Thank you to all who attended the 2022 NAIRO Annual Symposium!


Each year, NAIRO and its member companies stage an annual Symposium discussing the latest developments and trends in independent medical review. The Symposium delivers in-depth educational content, along with networking opportunities to meet and exchange ideas with others in the industry.

For 2022, the Symposium moved to the beautiful Kiawah Island Golf Resort on Kiawah Island, South Carolina, March 29-31, 2022. The theme for the three-day event was “Protecting Review Integrity During Healthcare and Regulatory Evolution,” highlighting changes in healthcare and the regulatory environment and the impact on IROs, Workers’ Compensation Organizations and Health Utilization Management Organizations.

Program Agenda

Golf Tournament: Monday, March 28, 2022

Day 1: Tuesday, March 29, 2022
7:00 am-5:00 pm Registration
8:00-11:00 am Board & Membership Meeting (includes breakfast)
  Lunch on own
1:00-1:30 pm

Speakers: Ed Bolton, NAIRO President & Frances Scott, NAIRO Vice President & Symposium Committee Chair
Topic:  Welcome & Opening Remarks

1:30-2:45 pm

Guest Speakers: Diane Sacco, Product Development Principal, URAC &
Robin Adams, Vice President Strategy and Product Development, URAC
: URAC's Supporting Role in Protecting Review Integrity

2:45-3:00 pm


3:00-4:15 pm

Guest Speaker: Mark Anthony Germanos, CISO, Cyber Safety Net
: Cybersecurity

5:00-7:30 pm

Welcome Reception

Day 2: Wednesday, March 30, 2022
8:00-9:00 am Breakfast
9:00-10:15 am

Guest Speaker: Dr. Shawn Griffin
: View from the Capitol Value of Accreditation

10:15-10:30 am Networking Coffee Break
10:30-11:45 am

Guest Speaker: Garry Carneal, JD, MA
Assessing the Impact of Generally Accepted Standards of Care (GASC) Requirements on the UM and Appeals Process:  California SB 855 Spotlight

12:00-1:15 pm Group Lunch
1:15-2:45 pm Guest Speaker: Mara Osman, Senior Regional Director for State Affairs, America’s Health Insurance Plans (AHIP)
Topic: The National Healthcare Landscape: Healthcare continues to dominate headlines across the country. This session will look at the national dialogue and governmental activity on key issues facing consumers and health insurance providers, such as high cost prescription drugs, surprise medical bills, and safe care. 
2:45-4:00 pm

Guest Speaker: Joseph Ward
Topic: 5 Components of Internal Control

6:00-8:00 pm Dinner
Day 3: Thursday, March 31, 2022
7:30-8:30 am Breakfast
8:30-9:45 am Guest Speaker: Amanda Brander, Centers for Medicare & Medicaid Services
Topic: CMS/HHS Surprise Billing - IDR
9:45-10:15 am Networking Coffee Break
10:30-11:45 am Guest Speaker: Tom McGraw, Vice President of Growth and Business Development
Topic: Improving Medical Review Through Technology
11:45 am - 12:00 pm Closing Remarks


About the Speakers

Robin Adams, MS, MBA
Vice President Strategy and Product Development, URAC

Robin Adams, MS, MBA is the Vice President of Strategy and Product Development at URAC, an independent, not for profit national accreditation organization representing the health care industry. Robin began at URAC in 2016 as a Product Development Principal. During her tenure, she has led the Product Development Team to advance new programs in Telehealth, Remote Patient Monitoring, Independent Medical Examinations, Medicare Advantage, Medicaid, Measurement Based Care and Mental Health Parity. She supported URAC’s achievement of CMS deemed status for Medicare Advantage and Medicare Home Infusion Therapy Supplier programs. Robin works closely with the Team to ensure URAC’s legacy programs are revised to reflect contemporary evidence-based practice.

Robin has over two decades of experience working in pediatric academic and community-based integrated delivery systems. At Children’s National Health System in Washington, DC, she was responsible for leading the population health strategy supporting the development of Children’s regional outpatient centers to facilitate pediatric subspecialty network access to the broader District, Maryland and Virginia populations.  At INOVA, Robin served as Chief Growth Officer and was a member of a system-wide executive team that developed the INOVA Heart and Vascular Institute, INOVA Spine Institute, INOVA Breast Care Institute and the INOVA Neurosciences Institute.  At Sentara Healthcare, Robin led a Team that supported the system-wide expansion to introduce Sentara’s health care services and brand to Northern Virginia. 

Robin graduated with a dual degree in Finance and Nutrition from Cornell University. She received her Master of Business Administration from Virginia Tech. She is a fellow of the Advisory Board.

