Join the Houston Business Coalition on Health for this employer-only event (consultants may come with their client) where HBCH will be outlining the concept, timeline, and benefits for participating in the Houston Smart Network. Our CEO, Steve Cyboran, ASA, MAAA, FCA, CEBS will presenting during the meeting.
Lunch will be served!
HBCH is on the cusp of developing a Houston-based alternative to your regular health plan that provides more for less. HBCH will highlight Smart Network benefits, including better health outcomes, less cost for you and your employees, and an integrated, simple employee experience.
This interactive discussion will include:
The urgent need for a Smart Network in Houston
Overview of the Smart Network – a different but proven type of benefits option
Explain the benefits of the Houston Smart Network, understand employer interests, including willingness to support financially, and learn about new Texas legislation that will be gamechanger for employers. Interested employers can contribute to the development of the Houston Smart Network, and each dollar may be matched by two major philanthropic organizations.
Watch a replay of the Insurance Collaboration to Save Lives (ICSL) Executive Briefing, in which our CEO, Steve Cyboran, ASA, MAAA, FCA, CEBS participated. Steve discusses how small investments can yield significant returns. Not only does preventive medical screening in this collaborative need to achieve outcomes, but it also needs to make economic sense. Return on investment can be increased by decreasing screening costs, increasing the effectiveness of screening, and targeting larger policies first.
Presenters
Josh Stirling, Founder of Insurance Collaboration to Save Lives, Insurtech Advisor, Board Director and Former #1 Ranked Insurance Analyst
Steve Cyboran, ASA, MAAA, FCA, CEBS, CEO, Consulting Actuary, Chief Behavioral Officer, Humaculture, Inc.
Sven Lohse, Principal, Research at Canton & Company
Objective
At the ICSL, dozens of industry executives have been developing a plan to help insurers proactively address the tragedy of rising mortality and morbidity. Excess mortality and morbidity is a problem for our industry, and society. The ICSL is bringing together insurers to work together to solve it. Find out the impact we can make from Steve Cyboran in this presentation on slides 33-36 and at 32:46 in the video.
We are available to support you in your strategy, design, compliance, financial, and monitoring needs. Our team includes business and human relations leaders, finance experts, actuaries, clinicians, behavioral health experts, pharmacy experts, and legal resources to guide you through the strategy and compliance process. Please contact us: [email protected].
Watch a replay of the fifth webinar in Humaculture, Inc.’s “People Development: A Humaculture® Perspective Series” to learn how to conduct Career Planning to support leadership development, and why “Effective Pruning Bears Fruit” by building leadership capabilities.
Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
Wes Rogers, Humaculturist® and strategy consultant
Christi Green, RN, MS, PHR, strategy and people consultant
Objective
We’ve talked about how to develop managers to lead to growth and new directions as opposed to staying rooted in the current problems. Now this webinar focuses on how to develop leaders to advance strategy, focus on people, and inspire performance. This results in leadership cultivating the organizational “soil” which leads to real, practical changes that advance the business.
Career Planning: Leadership Development Key Takeaways
During this session, participants will learn that:
Leaders fail to make decisions
Leadership vacuums create confusion and a toxic environment
Leaders who lack a broad perspective undermine operations
For effective leadership development organizations must:
Understand effective leadership qualities
Build and cultivate the right organizational “soil”
Develop leaders who have good intuition and decision-making skills
Ensure well-rounded leadership team with appropriate autonomy
Nurture and develop for intended purposes
Available Support
We are available to support you in your strategy, design, compliance, financial, and monitoring needs. Our team includes business and human relations leaders, finance experts, actuaries, clinicians, behavioral health experts, pharmacy experts, and legal resources to guide you through the strategy and compliance process. Please contact us: [email protected].
Watch
Watch the Career Planning: Effective Pruning Bears Fruit: Manager Development Webinar Replay via Rumble or YouTube.
Join us on Thursday, April 20 from 12:00 to 12:30 CDT for the fifth webinar in Humaculture, Inc.’s “People Development: A Humaculture® Perspective Series.” You will learn how to conduct Career Planning to support leadership development, and why “Effective Pruning Bears Fruit” by building leadership capabilities.
Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
Wes Rogers, Humaculturist® and strategy consultant
Christi Green, RN, MS, PHR, strategy and people consultant
Objective
Last webinar, we talked about how to develop managers to lead to growth and new directions as opposed to staying rooted in the current problems. Now it’s time to talk about how to develop leaders to advance strategy, focus on people, and inspire performance. This results in leadership cultivating the organizational “soil” which leads to real, practical changes that advance the business.
Career Planning: Leadership Development Key Takeaways
During this session, participants will learn that:
Leaders fail to make decisions
Leadership vacuums create confusion and a toxic environment
Leaders who lack a broad perspective undermine operations
For effective leadership development organizations must:
Understand effective leadership qualities
Build and cultivate the right organizational “soil”
Develop leaders who have good intuition and decision-making skills
Ensure well-rounded leadership team with appropriate autonomy
Watch a replay of the fourth webinar in Humaculture, Inc.’s “People Development: A Humaculture® Perspective Series” to learn how to conduct Career Planning to support manager development, and why “Effective Pruning Bears Fruit” by building manager capabilities.
Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
Wes Rogers, Humaculturist® and strategy consultant
Christi Green, RN, MS, PHR, strategy and people consultant
Objective
We’ve talked about how to “Effectively Prune” to activate and inspire our workplace AND workforce to further grow and develop employees. Now this webinar focuses on how to develop managers to facilitate growth instead of control, to focus on people in addition to results, and to be vision driven instead of a problem solver. This leads to growth and new directions as opposed to staying rooted in the current problems.
Career Planning: Manager Development Key Takeaways
During this session, participants will learn that:
Organizations fall into the “star” employee syndrome
Organizations don’t think from a people development perspective
Culture of Control creates a toxic environment
For effective manager development organizations must:
Promote intentionally to fulfill vision, mission, values
Effectively identify manager qualities/potential
Develop and deploy learning and growth opportunities
Shift from Culture of Control to Culture of Growth
Prepare for appropriate transitions
Available Support
We are available to support you in your strategy, design, compliance, financial, and monitoring needs. Our team includes business and human relations leaders, finance experts, actuaries, clinicians, behavioral health experts, pharmacy experts, and legal resources to guide you through the strategy and compliance process. Please contact us: [email protected].
Watch
Watch the Career Planning: Effective Pruning Bears Fruit: Manager Development Webinar Replay via Rumble or YouTube.
Watch a replay of our CEO, Steve Cyboran, ASA, MAAA, FCA, CEBS, present at the Houston Business Coalition on Health on How to Reduce Total Cost of Care Through Organizational Culture. Joining him as a presenter is Ray Fabius, MD, Co-Founder and President of HealthNEXT.
We are available to support you in your strategy, design, compliance, financial, and monitoring needs. Our team includes business and human relations leaders, finance experts, actuaries, clinicians, behavioral health experts, pharmacy experts, and legal resources to guide you through the strategy and compliance process. Please contact us: [email protected].
Join us on Thursday, February 16 from 12:00 to 12:30 CDT for the fourth webinar in Humaculture, Inc.’s “People Development: A Humaculture® Perspective Series.” You will learn how to conduct Career Planning to support manager development, and why “Effective Pruning Bears Fruit” by building manager capabilities.
Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
Wes Rogers, Humaculturist® and strategy consultant
Christi Green, RN, MS, PHR, strategy and people consultant
Objective
We’ve talked about how to “Effectively Prune” to activate and inspire our workplace AND workforce to further grow and develop employees. Now it’s time to talk about how to use management to grow instead of control, focus on people in addition to results, and be vision driven instead of a problem solver. This leads to growth and new directions as opposed to staying rooted in the current problems.
Career Planning: Manager Development Key Takeaways
During this session, participants will learn that:
Organizations fall into the “star” employee syndrome
Organizations may not think from a people development perspective
Culture of Control creates a toxic environment
For effective manager development organizations must:
Promote intentionally to fulfill vision, mission, values
Effectively identify manager qualities/potential
Develop and deploy learning and growth opportunities
The Compliance Toolkit first quarterly update addresses:
The Independent Dispute Resolution section was updated to include a section for the Revenue Procedure 2022-11 which published the percentage adjustment for median contracted rates.
The Pharmacy Benefit and Drug Cost Reporting section was updated to include a section reflecting the guidance contained in the November 23, 2021 Prescription Drug and Health Care Spending Interim Final Rules, implementing Section 204, Title II, another phase of the transparency provisions of the Consolidated Appropriations Act (CAA) of 2021.
The Direct and Indirect Compensation section was updated to reflect clarifying language and a section was added to address guidance contained in the Field Assistance Bulletin No. 2021-03 released by the Department of Labor (“DOL”) on December 30, 2021.
Attachment 1: Compliance Tool – CAA and Transparency Financial Impact Analysis Tool was updated to reflect additional calculations.
Attachment 9: Compliance Tool – MHPAEA Comparative and Fee Analysis Tool was updated to improve some of the functionality.
Compliance Toolkit Second Quarterly Update
The Compliance Toolkit second quarterly update addresses:
The Initiation of IDR Process section was updated to indicate that online IDR portal was opened on April 15, 2022.
The Determination of Payment section was updated to report a court case that invalidated the portion of the interim final rule relating to the presumption that the QPA is the most appropriate amount and a release of a Memorandum, withdrawing the portion of the interim final rule that was invalidated by the court.
The Petition to Deny or Revoke IDR Certification was updated to report the release of IRS Notice 2022-11, which provides guidance on indexing “the qualifying payment” amount for items and services furnished in 2022 in the case of a group health plan or insurer that does not have enough information as of January 31, 2019, to calculate the median of the in-network contracted rates or in the case there are new items or services being furnished.
