Insurance ealth&P U E R T O R I C O

C O N F E R E N C E 2 0 1 4

The Puerto Rico Chamber of Commerce, the University of Miami School of Business

Administration and the Medicaid and Medicare Advantage Products Association present

Doing More with Less: The 2014 Economics of Productivity and Quality in Healthcare for Puerto Rico

March 5, 2014The Condado Plaza Hilton

Registration: 7:00 a.m. - 8:00 a.m.Conference: 8:00 a.m. - 4:30 p.m.

Networking Cocktail: 4:30 p.m. - 7:00 p.m.

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Message from your hosts:

Mr. Roberto Pando, MS, JDChairman

PR Health & Insurance Conference 2014

Insurance Executives, Entrepreneurs and Investors:

Acknowledging the crucial role of healthcare for the island’s quality of life, jobs and socio-economic development, the Puerto Rico Chamber of Commerce has partnered with the University of Miami School of Business Administration, and the Medicaid and Medicare Advantage Products Association to present the third edition of the Puerto Rico Health & Insurance Conference “Doing More with Less: The 2014 Economic Productivity and Quality in Healthcare for Puerto Rico” for the whole business and commercial community.

The Conference will provide a unique opportunity for the audience to understand the macro-economic scenario of the Puerto Rico Healthcare System and learn about the vision of the major managed care organizations and institutional providers in relation to particular challenges and opportunities of the system in the coming years considering Federal and Local health reforms. Today, our 2014 Conference will provide a timely and unparalleled opportunity for deep discussion on some of the most critical areas where business, government, public policy, and health care intersect.

We have prepared a robust agenda that will be delivered by a

Mr. Jorge M. Cañellas Fidalgo, Esq., CPA

Chairman of the Board, Puerto Rico Chamber of Commerce

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Message from your hosts:

Dr. Steven G. UllmannProfessor and Director, Programs

in Health Sector Management and Policy, School of Business

Administration, University of Miami & Co-Chairman PR Health & Insurance Conference 2014

remarkable line-up of visionary speakers. Therefore, we hope that this edition of the Puerto Rico Health & Insurance Conference not only will educate our audience, but will also stimulate and energize our entrepreneurial spirit, optimism and confidence. Evolution is inevitable, and all components need to adapt, including patients, employers and consumers. The healthcare scenario in Puerto Rico needs more ACTION, with new interactions and integrations across the stakeholders that serve in the system. Healthcare is a platform where Puerto Rico needs to maximize opportunities and tackle challenges up front.

Congratulations for being part of one the most significant health insurance forum in our Island. This shows us your interest and responsibility.

Mr. James P. O’DrobinakCEO of MCS, Inc., President of the Medicaid and Medicare Advantage Products Association (MMAPA) &

Co-Chairman PR Health & Insurance Conference 2014

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Schedule of Events

Ponce de León A

Ponce de León A

Ponce de León A

Ponce de León A

Ponce de León Foyer

7:00 a.m. - 8:15 a.m.Registration

8:15 a.m. - 8:30 a.m. Welcome Remarks • Mr. Roberto Pando, MS, JD, Chairman, PR Health & Insurance Conference 2014 • Mr. James P. O’Drobinak, CEO of MCS, Inc., President of the Medicaid and Medicare Advantage Products Association (MMAPA) & Co-Chairman of the Puerto Rico Health & Insurance Conference 2014 • Dr. Steven G. Ullmann, PhD, Professor and Director, Programs in Health Sector Management and Policy, School of Business Administration, University of Miami & Co-Chairman of the Puerto Rico Health & Insurance Conference 2014 • Mr. Jorge M. Cañellas Fidalgo, Esq., CPA, Chairman of the Board, Puerto Rico Chamber of Commerce

8:30 a.m. - 8:50 a.m. Plenary SessionThe 2014 Demographic Update and Healthcare NumbersKeynote Speaker: • Dr. Mario Marazzi Santiago, Executive Director Puerto Rico Institute of Statistics

8:50 a.m. - 10:00 a.m. Plenary SessionThe Puerto Rico Medicare Coalition for FairnessModerator: Mr. Roberto Pando, MS, JD, Chairman, PR Health & Insurance Conference 2014