Amanda Brander
Team Lead for the Dispute Resolution Team, Center for Consumer Information and Insurance Oversight (CCIIO) at the Centers for Medicare and Medicaid Services (CMS)

Amanda Brander serves as Team Lead for the Dispute Resolution Team providing policy and operations implementation leadership for expanding consumer protections in the private health insurance market at the Center for Consumer Information and Insurance Oversight (CCIIO) at the Centers for Medicare and Medicaid Services (CMS). Prior to her current role, she served as Team Lead supporting Marketplace policy and operations in CCIIO and various other roles in CMS. Brander has a Masters in Professional Communication from University of Alaska, Fairbanks.


Garry Carneal, JD, MA
President & CEO, Schooner Strategies

Garry Carneal is a leading expert in healthcare.  He has researched, written and published extensively on quality, medical management, information technology and regulatory trends.  He has an established track record in helping accreditation agencies, healthcare organizations, nonprofits and trade associations develop national policy positions and expand their operations. 

Carneal currently heads up Schooner Strategies, based in Annapolis, MD.  Founded in 2007, the firm  offers an array of consulting services which leverage his previous work experiences:  

  • Accreditation.  Carneal has spent much of his career focused on healthcare quality improvement.  He has spearheaded and launched 25 accreditation programs working with five different accreditation agencies.   For example, he served as URAC’s President & CEO for nine-years, where he helped establish national standards for PPOs, case management and external review – among other new accreditation programs.  More recently, he also worked with the American Telemedicine Association to develop national standards for telemedicine and remote patient monitoring. Today, he oversees RadSite which offers five accreditation programs for advanced diagnostic imaging covering CT, MRI and nuclear medicine.  He also is currently supporting accreditation programs under development by the Center for Genomic Interpretation and the Council for Autism Service Providers.
  • Government Relations.  Carneal also has held several leadership positions in the government relations arena.  Since 2014, Carneal has worked with The Kennedy Forum to promote a better healthcare system through mental health parity and other key initiatives.  Earlier in his career, he served as legislative counsel to the NAIC and helped draft many model states laws governing managed care and also represented the state insurance regulators before Congress during the 1993-1994 healthcare reform debate.  He also helped build the state government relations programs for the Group Health Association of America (now AHIP).
  • Medical Management Expertise.  Carneal is recognized as a national thought leader in the medical management field.  He served as President of InforMed Medical Management Services, LLC (now Conifer Health Solutions) which specialized in offering complex, condition management services to several self-funded hospital systems.  For the past 20 years, he has served as a volunteer advisor to the Case Management Society of America, where he spearheaded the development of the Case Management Model Act and co-led an initiative to establish standardized caseloads.
  • Legal Support.  Carneal has held several legal positions throughout his career which includes   working as an attorney for the national health law firm of Epstein Becker & Green, Serving as the founding chair of the  Kennedy Forum Legal Taskforce, and serving as lead-in house counsel for the American Association of Health Plans (now AHIP).

Mr. Carneal received his college degree from Washington & Lee University; a master’s degree from Yale University; and a law degree from the University of Virginia.

Mark Anthony Germanos
CISO, Cyber Safety Net

Mark Anthony Germanos has been a computer guy since 1992. He protects the confidentiality, integrity and availability of his clients' data, networks and reputations. He specializes in HIPAA and PCI-DSS audits and remediates the issues they uncover. He also runs and analyzes Qualys vulnerability scans to assess client network security.

Mark's fourth book, How Hacks Happen, presents two personas. The evil persona wants to victimize you through phishing, installing keystroke loggers and holding data for ransom. The good persona shows how to protect yourself, how hackers cover their tracks and how to make hacking you so time intensive hackers will give up and pursue other targets.

Mark is the CISO at Cyber Safety Net. He also holds CompTIA's Pentest+, Microsoft’s MCSE and EC-Council's Certified Ethical Hacker certifications. He is a KnowBe4 partner, ConnectWise partner, Sophos partner, national speaker and Dale Carnegie graduate. He lives with his wife of 20 years and dog near Sacramento.

Shawn Griffin, MD
President & CEO, URAC

Dr. Shawn Griffin is the President/ CEO at URAC. He leads one of most trusted independent accrediting organizations in the country and one of the largest telehealth accreditors in the world. With a background in rural health, technology, and population management, Dr. Griffin is a nationally-recognized subject matter expert and speaker on population health, quality improvement, accreditation, telehealth, network development, CIN's, ACO's, and physician alignment. He previously served as Vice President for Clinical Performance Improvement and Applied Analytics at Premier and Chief Quality and Informatics Officer for MHMD—The Memorial Hermann Physician Network in Houston. He trained in Rural Family Medicine and practiced in Iowa and Missouri.


Tom McGraw
Vice President of Growth and Business Development

Tom McGraw is Vice President of Growth and Business Development for Telligen, a company supporting healthcare payers to improve health outcomes for millions of people nationwide through health management solutions and healthcare expertise. 

