Dr. Abbate has over 25 years’ experience in private practice as a pulmonologist until he joined Banner Plan Administration in February 1999. He has served as Chief Medical Officer for Banner Plan Administration and Banner Physicians Hospital Organization where he also worked as a hospitalist and managed both employed and contracted hospitalist groups for Banner Plan Administration. He was the Chief Medical Officer for Banner Health’s self-insured short-term and long-term disability programs as well as their Worker’s Compensation program and became a Disability Analyst with National Board Certification in November 2008. He also later served as the Chief Medical Officer for Banner MediSun – a Medicare Advantage Plan.

In his various roles within Banner Health, he provided medical oversight for Banner Health Plans and all delegated Medicare Advantage Plans through Banner Physician Hospital Organization and for Banner’s wholly-owned Medicare advantage plan-Banner MediSun. He participated in the development of Banner’s Case Rate Reimbursement Initiative.

He currently co-leads a team of 25 full time facility based and 4 Central Core Medical Directors Care Coordination (MDCCs) along with 28 per diem MDCC EXS providers, The MDCC EXS providers perform secondary medical necessity review determinations on nights, weekends and holidays. The 25 full-time facility based MDCCs perform all secondary medical necessity review determinations, provide physician education and support for patient placement in the correct status determination, thus helping to reduce both concurrent and retrospective denials while satisfying Medicare Conditions of Participation regarding appropriate status placement at the time of initial bed assignment. The 4 Central Core provide backup for the on-site facility based MDCC’s in Arizona and Northern Colorado as well as cover the other Banner facilities where there is no on-site MDCC coverage. In addition, as part of the Central Core, he participates in the denial management process by reviewing retrospective denials through medical record review and any necessary medical literature review to determine whether it is appropriate to move forward with the appeal process in order to help support Banner’s financial position. In addition, he participates in the RAC, QIC, and QIO denials’ process as well as participates in all face-to-face Banner/Payer Joint Operating Committees (JOC) denial meetings.

Dr. Ansari is an Associate Professor in the Department of Medicine at Loyola University Medical Center and is the Associate Director of the Division of Hospital Medicine. He graduated from Midwestern University and completed his residency training at Loyola University Medical Center. He is a practicing hospitalist and palliative care physician and is board certified in both palliative care and hospital medicine. Dr. Ansari oversees the operational management of the division and the medical center’s observation unit. In addition, Dr. Ansari is the lead physician advisor for Loyola’s utilization review, care management and clinical documentation improvement program as well as championing the ICD-10 physician education program.

Current Responsibilities
Dr. Derek Braun is a Medical Director of Care Coordination for Banner Health. His main role is as a physician advisor to ensure appropriate and efficient medical management of patients admitted to the hospital while assuring quality of care is maintained. He is currently assigned to a core group of physicians assisting facility based medical directors as well as performing retrospective denial management appeals. He is also a member of the Banner Medical Hospitalist Medicine Clinical Consensus Group as well as Cardiology, Critical Care, and Nephrology. Dr. Braun was very involved in the restructuring and implementation of standardized processes in our observation units. He works closely with the clinical documentation team and Documentation Excellence committee.

Prior Experience
Prior to his current position, Dr. Braun was a divisional director for a nationwide hospitalist company. During this time he assisted in implementing new hospitalist programs and ongoing coaching for the physicians in those programs. He also developed and implemented clinical pathways to be used throughout the company. Dr. Braun was also a hospitalist with a focus on the efficient management of managed care patients. He has also been in private practice where he was a solo practitioner for many years. He has also served in the U.S. Navy on Submarines followed by teaching at a nuclear power prototype. Dr. Braun was honorably discharged after completing 9 years on active duty.

Education
He did his undergraduate training at California State University, Fullerton majoring in Biochemistry. He also has a degree in Health Care Administration from the University of Phoenix. He went to Medical School at American University of the Caribbean. He completed a residency in Internal Medicine and Pediatrics at St. John’s Medical Center in Detroit, Michigan. Dr. Braun has completed board certifications in both Internal Medicine and Pediatrics. He is a Fellow of the American College of Health Care Executives.