Keynote Speakers: • Mr. James P. O’Drobinak, CEO of MCS, Inc. & President of MMAPA • Mr. Elliot Pacheco Beauchamp, President, Puerto Rico Community Pharmacies AssociationDiscussion Panel and Invited Panelists: • Dr. Richard Shinto, M.D., President & CEO MMM Holdings, Inc. • Mr. David Goltz, CFO, Chief Financial Officer Triple-S Advantage • Mr. Jaime Plá Cortes, Esq., Executive President, Puerto Rico Hospital Association 10:00 a.m. - 10:15 a.m. Special Alert HIPAA Omnibus Final Rule Goes into Effect with Stricter Fines and Covering a Broader SpectrumKeynote Speaker: • Mr. Sigfredo Vélez, CPA, Shareholder Audit & Attest Service, BDO

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Schedule of Events

Ponce de León A

Ponce de León B

Ponce de León C

10:15 a.m. - 10:25 a.m. COFFEE BREAK

10:25 a.m. - 11:05 a.m. Plenary SessionAn HHS Update: Quality, Exchanges and the President’s Task Force on Puerto Rico Presenter: • Mr. William Toby Jr., Former HCFA Administrator & Health Policy Consultant

Keynote Speaker: • Dr. Jaime R. Torres, DPM, MS, Regional Director, Region II (NY, NJ, PR,VI) U.S. Department of Health and Human Services

A Quick Update from Washington and PRFAA • Mr. Juan E. Hernández Mayoral, Executive Director, Puerto Rico Federal Affairs Administration

CONCURRENT SESSIONS

11:10 a.m. -12:10 a.m. Update on Information Technology, Management and Healthcare in PRModerator: Mr. Luis A. Pérez, Senior Vice-President, Abarca Health, LLC

Discussion Panel and Invited Panelists: • Mr. Antonio Sisco, State Coordinator, PR Health Information Network • Eng. Ricardo A. Rivera Cardona, Executive Director PR Health Insurance Administration (ASES) • Mr. Antonio Fernández, Executive Director, Regional Extension Center, Ponce School of Medicine

11:10 a.m. -12:10 p.m. Balancing Quality Care and Costs for Chronic ConditionsModerator: Dr. Inés Hernández, M.D., Chief Medical Officer, MCS, Inc.

Keynote Speaker: • Dr. Kenneth E. Thorpe, PhD, Professor and Chair of the Department of Health Policy & Management, Rollins School of Public Health of Emory University, Atlanta, GeorgiaDiscussion Panel and Invited Panelists: • Hon. Ana del Carmen Ríus Armendáriz, MD Secretary of Health, Commonwealth of Puerto Rico • Mrs. Waleska Crespo Rivera, MHSA, Executive Director, Cardiovascular Hospital of Puerto Rico

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Schedule of Events12:10 p.m. - 2:00 p.m. Lunch ConferenceWorking on the Future of Medicaid, Medicare and Commercial Healthcare to Support Universal Access to Care in Puerto Rico

CONCURRENT SESSIONS

2:00 p.m. - 3:00 p.m.A Health Insurance Marketplace Update: Any Lessons for Puerto Rico?Moderator: Mr. Luis Pizarro, Esq., PR Chamber of Commerce Health Committee Member

Discussion Panel and Invited Panelists: •Mrs. Angela Weyne Roig, Esq., Commissioner of Insurance Office of the Commissioner of Insurance of Puerto Rico • Eng. Ricardo Rivera Cardona, Executive Director, PR Health Insurance Administration (ASES)

2:00 p.m. - 3:00 p.m.Making Quality Work: Hospital Engagement Network (HEN) and the CMS STAR Rating SystemModerator: Mr. Héctor Mújica-Trenche, JD-LPRP, PR Chamber of Commerce Health Committee Member

Keynote Speakers: • Mr. Jaime Plá Cortes, Esq., Executive President, Puerto Rico Hospital Association • Mr. Stephen Wood, Senior Vice-President, Universal American CorporationDiscussion Panel and Invited Panelists: • Mr. Omar Candelas, CPA, Vice President of Finance, Millennium Medical and Center for Integrated Services • Mr. Néstor Ortiz, Director Commercial & Government Affairs, AbbVie Corp. • Ms. Marileny Lugo, Vice President of Operations MC-21, Inc.