The Fee Disclosure Related to Covered Group Health Plans Section was updated to remove duplicate sections.
The Public Disclosure of Provider Fees Requirement section was updated to report the release of two new FAQs discussing the machine-readable files used for public disclosure.
Compliance Toolkit Third Quarterly Update
The Compliance Toolkit third quarterly update addresses:
The “Independent Dispute Resolution (IDR) Procedures for Determining Certain Out-of-Network Rates to Be Paid by Group Health Plans” section has been updated to reflect the following:
Departments jointly issued FAQ guidance adopting an enforcement safe harbor for health plans and insurers reporting certain types of in-network rates under the transparency in coverage.
Departments jointly issued revised process guides for independent dispute resolution (IDR) under the No Surprises Act.
Federal Court stays proceeding in case vacating Portions of No Surprises Act’s IDR Regulations
Departments Jointly issued Checklist for Surprise Billing IDR Process
Departments Issued Checklist for Surprises Billing IDR process
The “Public Disclosure of Provider Fees Requirement” section was updated to clarify that the deadline for posting the Machine Readable Files is July 1, 2022.
Compliance Toolkit Fourth Quarterly Update
The Compliance Toolkit fourth quarterly update addresses:
Federal Court vacated key portions of the interim final regulation implementing the independent dispute (IDR) provisions of the No Surprises Act relating to air ambulance services.
The DOL, HHS and IRS finalized options of the No Surprise Act medical billing regulation covering the independent dispute resolution (IDR) process. These regulations first remove the provision that the court invalided and specify that certified IDR entities should select the offer that represents the value of the item or service under dispute after considering the QPA and all permissible information submitted by the parties. The regulation net expanded on the requirement that health plans and insurers disclosure to provided and facilities the QPA for items or services with each initial payment or notice of denial of payment.
In connection with the release of the final Surprise Billing regulations, the Departments of Labor (“DOL”), Health and Human Services (“HHS”) and Treasury (collectively, the “Agencies”) released an extensive set of FAQs covering surprise billing and price transparency rules. The FAQs are wide-ranging, but provide important clarifications.
CMS published more detailed reporting guidance along with reporting templates on its RxDC webpage for Prescription Drug reporting due on December 27, 2022. This guidance included the following:
RxDC reporting instructions
RxDC templates
RxDC drug name and therapeutic class crosswalk
CMS also revised the Model Disclosure Notice Regarding Patient Protections Against Surprise Billing and its instructions and the Standard Notice and Consent Documents Under the No Surprises Act to be used in 2022 and to be used in 2022 and beyond.
Attachment 2 now reflects the recently released revised “Model Disclosure Notice Regarding Patient Protections Against Surprise Billing.”
Attachment 3 now reflects the recently released revised “Standard Notice and Consent Documents Under the No Surprises Act.”
Compliance Toolkit Contents
To address the compliance needs of the industry, Humaculture, Inc. partnered with Attorneys Howard Lapin and Larry Grudzien to create a Compliance Toolkit to address all of the requirements in the new law and regulations. It contains over forty documents, including:
A detailed explanation of the law and regulations;
A compliance tool that highlights all of the required changes and what steps needed to be taken to comply;
Sample provisions for plan documents, Summary Plan Descriptions, and administrative services agreements;
All of the model notices that have to be provided to covered individuals;
Sample notices that have to be provided to participants; and
Sample disclosures and reports that have to be made to the governmental agencies.
There are over two hundred and eighty-five (285) pages of documents in this Compliance Toolkit. It has been specially designed for use by employers, insurers, brokers, and third-party administrator to help them effectively to comply with all of the requirements.
Webinar Reviewing the Compliance Toolkit
On December 14, 2021, we conducted a free webinar to review the Compliance Toolkit. We reviewed its contents and explained how it can be used to comply with the requirements. You can view the webinar here.
Hidden Opportunities, A Strategic Compliance Series
Humaculture, Inc. conducted a strategic compliance webinar series over the first five months of 2022 focusing on harnessing the Hidden Opportunities in the No Surprises Act and Transparency in Coverage Final Rule. Our goal was to help organizations create a competitive advantage. Does it make sense to expend limited resources to merely comply with the law and regulations, or is there a way to strategically “design the compliance away” while strategically differentiating the employee value proposition?
Ordering
You can purchase the Compliance Toolkit, which includes quarterly updates through October 31, 2023, for only $450 by contacting us and we will invoice you for the purchase price. Contact us to order your own copy or to ask any questions.
Available Support
We are available to support you in your compliance and financial needs. This Compliance Toolkit, including Financial Analysis Tools will help facilitate self compliance. Our team of consultants, including actuaries, clinicians, behavioral health, pharmacy, and legal resources are also available to guide you through the compliance process, or we can take the lead. We would be happy to have a conversation regarding your needs and can customize a proposal for the level and type of support you may need. Please contact us.