Current Responsibilities
Dr Debra Brown is one of 2 Senior Medical Directors of Care Coordination (MDCCs) currently providing Corporate/System support for Banner to help reduce concurrent and retrospective denials by providing secondary medical necessity reviews, satisfying Medicare Conditions of Participation, and by helping to champion good stewardship of our healthcare resources. Dr Brown is one of four MDCCs designated as part of the “core” MDCC team which provides back up support for the MDCCs assigned onsite at Banner facilities in Arizona and in Northern Colorado. This core MDCC team also covers the remainder of the Banner facilities where there is no onsite presence, supports the denials management process by reviewing retrospective denials through medical record and any necessary medical literature review to determine whether it is appropriate to move forward with the appeal process in order to help support Banner’s financial position.

Prior Experience
Dr Brown practiced many years as an anesthesiologist but, after sustaining a severe injury, she had to undergo an extensive surgical procedure on her shoulder, retire from anesthesia and then had to discover a new career path. She went back to school and completed an MBA with an emphasis in Health Care Management while also completing a Fellowship through the American College of Medical Quality. This led to several job opportunities, working first as one of the Medical Directors at Arizona Health Care Cost Containment System (AHCCCS) gaining a lot of insight around health care policies and the Medicaid program, being given several opportunities to go to Washington, D.C. to be involved in large forums with other political leaders from around the country. She then spent 4½ years as the Medical Director and eventually Chief Medical Officer at Health Net of Arizona where she gained experience learning about Commercial and Medicare lines of business. But the appeal of being back on the provider side, in the hospital setting, was recognized when she was able to join Banner in 2009 when the MDCC team was being established.

Education, Awards and Professional Affiliations
Dr Brown graduated from St. Mary College in Leavenworth, Kansas with a BS in Biology and Chemistry and a minor in Psychology. Her MD degree was earned from the University of Kansas School of Medicine in Kansas City, Kansas where she also completed her anesthesia residency. Dr Brown was recognized as a member of the National Register’s Who’s Who for Executives and Professionals in 2004-2005 and she was also acknowledged as a member of the National Association of Professional Women with special recognition in 2011.

Dr. Gregg Cohan is the Medical Director of Utilization for UC Irvine Health. Prior to joining UC Irvine, he was the Regional Medical Director of Care Management- LakeShore Region, at Presence Health in Chicago. While at Presence Health, he served as a Physician Advisor to the Clinical Documentation Improvement program from 2012-2016. He has been involved in a variety of medical staff leadership roles and has served on the Board of Directors of the Will County Medical Society.

Dr. Cohan attended medical school at the University of Chicago, and did his residency in Internal Medicine at Rush in Chicago. He is board certified in Pulmonary and Internal Medicine.

Raman Dhaliwal is a physician leader with extensive experience in complex hospital, Health Plan and medical group settings. A recognized leader in the development of collaborative approaches in healthcare delivery with physicians, related organizations and competitors, he is currently Senior Medical Director of Care Coordination for Banner Health, one of the largest nonprofit hospital systems in the US with twenty-four acute-care hospitals and health care facilities and more than 36,000 employees He is exceptionally strong in building teams and improving clinical and financial performance, including turnarounds, and has demonstrated experience in oversight of medical group physicians, coordination with various health plans and building patient centered care models.

Dr. Christine Foster is a hospitalist and physician advisor with Utah’s Intermountain Healthcare System. She completed her Internal Medicine residency in San Francisco, California in 2001. She practiced hospital medicine in the Bay Area until 2006, when she was recruited by Intermountain Healthcare to develop the hospitalist program at Dixie Regional Medical Center in southern Utah. In 2011, Dr. Foster joined the newly developed Internal Physician Advisor program for Intermountain Healthcare, and continues to work as both a hospitalist and physician advisor. She has been selected as a lead educator for the system because of her role in physician engagement and education, clinical documentation, utilization review, and CMS guidelines.

