
Bryan Hull, Washington Counsel, Division of Legislative Counsel, American Medical Association
Sidney S. Welch, "Bradley, Arant, Boult & Cummings LLP
- An overview of the final Medicare Physician Fee Schedule for 2026
- Implications of the changes contained in the final MPFS
- Trending topics in the MPFS
- Other new developments and realities of physician payment
- What we should expect in 2027
25. Medicare Advantage Fraud Enforcement Under a New Administration: Mitigating Risk for Criminal and Civil Actions
Jolie Apicella, Wiggin and Dana
26. Uncompensated Care DSH Cost Reporting and Reimbursement
Fred Fisher, Toyon Associates
Karen Kim, Athene Law
- Imminent changes to the uninsured population and its impact on state and federal DSH reimbursement
- How hospitals articulate various forms of patient financial assistance in financial assistance policies
- Best practices to fully recognize and report allowable uncompensated care costs
- Issues with federal and state uncompensated care cost reporting instructions and audits
9:15 - 10:30 AM
27. Medicaid Supplemental Payments and Current Issues (Primer) (not repeated)
Sarah E. Mutinsky, Eyman Partners LLC
Anne O'Hagen Karl, Manatt Phelps & Phillips LLP
28. Traditional Medicare v. Medicare Advantage: Acute Hospital Perspectives (not repeated)
Richelle Marting, Martomg Law LLC / Director of Managed Care Contracting, NKC Health
Praveen Mekala, Chief Financial Officer Lahey Hospital and Medical Center, Beth Israel Lahey Health
- The history, evolution, and significance of Medicare managed care
- Payment differences identified through including insurance payments, cost sharing, Medicare cost report settlement and value-based purchasing
- The importance of careful contracting including retroactive settlement provisions and denial management
- Current regulatory environment and upcoming changes
- Practical operational and strategic considerations that contemplate the current state of the industry
29. Medicare Litigation Update
Melissa D. Hart, Office of the General Counsel, US Department of Health and Human Services
Daniel J. Hettich, King & Spalding
- The past year’s significant Federal court cases or decisions affecting Medicare reimbursement, including the result and implications of the Supreme Court’s DSH decision in Advocate Christ v Becerra, as well as significant ongoing litigation challenging one of the building blocks of Medicare inpatient payments, i.e., the standardized amount
- Issues particularly pertinent to Medicare litigation such as agency deference post-Chevron, jurisdiction, substantive and procedural challenges, and remedies
- What recent decisions tell us about the strengths and weaknesses of ongoing Medicare reimbursement appeals
30. Hot Topics in Fraud and Abuse
Laura Laemmle-Weidenfeld, Jones Day
20. Hospital Inpatient Prospective Payment System Update (repeat)
Marc Hartstein, Health Policy Alternatives Inc
Katrina A. Pagonis, Hooper Lundy & Bookman PC
10:30 - 11:00 AM
Coffee and Networking Break
Exhibits Open--Meet the Exhibitors. Interested in sponsoring this event? Sponsor.
11:00 AM - 12:00 PM
31. Navigating Medicare Claim Appeals (not repeated)
Deborah Samenow, DLA Piper LLP (US)
32. Medicaid Managed Care: Its Growing Role in Medicaid Financing and Delivery of Care (not repeated)
Susan Feigin Harris, Norton Rose Fulbright
Rachel Gilbert, Burr & Forman LLP
33. Safety Net Providers in the Medicare and Medicaid Programs and the Anticipated Consequences of the OBBBA
Kathy Ghiladi, Feldesman LLP
10. Medical Necessity in Medicare Advantage (repeat)
Timothy P. Blanchard, "Blanchard Manning LLP
Kathy Roe, Health Law Consultancy
15. Current Issues with Provider-Based Status (repeat)
Andrew D. Ruskin, K&L Gates
- Provider-Based Status Fundamentals
- Protecting Bipartisan Budget Act excepted status
- Using provider-based status to protect 340B eligibility
- Implications of CMS’s site neutrality rule for provider-based statute
- Updates on the drug acquisition cost survey
- Implications of provider-based status in commercial payer arrangements
12:00 - 1:00 PM
Lunch on your own
1:15 - 2:15 PM
34. Wasteful and Inappropriate Service Reduction (WISeR) Model (not repeated)
Amy Turner, Deputy Director, Innovation Center, Centers for Medicare & Medicaid Services, Washington DC
35. Legal Ethics
36. Hospitals and House Slippers: Shifting Care to the Patient’s Home
Ryan Thurber, Polsinelli PC
25. Medicare Advantage Fraud Enforcement Under a New Administration: Mitigating Risk for Criminal and Civil Actions (repeat)
Jolie Apicella, Wiggin and Dana
26. Uncompensated Care DSH Cost Reporting and Reimbursement (repeat)
Fred Fisher, Toyon Associates
Karen Kim, Athene Law
- Imminent changes to the uninsured population and its impact on state and federal DSH reimbursement
- How hospitals articulate various forms of patient financial assistance in financial assistance policies
- Best practices to fully recognize and report allowable uncompensated care costs
- Issues with federal and state uncompensated care cost reporting instructions and audits
2:15- 2:45 PM
Coffee and Networking Break
Exhibits Open--Meet the Exhibitors. Interested in sponsoring this event? Sponsor.