Tom has over 25 years in the healthcare industry.  From four years, Tom led product development for Secure Exchange Solutions (SES), which was purchased by Centauri Health Solutions in 2021, focused on developing products using Natural Language Processing (NLP) to evaluate medical records’ text against payers’ requirements.  From 2012 to 2017, Tom served as CEO of Noridian Healthcare Solutions, a company that managed and reimbursed over $50 Billion in services for over 15 million Medicare beneficiaries.  He led company the company into the population health and program integrity markets.

Tom previously led the government solutions group for UnitedHealth’s Optum/Ingenix health informatics subsidiary and its Integris, Inc. program integrity company.  At MAXIMUS, he oversaw numerous functions including the company’s Medicare appeals, utilization review, and program integrity operations.  As a Virginia government employee, Tom led the implementation of Medicaid managed care and led numerous other Medicaid operations including utilization review, long term services and support, and recipient program integrity.

Tom has a BS in Economics, Political Science and History from the US Naval Academy and an MA in Economics from Old Dominion University.  He served on active duty in the submarine force and retired from the US Navy Reserves. 

Tom recently moved to Conway, SC and has three grown children.


Mara Osman, J.D.
Senior Regional Director for State Affairs, America's Health Insurance Plans

Mara Osman is Senior Regional Director for State Affairs at America’s Health Insurance Plans, and has more than twenty-five years of experience working with state and national leaders to educate decision-makers and the public about diverse policy issues. At AHIP, she advances the association’s interests on state legislative and regulatory health care and insurance matters in the southeast region and leads AHIP’s work with the Council of State Governments.

Osman came to AHIP from Milliman Care Guidelines, where she led Government and Quality Agency Relations for the company that produces evidence-based medical guidelines and interactive clinical decision support tools. Prior to MCG, Osman served as the Government Relations Director at the health care accreditor URAC, where she managed company activities involving state and federal government representatives and government programs.

Earlier in her career, Osman managed a public safety project at the National Education Association Health Information Network, designed and launched the Leukemia and Lymphoma Society’s Grassroots Advocacy Program as the Society’s first National Grassroots Manager, and pioneered the State Legislative Field Representative role at the American Psychiatric Association. Osman began her career as a Legislative Fellow in the U.S. Senate, and graduated from Cornell University and Washington University School of Law.

Diane Sacco, DNP, MSN, RN
Product Development Principal, URAC

Diane Sacco DNP, MSN, RN is a Product Development Principal at URAC, an independent, not for profit national accreditation organization representing the health care industry. Diane began at URAC in 2013. Diane was a Clinical Accreditation Reviewer before moving to her current role as Product Development Principal.

Her career in health care includes behavioral health, medical-surgical, nursing research, and graduate education. Diane has also worked for national health plans in quality management, utilization management, and case management. She has served on American Association of Diabetes Educators (AADE) committees and as a manuscript reviewer for the Journal of Professional Nursing. During her time in the university setting, Diane has served as faculty on student Doctor of Nursing Practice committees and coauthored nursing research articles.

Diane has a Doctor of Nursing Practice degree from Rush University and master’s degree in Nursing Administration from Indiana University of Pennsylvania.

Joseph Ward, Jr., SES (R)
Founder, President and CEO, Ward Management Group

Joe Ward is the Founder, President and CEO of Ward Management Group. He provides keynote speaking, executive training, coaching and management consulting services. As a professionally certified speaker, teacher, trainer, and coach, Joe helps individuals and businesses achieve their goals while wowing audiences with a special blend of humor, raw candor, and wit. The first in his family to attend college, Mr. Ward brings a unique perspective having had successful careers in the military, as a senior executive, and survivor of the 9-11 attack on the Pentagon. His
presentations will make you laugh, cry, and think. They will also inspire you!

Joe is a retired USAF officer and veteran of OPERATION RESTORE HOPE. He served as an officer with two global management consulting firms and retired as a member of the federal government Senior Executive Service. Joe specialized in helping federal clients with shared
services, governance, strategy, and enterprise risk management. Mr. Ward led the National Business Center (NBC), one of the largest federal shared service centers, to new heights.  Under his leadership, the NBC won awards for Excellence in Culture Creation; Customer Service; and
People & Communications from the Shared Services & Outsourcing Network (SSON). The SSON is a global network of both public and private shared services professionals to include numerous Fortune 500 companies.

Joe’s bold vision is widely recognized for bringing attention to overdue changes in federal shared services governance and helping shape the establishment of the Uniformed Shared Services Management Office. Mr. Ward is the recipient of numerous awards to include selection as one of the top accounting and finance officers in the DoD, top writer and speaker at the premiere DoD financial management school, and recognition as author of the year from the Air Force Comptroller magazine.

Joe is an Executive Fellow with the KPMG Government Institute and past treasurer, African American Federal Executive Association.  He is also a Certified Defense Financial Manager, Certified Government Financial Manager, and Certified Change Management Practitioner.

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