Wed, Oct 21
|Webinar
Where the Compliance Framework Can Fail: What the OIG Found When It Looked Inside Plan Screening
What the government's review examined, where the gaps were, and questions worth raising at your next leadership meeting.
Webinar Details
Oct 21, 2026, 12:00 PM – 1:00 PM EDT
Webinar
About the Event
Earlier this month, the OIG reported that Medicare Advantage Organizations screen out-of-network equipment suppliers less thoroughly than in-network suppliers and that suppliers who bill out of network without Medicare enrollment carry the greatest fraud risk. This session walks through what the OIG examined, what it found, and what the findings suggest about screening, delegated oversight, and how plans can verify who is billing them.
What you will take away:
Understanding of how the OIG approached the review and the kinds of questions regulators ask about screening.
Understanding of how to recognize where screening and oversight gaps can arise in your own networks, delegated arrangements, and vendor relationships.
Understanding of how supplier screening findings connect to your plan's broader compliance monitoring, investigation, and correction processes.
Presenter
S. Jnatel Sims, J.D. is the President and Principal Consultant of Catapult Healthcare Consulting, LLC. She is a licensed attorney and compliance professional with more than 26 years of experience in business, legal, and government settings. Ms. Sims offers a distinctive perspective shaped by her experience on both sides of healthcare regulation as a government regulator and as a compliance leader within regulated entities. Before founding Catapult Healthcare Consulting, LLC, Ms. Sims served as a Senior Attorney in the Office of Inspector General for the U.S. Department of Health and Human Services. There, she negotiated and monitored Corporate Integrity Agreements, conducted OIG site visits, evaluated compliance programs, and handled cases involving federal healthcare fraud, waste, and abuse authorities. For her role in significant healthcare fraud matters, she earned the Inspector General’s Exceptional Achievement Award. Ms. Sims also has held executive-level roles within managed care companies and healthcare systems, where she developed and oversaw comprehensive compliance programs and provided strategic guidance to leadership and Boards on regulatory compliance and program performance.