3:00 p.m. - 3:20 p.m. COFFEE BREAK

Invited Keynote Speaker:Hon. Alejandro García PadillaGovernorCommonwealth of Puerto Rico

Ponce de León A

Ponce de León B

Ponce de León C

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Schedule of EventsCONCURRENT SESSIONS

3:20 p.m. -4:20 p.m. The 2014 Economics of Healthcare for Small Businesses and IndividualsModerator: Mr. Carlos Iván De Jesús, PR Chamber of Commerce Health Committee Member

Keynote Speaker: • Dr. Steven G. Ullmann, PhD, Professor and Director, Programs in Health Sector Management and Policy, School of Business Administration, University of MiamiDiscussion Panel and Invited Panelists: • Mr. Eduardo Zetina, Principal, Qinetix Group • Mr. Luis O. Maldonado Irizarry, FSA, MAAA, Consulting Actuary, Milliman • Ms. Elena M. Díaz Molina, Vice President of Sales & Account Management, Triple-S Salud, Inc. • Dr. Eddie Ortiz, MD, Vice President of Medical Affairs, First Medical Health Plan, Inc.

3:20-4:20pm Exporting Healthcare from Puerto Rico and Economic Development Moderator: Mr. Julio Ortiz, Partner, FULCRO Insurance, Inc.: Puerto Rico in Atlanta and Dominican Republic

Discussion Panel and Invited Panelists: • Mrs. Rosa Hernández, R Ph, President, MC-21 Puerto Rico in Colombia • Mr. Francisco Chévere Mouriño, Esq., Executive Director, Puerto Rico Trade & Export Company

4:20 p.m. - 4:30 p.m. Conclusions | Closing Remarks • Mr. Roberto Pando, MS, JD, Chairman, PR Health & Insurance Conference 2014 • Mr. Jorge M. Cañellas Fidalgo, Esq., CPA, Chairman of the Board, Puerto Rico Chamber of Commerce

4:30 p.m. -7:00 p.m.Networking Cocktail

Ponce de León B

Ponce de León A

Ponce de León Foyer

Ponce de León C

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GARCÍABorn in Coamo on August 3, 1971. His father, a veteran of World War II, worked his way up, at one point holding down a job as a bulldozer driver, until he retired as the general manager of a manufacturing plant. Alejandro’s mother, a dedicated homemaker, still lives in the

same three-room family home where she raised six children through good times and bad. He is married to Wilma Pastrana and is the proud father of two boys, Juan Pablo and Diego Alejandro, and one girl, Ana Patricia.

After going through college and law school in Puerto Rico, Alejandro clerked on the Appellate Circuit, served as a legislative aide, directed the Association of General Contractors and practiced law at a well-reputed firm, focusing on contracts and real estate. He also took a teaching job at Inter-American University Law School and was a panelist on a highly-rated AM talk radio show.

He went on to serve as Secretary of the Department of Consumer Affairs, where he championed the rights of ordinary Puerto Ricans. His work kept gas prices in check during critical periods of the Iraq War, with the Commonwealth having the lowest prices of any U.S. jurisdiction, despite international turmoil and the higher costs of bringing fuel to an island market.

In 2008, Alejandro was elected to the Commonwealth Legislature with the most votes of any senator from either party. During his time at the Capitol, he reached across the aisle to pass important bills providing scholarships for university students, economic development incentives and pension benefits for the widows of police officers killed in action. A prolific body of bills, most of them stalled due to partisan bickering, would promote job creation, innovative solutions to Puerto Rico’s crime wave and the defense of consumer rights.

In 2011, after announcing his intention to run for Governor of Puerto Rico, he was unanimously elected President of the Popular Democratic Party. During his tenure he has refocused the Party behind a message of hope and growth, has led an effective opposition and has united the leadership in rejecting a rigged status plebiscite pushed forward by the party in power.

As Governor, Alejandro will dedicate himself to restoring safe streets for every family and to putting Puerto Ricans back to work, by promoting private investment and entrepreneurship. He’s driven by the very basic value that a Governor should stand by average folks and fight for their rights andopportunities for growth.

Lunch Keynote Speaker

Insurance ealth&P U E R T O R I C O

C O N F E R E N C E 2 0 1 4

Hon. Alejandro García PadillaGovernorCommonwealth of Puerto Rico

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Our Speakers

MARAZZIDr. Mario Marazzi-Santiago was appointed as the first Executive Director of the Puerto Rico Institute of Statistics in August 2007. In this position, Dr. Marazzi-Santiago has had numerous achievements, such as the preparation of the first Inventory of  

Dr. Mario Marazzi-SantiagoExecutive DirectorPuerto Rico Institute of Statistics

Statistics of Puerto Rico, the establishment of Quality Criteria for Puerto Rico statistics, the implementation of a professional development program for the statisticians of the Puerto Rico government, the methodological revision of the cost-of-living and mortality statistics of Puerto Rico, amongst others. At the same time, from the Institute, he has undertaken several research projects and published various statistical reports, including the Private School Profile of Puerto Rico and Puerto Rico’s Knowledge Economy Index, amongst others.

