2024 WEDI Summer Forum

Unlock the Future of Health Care at WEDI's Summer Forum 2024!

View the Agenda Here.

WEDI invites you to our highly anticipated Summer Forum, a premier event where the brightest minds in our industry converge to discuss and shape the future of health care. This year, we're excited to feature dynamic panels focused on the recently released prior authorization final rule. Not only will you hear payers, providers, and vendors share their insights and unique perspectives, but we're happy to welcome CMS' Alex Mugge who will offer updates and listen to your feedback. You're opportunity to offer feedback to one of the authors of the CMS Interoperability and PA Final Rule.  The forum will also feature intimate, small group discussions, allowing stakeholders to share thoughts on their prior authorization process. What stage are they in? What are the adoption challenges? How can WEDI assist and support implementation efforts as the industry moves toward the January 2027 compliance date?

Additionally, the event will feature updates on the work from the WEDI Claims and Remittance Advice & Payment Workgroups, including a deep dive into the potential new versions of the claim transactions and the remittance advice transaction.  Most importantly, the Centers for Medicare & Medicaid Services National Standards Group will be hosting listening sessions on these transactions and other administrative simplification issues. Take advantage of this unique opportunity to interact with policymakers and industry experts.

Forum Highlights: 

Interoperability & Prior Authorization Pulse Panel: We welcome speakers from 4 of the most important healthcare organizations to offer their thoughts on the interoperability and prior authorization rule. Challenges, benefits, and the need for partnership and collaboration. 

• Andrea Preisler, Senior Associate Director, Administrative Simplification Policy, American Hospital Association
• Danielle Lloyd , Senior Vice President of Private Market Innovations and Quality Initiatives for Clinical Affairs, America's Health Insurance Plans
• Heather McComas, Director, Administrative Simplification Initiatives, American Medical Association
• Karuna Relwani, Business Interoperability Lead, Health Information Technology, Blue Cross Blue Shield Association

CMS Interoperability and Prior Authorization Feedback Session: Your opportunity to discuss how the rule will impact your organizations and decision making regarding implementation. 

• Alexandra Mugge, Chief Health Informatics Officer, and Director of the Health Informatics and Interoperability Group, Centers for Medicare & Medicaid Services

Stakeholder Panels (Payers, Providers and Vendors) Focusing on the Recently Released Prior Authorization Final Rule. Panel Participants (more to be announced):

• BCBS South Carolina
• Edifecs
• MCG Health
• Cambia Health Solutions
• Providence
• MultiCare Connected Care
• Availity
• InterSystems
  
  

Updates from WEDI's Claims and Remittance Advice & Payment Workgroups

Listening Session hosted by CMS' National Standards Group:The National Standards Group (NSG) will host a listening session to solicit input on feedback garnered from WEDI’s survey regarding updates in X12’s version 8020 for the claims and ERA transactions. NSG hopes to gain a better understanding of the expected business impact from the updates in this latest version from X12

PA Spotlight on Massachusetts: Like numerous states, Massachusetts is tackling the burdens of prior authorization on multiple fronts. On the policy front, legislation proposed by provider and patient associations is working through the law-making gauntlet. The state's not-for-profit health plans have been national leaders in reducing or eliminating prior authorization requirements for multiple medical services.
On the technology and process front, the Massachusetts Health Data Consortium (MHDC) is convening the state's payers, providers, regulatory agencies, associations, and other constituents to implement electronic prior authorization (ePA) by January 1, 2027, in keeping with, and moving beyond, the regulatory deadline set by the Center for Medicare and Medicaid Services.
In consultation with Point of Care Partners (POCP), MHDC has selected ZeOmega as its technology partner in launching NEHEN 3.0, the latest version of its health information exchange, including X12-EDI and FHIR-API exchange and automation, with an initial focus on ePA and quality measures exchange.
Join MHDC, POCP, and ZeOmega for an open conversation on how we got to where we are today and what comes next on our journey.

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Why Attend?

1. Comprehensive Insights from All Angles:

• Payers: Discover how payers are navigating the complexities of the prior authorization final rule, from regulatory mandates to technological advancements.
• Providers: Learn from leading health care providers about the practical challenges they face and the innovative solutions they are implementing.
• Vendors: Hear from technology vendors offering cutting-edge tools and platforms that will drive efficiency and ensure compliance with the federal prior authorization requirements.

2. Current Environment Analysis:

• Gain a deep understanding of the current prior authorization environment. Our panels will dissect how existing manual and burdensome processes will take advantage of API technology, highlight common pain points in the implementation journey, and discuss implications of this new approach on impacted stakeholders.
• Evaluating Future Transaction Versions. Join with CMS regulators and industry colleagues to discuss the potential value of moving to updated versions of some of the most critical transactions, including the claim and remittance advice. Share your opinions on how the updates could impact your organization and what potential implementation challenges you will face.

3. Addressing Challenges:

• Explore the most pressing challenges associated with implementing  the prior authorization final rule. From administrative burdens to interoperability issues, our expert panels will delve into the obstacles hindering progress and share strategies for overcoming them.

4. Highlighting Benefits:

• Uncover the tangible benefits of a well-optimized, API-based  prior authorization process. Learn how streamlined workflows can improve patient outcomes, reduce costs, and enhance the health care delivery process.

5. Future Directions:

• Get a sneak peek into the future of prior authorization. Our panels will discuss the impact of the new regulation and how the rule will drive significant industry change over the next several years. Understand how to prepare and adapt to these changes to stay ahead of the curve.

Who Should Attend?

• Healthcare Executives
• Medical Practitioners
• Insurance Providers
• Health IT Professionals
• Regulatory and Compliance Officers
• Healthcare Consultants
• Policymakers

Immediately following the sessions on day 1, onsite attendees are invited to join us around the corner from the ADA Conference Center as we enjoy food and drink at one of Chicago's most loved pizzerias. 

WEDI will not have a hotel block for this event, and encourages attendees to research hotels near the ADA Conference Center (211 E Chicago Ave, Chicago, IL 60611)

Nearby Properties include but are not limited to:

• Hampton Inn Chicago Downtown/ Mag Mile
• Homewood Suites by Hilton Chicago Downtown Mag Mile
• Warwick Allerton Chicago
• Hyatt Centric Chicago Mag Mile
• Hotel St Clair, Mag Mile
• Hilton Chicago, Mag Mile Suites
• Millennium Knickerbocker Chicago
• Sonesta ES Suites Chicago Downtown Mag Mile
• Aloft Chicago Mag Mile

Interested to become an Event Sponsor or Education Partner?

Contact Bill Allder with any questions or to request a sample list of past attendees!