2:45 - 3:45 PM
37. Clinical Trial Billing (not repeated)
Robert Wanerman, Epstein Becker & Green PC
38. Creating High-Performing Post-Acute Care Networks to Succeed in Risk-Based Payment Models (not repeated)
James M. Daniel, Hancock Daniel & Johnson PC
Chad Mulvany, Forvis Mazars
- How PAC discharge decisions can impact patient outcomes and financial performance in risk-based payment models
- Legal requirements for creating compliant high-value PAC networks
- Regulatory, legal, and operational issues providers encounter when discharging patients to high-value PAC networks
- The data and process used to identify high-value PAC providers and recruit them to participate in the network
- Strategies for engaging providers in care redesign related to PAC networks and discharge decisions
9. Graduate Medical Education (GME) in the USA – Key Metrics & Opportunities for 2026 (repeat)
Scott Bezjak, Forvis Mazars
Bradley Cunningham, Lead Policy and Regulatory Analyst at the Association of American Medical Colleges (AAMC)
- The structure and purpose of DGME, IME, and GME caps
- The Need for Additional Graduate Medical Education and the Impact on the US Healthcare Delivery System
- Operational decision making that affects GME reimbursements and program funding
- Payment metrics associated with the current funding of US Graduate Medical Education programs that are favorable to Graduate Medical Education
- State-level strategies for expanding GME funding and capacity and geographic distributions of Medicare supported GME positions
14. Medicare Reimbursement for Hospital-Based Nursing and Allied Health Programs (repeat)
Alek Pivec, King & Spalding, LLP
Ann Showers, Director-Finance & Regulatory, TPR Solutions, LLC
- Overview of Medicare’s payment rules for nursing and allied health programs
- The provider-operated criteria and the friction with hospital operations and accreditation standards
- Common audit requirements and expectations
- Statutory and regulatory exceptions to the provider-operated rules
- Litigation implicating nursing and allied health reimbursement, including pending and recently decided cases.
- Proposed legislative and regulatory changes to the nursing and allied health payment rules
16. Staying the Course: Civil Rights Compliance and Health Equity (repeat)
Margia Corner, Sheppard Mullin Richter & Hampton
Aaron Schuham, University of California Office of the President
- The major shift since 2025 in policy priorities related to health equity for federal government funding and changes in the federal and state legal and regulatory landscape, including the anti-discrimination provisions in Section 1557 of the Affordable Care Act and their related regulations, the US Department of Health and Human Services Assurance of Compliance, and other federal certification requirements
- Notwithstanding these changes, many health care organizations and professionals remain deeply committed to identifying disparities in health outcomes and access to care, understanding the systemic barriers and other factors that may contribute to those disparities, and developing innovative solutions (such as digital health or community-based services) to eliminate them
- This session will give real-life examples of how ongoing initiatives to improve health equity can be aligned with the evolving federal policy and legal landscape and other practical tips for health care organizations seeking to ensure compliance in an ever-changing environment
4:00 - 5:15 PM
39. Medicaid Financing Issues (not repeated)
Catherine Kirkland, Burr & Forman, LLP
Baxter Morgan, Husch Blackwell LLP
40. Audits of the Medicare Enrollment Screening Process and Revocations for Suppliers of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (not repeated)
41. Medicare Hospital Payment Reform: Modernizing Reimbursement to Reflect the Cost of Care
Heather D. Mogden, Hall Render Killian Heath & Lyman PC
K. Michael Nichols, Senior Director Reimbursement, University of Illinois Hospital and Clinics
29. Medicare Litigation Update (repeat)
Melissa D. Hart, Office of the General Counsel, US Department of Health and Human Services
Daniel J. Hettich, King & Spalding
- The past year’s significant Federal court cases or decisions affecting Medicare reimbursement, including the result and implications of the Supreme Court’s DSH decision in Advocate Christ v Becerra, as well as significant ongoing litigation challenging one of the building blocks of Medicare inpatient payments, i.e., the standardized amount
- Issues particularly pertinent to Medicare litigation such as agency deference post-Chevron, jurisdiction, substantive and procedural challenges, and remedies
- What recent decisions tell us about the strengths and weaknesses of ongoing Medicare reimbursement appeals
30. Hot Topics in Fraud and Abuse (repeat)
Laura Laemmle-Weidenfeld, Jones Day
5:15 - 6:00 PM
Reception
This event is included in the conference registration. Attendees, speakers, and registered guests are welcome. Interested in sponsoring this event? Sponsor.