Previously, he served as an Economist at the International Finance Division of the Board of Governors of the Federal Reserve System in Washington, DC. During this time, he worked on the macroeconomic projections used by the Federal Reserve to make monetary policy decisions, and published several articles in academic journals and two chapters on the subject of international economics.

Dr. Marazzi-Santiago has a bachelor’s degree in economics from Harvard University, a master’s degree in economics from the London School of Economics, and a doctorate in economics from Cornell University. In 2012, Dr. Marazzi was elected as the first Puerto Rican member of the International Statistical Institute.

PANDOMr. Roberto Pando, MS, JDChairman of the PR Health & Insurance Conference 2014Roberto Pando, is the Vice President of Strategy, Business and Development at MCS. He studied his Bachelor’s Degree in Economics at the University of Michigan in Ann Arbor, and later went on to the London’s School of Economics to obtain a Masters

in Social Planning. After he began working full time as a consultant in the late 1990’s, he also continued his academic development at night and obtained a Juris Doctor’s at the University of Puerto Rico. Roberto went into the challenges of healthcare systems since the beginning of this career when he worked as a consultant for the Federal District Court in several projects related to the Correctional Health System in the Puerto Rico. He later on became Deputy Executive Director of Puerto Rico’s Trade & Export Company where he was in charge of multiple programs that support the development of small businesses in the island, as well as their involvement in international trade. In 2004, Roberto joined the MCS team as Medicare Compliance Director and supported multiple areas before being promoted to Vice President of Business Development. Among his various projects and tasks, Roberto has led the development of products and services for all the business lines at MCS including Medicare, Medicaid and commercial health. With the newly appointed title of Vice President of Strategy, Research and Development, Roberto is part of the MCS team of leaders focusing on the continuous development of the company towards the future. While maintaining active participation in the business community, Roberto also serves this year as president of the PR Chamber of Commerce Health Committee and Wellness Unit.

Elliot Pacheco Beauchamp, a BA Finance graduate from the University of Puerto Rico, since 2006 owns Farmacia Reyes #4 located at downtown Cayey. In six (6) years of business

PACHECOMr. Elliot Pacheco BeauchampPresident, PR Community Pharmacy Association

Farmacia Reyes has doubled the number of customers and increased service area by 50% in first year. Cultivated & grew business from an 8 employee’s operation to 45 in 6 years. This has been accomplished by establishing & developing an integrated WORKFLOW in the prescription department using Automated Dispensing Machines (ROBOTS).

Since July 2009 presides the Puerto Rico Community Pharmacies Association. Mr. Pacheco was member of the Board of Director of Farmacias Aliadas from 2007 to 2010. Farmacias Aliadas is one of the most successful pharmacies buying groups in the island. Also, Member of the Board of Directors of the Puerto Rico’s Health Information Network (PRHIN); Alianza de Farmacias de Comunidad; Cayey’s Merchants Association. Former committeeman of the Drug Price Regulation Committee of the DACO and Comprometidos con la Salud. Mr. Pacheco has been a member of the Puerto Rico Chamber of Commerce Board of Directors since 2013.

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Our Speakers

Jim O’Drobinak is a results-oriented executive with over 25 years of business, operations, finance and IT experience, including over 15 years in C-level positions. He is a demonstrated change leader with a successful track record of meeting operating commitments and developing business results to achieve differentiated market and product advantages.

Jim is an expansive leadership thinker with outstanding record of achievement implementing and improving new or existing business concepts, delivering innovative business solutions and facilitating business expansions while maintaining a high level of ethics and risk management.

Prior to joining Gorman Health Group, Jim was most recently the Chief Operating Officer of a Medicare Advantage health plan with over 100,000 lives across 14 states. In this role, Jim successfully transformed internal operations and employee moral during periods of intense scrutiny from external sources.

O’DROBINAKMr. James P. O’DrobinakCEO MCS, Inc. & President of MMAPA

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Our Speakers

SHINTO

GOLTZ

Dr. Richard Allan Shinto, M.D.President and CEO, MMM Holdings, Inc.

Dr. Richard Shinto, a specialist in pulmonology and internal medicine is President and Chief Executive Officer of MMM Holdings, Inc. He has over 20 years of clinical and operational administration experience in healthcare and is also the Chief Executive Officer for InnovaCare Health Solutions, Inc.