Abby Pendleton and Jessica L. Gustafson are founding shareholders with the health care law firm of The Health Law Partners, P.C. The firm represents hospitals, physicians, and other health care providers and suppliers with respect to their health care legal needs. Ms. Pendleton and Ms. Gustafson co-lead the firm’s Recovery Audit (RAC) and Medicare appeals practice group, and specialize in a number of areas, including: Medicare, Medicaid and other payor audit defense and appeals, health care investigations, health care regulatory matters, compliance, HIPAA privacy & security compliance matters, overpayment refunds, reimbursement and contracting matters, and payor de-participation matters. They can be reached at apendleton@thehlp.com and jgustafson@thehlp.com.

Dr. Hull is a Physician Advisor and the Medical Director of Care Management at Mayo Clinic Hospital in Phoenix, Arizona. His interests include high value care, clinical documentation and medical education. Dr. Hull attended Medical School at Loma Linda University. He subsequently completed a combined Internal Medicine and Pediatrics residency at Good Samaritan Medical Center / Phoenix Children’s Hospital in Phoenix, Arizona.

Cheri A. Lattimer, RN, BSN, CEO of Consulting Management Innovators (CMI): As CEO, Cheri is responsible for the overall strategic direction of the association management company working with various healthcare entities. She serves as the Executive Director for the National Transitions of Care Coalition (NTOCC). In addition she is the Executive Director of the Case Management Society of America. She participates on numerous advisory panels and non-profit Boards within the healthcare industry and is a member of the American Society of Association Executives (ASAE) and the American College of Healthcare Executives.

An RN with experience as an emergency room nurse, the office and clinical supervisor of a family practice clinic, director of utilization for a large psychiatric hospital, program director for community health organizations, and vice president of clinical services, she has provided consulting services to national and international health care programs. Ms. Lattimer is a frequent lecturer to C-Suite executives in hospital and health systems internationally speaking on topics such as management of chronic and high risk conditions, the role of case/care management, medication adherence, integrated care management programs and information systems, transitions of care, care coordination and performance and outcome studies. In 2009 she was asked to deliver the prestigious Anna Reynvaan Lecture at the University of Amsterdam addressing 900 nurses from the Netherlands and Belgium on integrated nursing health management of the complex patient.

As a sought after healthcare leader and consultant she has had the opportunity to work with healthcare professionals abroad in the United Kingdom, Netherlands, Canada, Central America and Mexico.

Beverly Litton is a driven, passionate registered nurse and mother of one who is dedicated to becoming a leader in the health care industry. Over the past 12 years, she has held various positions in Cardiac ICU, Level One Trauma/Emergency Medicine, research, case management, program development and the health insurance industry. Beverly’s experience working across nearly every sector of health care has awarded her a unique and valuable perspective. Her keen awareness of the processes, goals, strengths and barriers faced by patients, providers and payers makes her insight practically invaluable. Slated to earn her Master’s degree in the Science of Nursing with an emphasis in public health (MSN-PH) from Grand Canyon University this October, Beverly continues to be a true patient advocate who is focused on being influential and positively impactful.

Abby Pendleton and Jessica L. Gustafson are founding shareholders with the health care law firm of The Health Law Partners, P.C. The firm represents hospitals, physicians, and other health care providers and suppliers with respect to their health care legal needs. Ms. Pendleton and Ms. Gustafson co-lead the firm’s Recovery Audit (RAC) and Medicare appeals practice group, and specialize in a number of areas, including: Medicare, Medicaid and other payor audit defense and appeals, health care investigations, health care regulatory matters, compliance, HIPAA privacy & security compliance matters, overpayment refunds, reimbursement and contracting matters, and payor de-participation matters. They can be reached at apendleton@thehlp.com and jgustafson@thehlp.com.

