NAIRO Board and Membership Meeting
All are invited to attend.

Welcome Session
Val Aiello, NAIRO President & Eric Hatfield NAIRO Vice President and Symposium Chair

A View from the Capitol - What the new administration means for health care in 2025 and beyond
Presented by Shawn Griffin, MD - URAC

Silver Welcome Reception Sponsor Presentation
Tavrn

The Age of AI enabled Agentic Bots in the business of Review Services
Presented by Madhu Reddiboina, MS - RediMinds

Madhu will be covering some practical scenarios that are in play and on the horizon for the efficiency and optimization of review services.

Emerging Review Markets
Presented by Tom Naughton, JD, LLM - Capitol Bridge

Overview for Good Medical Review
Presented by Jacqueline Cain, MD - Maximus, and Mary Pascucci, MD - EmpowerAI

Back for an encore performance with a new segment of “Ask the Medical Directors.” Join Medical Directors Drs. Cain and Pascucci in an interactive panel discussion of what makes and breaks complex medical record review as seen through the medical directors’ lens. They explore the application of regulations across all claim types: what holds, what doesn’t, and best preparation for appeals. Also, up for discussion will be common errors made in medical documentation, other factors that cause denial of payment, as well as the latest and greatest items in the DME world to “pay, or not to pay.” Bring your questions along as this will be a lively interactive session!

Medication Trends in Workers’ Compensation
Presented by Courtney Deck, RPh - myMatrixx, by Evernorth

You can find a lot of today’s medication trends by just turning on your television or phone. Advertisements for the latest treatments for weight loss, migraines, diabetes, pain management and more fill our screens and social media. Many of these medication trends cross over to workers’ compensation claims via treatments for comorbid conditions and an injured workers’ total health. In this session, Courtney Deck, MyMatrixx Senior Clinical Account Executive, will review how medications to treat migraines and medication classes such as topicals, GLP-1s, specialty, and opioids are being used and managed in workers’ comp claims.

Keys to Identifying, Preparing For, and Responding to Opportunities
Presented by Tim Mechlinski - Crestline Advisors

Cybersecurity Panel Discussion
Panelists: Kynan Carver - Maximus, Cris Ewell, PhD - Propeer, Matthew Katra - Kyndryl, and Herb Williams, MS - Arctic Wolf

Dr. Chris Ewell of ProPeer, Kynan Carver, and Matthew Katra will discuss the significance and impact of cybersecurity on the independent review industry, moderated by NAIRO Vice President Eric Hatfield.

Investigation: Best Practices and Ethical Considerations in the realm of AI
Michelle Lopez, JD - Wright Welker & Pauole Attorneys at Law, and Ken Whattam - JTF Investigative Services, LLC

The State of Cybersecurity: 2024 Trends and the Darkweb
Presented by Herb Williams, MS - Arctic Wolf

In the past year, IT and security leaders faced off with digital sprawl and the profound impact of emerging technologies like generative AI. The growth of attack surfaces has left organizations with more potential exposures from vulnerabilities and misconfigurations rife for exploitation in the evolving threat environment. Join me as we explore insights uncovered in The State of Cybersecurity: 2024 Trends Report, where you’ll gain lessons to put into practice, confirmation that others face the same decisions and risks as you, and — most importantly — a reminder that cybersecurity is not all doom and gloom.

The Future of Artificial Intelligence in Utilization Management and Medical Review
Presented by Katie Bakewell, MS - NLP Logix, and Mark Hiatt, MD, MBA, MS - Hiatt Advisory Services

In this fireside chat, Mark and Katie will discuss how artificial intelligence (AI) is being used (and can be used) in utilization management. They will address such common questions and concerns as how does an organization begin to use AI and avoid bias and lack of “human” oversight in doing so.

Integrating Ethics, Fiscal Integrity, and Medical Necessity: Challenges and Opportunities
Presented by Dennis A. Robbins Ph.D., M.P.H., and Mark Hiatt, MD, MBA, MS - Hiatt Advisory Services

The United upheaval has highlighted the need to take a more careful look into the upsides and downsides of utilization management. We will explore the legal and ethical legacy, as well as the prevailing environment and public perception. In this interactive session, we will discuss novel conceptual frameworks and solutions to get a better handle on how to pursue more palatable and effective utilization management.

Break with the Symposium Sponsors

URAC Hot Button Standards
Presented by Jenn Richards, PharmD, JD - URAC

URAC presents the most commonly missed Independent Review Organization Accreditation Standards, along with reviewer best practices for overcoming challenges. For each standard presented, a review of how to demonstrate compliance will be discussed. Recommendations from reviewers on how to miss common pitfalls and how to demonstrate best practices are also included.