Friday, March 20, 2026
7:00 - 11:45 AM
Conference Attendee Assistance
7:00 - 8:00 AM
Conference Breakfast
This event is included in the conference registration. Attendees, speakers, and registered guests are welcome. Interested in sponsoring this event? Sponsor.
8:00 - 9:00 AM
42. The IRA's Drug Pricing Provisions from All Sides (not repeated)
Sabrina Aery, Aery Partners
Chris Schott, Latham & Watkins
43. Key Elements of Medicare Wage Index, Occupational Mix, and Reclassifications (not repeated)
Joseph R. Krause, Hall Render
Brian Restivo, Moss Adams X Baker Tilly
- How the wage index impacts Medicare payments
- How the Medicare Wage Index is calculated and identify reporting risks and opportunities for hospitals
- Critical keys to success when approaching Medicare Wage Index and rural reclassifications
- The critical timelines and requirements for applying for special provider statuses used in MGCRB reclassifications
- The key elements involved in completing the Occupational Mix Survey accurately
11. Best Practices for Legal Oversight of 340B Programs in Turbulent Times (repeat)
Trevor Coe, Senior Associate Counsel, University of Maryland Medical System
Emily J. Cook, McDermott Will & Schulte
- Recent material 340B developments
- Myths and truths about 340B Program compliance and oversight obligations
- Examples of recent federal and state enforcement priorities
- Best practices for in-house legal teams to support 340B Program operations
- Examples of hypothetical 340B scenarios and practical guidance for in-house responses
24. Pennies or Payments: Physician Fee Schedule & Part B in 2026 (repeat)
Bryan Hull, Washington Counsel, Division of Legislative Counsel, American Medical Association
Sidney S. Welch, "Bradley, Arant, Boult & Cummings LLP
- An overview of the final Medicare Physician Fee Schedule for 2026
- Implications of the changes contained in the final MPFS
- Trending topics in the MPFS
- Other new developments and realities of physician payment
- What we should expect in 2027
9:15 - 10:30 AM
44. PRRB Appeals: Current Topics (not repeated)
Page M. Smith, Bass Berry & Sims
19. Medicaid Litigation Update (repeat)
Garrett F. Mannchen, Office of the General Counsel, US Department of Health and Human Services
Felicia Y. Sze, Athene Law, LLP
21. The Underpinnings of Overpayments (repeat)
Susan Banks, Holland & Knight
B. Scott McBride, Morgan Lewis & Bockius LLP
- Frame the report-and-return requirement and analyze self-audit obligations under the federal Overpayment Statute, including when an overpayment is “identified”
- The Overpayment Statute’s intersection with the False Claims Act
- Address critical distinctions and considerations for overpayments in the Medicare FFS versus Medicare Advantage contexts
- Consider the role and relative weight of statutory, regulatory, and subregulatory agency guidelines, reflecting on the significance of Loper Bright and the current deregulatory environment
- Discuss several compliance and overpayment scenarios to assess likely conditions of payment, evaluate available deference and rulemaking related defenses, and consider implications for scienter arguments
- Distill practical takeaways for providers conducting internal investigations and defending false claims allegations
41. Medicare Hospital Payment Reform: Modernizing Reimbursement to Reflect the Cost of Care (repeat)
Heather D. Mogden, Hall Render Killian Heath & Lyman PC
K. Michael Nichols, Senior Director Reimbursement, University of Illinois Hospital and Clinics
10:45 - 11:45 AM
33. Safety Net Providers in the Medicare and Medicaid Programs and the Anticipated Consequences of the OBBBA (repeat)
Kathy Ghiladi, Feldesman LLP
35. Legal Ethics (repeat)
36. Hospitals and House Slippers: Shifting Care to the Patient’s Home (repeat)
Ryan Thurber, Polsinelli PC
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