Ms. Schatz has over 30 years of professional experience in health care including neonatal, pediatric, adult critical care, post-anesthesia care and medical-surgical nursing, nursing management and Clinical Documentation Improvement. In addition to her clinical experience, she was Medicare Reviewer in the DME arena, completing supplier reviews of claims for medical necessity and education regarding documentation requirements for appropriate claim approval. Ms. Schatz also assisted Provider Outreach and Education on national education calls.

Prior to joining Intermountain Healthcare in May of 2017, Ms. Schatz was a Senior Director of Clinical Documentation Services at the Advisory Board Company. She worked with members including Intermountain Healthcare, Mountain States Health Alliance, University of Pittsburgh Medical Center, Asante, Mercy Health, Wake Forest, Fairfield and Avera with strategies to improve physician documentation and assessing and redesigning Clinical Documentation Improvement Programs to achieve Best Practice Standards.

Prior to joining The Advisory Board Company, Ms. Schatz was a Clinical Documentation Improvement Consultant working collaboratively with clients to design and implement comprehensive clinical documentation programs across the nation from critical access hospitals to large academic centers and hospital systems.

A graduate of The University of North Dakota with a Bachelor of Science in Nursing, Ms. Schatz is credentialed as a Certified Clinical Documentation Specialist (CCDS), a member of the Association of Clinical Documentation Improvement Specialists (ACDIS) and an AHIMA Approved ICD-10 CM/PCS Trainer.

Dr. Mohammad Shaheed is currently Lead Physician Advisor for Rochester General and Eastern Region hospitals at Rochester Regional Health System, Clinical Assistant Professor of Medicine in the School of Medicine and Dentistry at the University of Rochester, UM Committee member, and senior Hospitalist Attending at the Rochester General Hospital all in Rochester, NY. Dr. Shaheed earned his medical degree at Kabul Medical University and continued his training and chief Residency at Lincoln Medical Center, Weil Medical College at Cornell University. His professional interest include utilization management, efficiency of care, provider communication and education, process improvement for TIA/Stroke patients, leading implementation of EDRS at RGH, and training new Physician Advisors. His professional membership include Diplomat of ABQUARP, Senior Fellow of Hospital Medicine, and ACP Physician Advisor

Ann-Marie serves as the Associate Vice President, Patient Care Services at Eastern Maine Medical Center, a 411 bed tertiary hospital located in Bangor, Maine. Overall responsibilities include transitions of care, utilization review, social work, one-call transfer center and bed placement. Ann-Marie has earned an Associate Degree in laboratory medicine, a Baccalaureate degree in nursing and a Master’s degree in business from Husson University. Throughout her 23 years at EMMC, she has served as staff and relief charge RN, nurse care manager, manager and director. She is passionate of patient flow within EMMC walls and rural Maine. Ann-Marie is a member of Case Management Society of America, American Case Management Association and American College of Healthcare Executives.

Dr. Ashby Wolfe is a board-certified family physician and currently serves as Chief Medical Officer for Region 9 of the Centers for Medicare and Medicaid Services (CMS) which includes California, Arizona, Nevada, Hawaii, and the Pacific Territories. In her current position, Dr. Wolfe focuses on implementation of Medicare and Medicaid policy and the programs roles in providing access to high quality care and improved health at a lower cost. In addition, Dr. Wolfe provides clinical expertise to many regional CMS programs and divisions, and serves as the medical and scientific lead for quality improvement and outreach/education efforts in the region. She also continues to see patients regularly as a family physician, at Clinica Alta Vista in Oakland, CA.

Dr. Wolfe completed her medical degree at Stony Brook School of Medicine in New York, and her residency training at the UC Davis Medical Center in Sacramento, California. She also holds a Masters of Public Policy and a Masters of Public Health from the University of California, Berkeley. She practiced broad-scope family medicine at Kaiser Permanente in Oakland, California before joining CMS in 2015. Dr. Wolfe has experience in the development and implementation of health policy at the local, state and federal levels and holds particular interest in improving the quality and equity of care for underserved and low-income populations. She has published articles on Medicare and Medicaid policy, and is a contributing author of the public health text, Prevention is Primary (Jossey-Bass).