Before joining MMM Holdings, Inc., Dr. Shinto was the Chief Operations Officer and Chief Medical Officer for Medical Pathways Management Company. After being Vice President of Medical Management for MedPartners, from 1995-1997, he became the Chief Medical Officer for Cal Optima Health Plan, in California.

Dr. Shinto is a graduate of the University of California, in Irvine; the University of New York, Stony Brook; and the University of Redlands. Among his various honors, a highlight was the Ernst & Young Entrepreneur of the Year® in the Service category for the state of New Jersey. This honor is awarded to outstanding executives who show excellence and extraordinary success in areas such as innovation, financial results and personal commitment towards their companies and communities.

Mr. David GoltzChief Financial Officer, Triple-S Advantage

David is originally from Green Bay, Wisconsin. He earned his BBA in accounting from the University of Wisconsin, and an MBA from the University of Saint Thomas in Houston. Dave brings 25+ years of finance experience to Triple-S Advantage, much of that in the managed care industries. His most recent assignment was as CFO for Windsor Health Group in Atlanta, GA. Windsor is the US direct health insurance subsidiary of Munich Re, based in Germany, focused on Senior Products in the states, primarily Medicare Advantage. Prior to joining Windsor, Dave spent five years with Fidelis Senior Care, a venture backed start up organization (in 2005) that developed licensed HMO’s to provide services under contract with the Centers for Medicare and Medicaid Services (CMS), specifically as a Medicare Advantage Institutional Special Needs Plan. His hands-on management style is reflected in his understanding that the key to success is in the details, and working with those details – and with others - to achieve the company’s goals.

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Our Speakers

Mr. Jaime Plá-Cortés is executive president of the Puerto Rico Hospital Association, a non-profit organization founded in 1942 that represents hospitals, other public and private health

PLÁ

VÉLEZ

Mr. Jaime Plá-Cortés, Esq.Executive President, Puerto Rico Hospital Association

institutions and health care professionals in Puerto Rico. Mr. Plá is a recognized health care leader in Puerto Rico, has served on the governing board of two major hospitals as well as having served as administrator of Saint Luke’s Episcopal Hospital. He is currently President of the Board of Trustees of the Carlos Albizu University.

Mr. Plá is past president of the Association of Health Services Administrators and past president of the Puerto Rico Healthcare Quality Association. For the first time in the history of the Puerto Rico Hospital Association, Mr. Plá was reelected in 2009 to serve a second consecutive term as president of the Association. As past president and currently executive president of the Puerto Rico Hospital Association, Mr. Plá leads efforts to achieve parity for Puerto Rico under federal health care programs, working together with the government of Puerto Rico and other stakeholders to represent the needs of Puerto Rico in Washington.

Mr. Plá holds a Masters degree in Health Services Administration from the University of Puerto Rico and is a licenced Health Services Administrator.

Mr. Vélez joined BDO Puerto Rico in 2006 as Audit Manager. With over fifteen years of experience, he is now a Shareholder of the Audit and Attest Services Division of the Firm. He has worked in both private and public accounting, focusing his career in financial institutions, insurance companies, real estate and employee benefit plans, among other industries and sectors.

Sigfredo’s experience in the banking field exposed him to the implementation of important regulatory frameworks related to bank-secrecy and anti-money laundering regulations. It also helped him gained hands-on experience in complex operations, such as: the administration of public debt issuances and collateralized debt instruments, transfer agency and paying agent functions, mutual funds pricing, electronic and physical custody of financial instruments, among others.

He is currently serving in the Board of Directors of various Puerto Rico enterprises and non-profit entities.

Mr. Sigfredo Vélez, CPAShareholder Audit & Attest Service, BDO

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Our Speakers

TOBYMr. William Toby Jr., Former HCFA Administrator & Health Policy Consultant

TORRESDr. Jaime R. TorresDPM, MS, Regional Director, US Department of Health and Human Services, New York Regional Office

 

Dr. Jaime R. Torres was named Regional Director of the New York Regional Office for the US Department of Health and Human Services by Secretary Kathleen Sebelius and serves as the Region II representative of Secretary Sebelius. As the highest ranking

Government Official in Region II he helps coordinate the implementation of departmental policies and initiatives in Region II, which includes New York, New Jersey, Puerto Rico, the U.S. Virgin Islands and eight Tribal nations. He plays a vital role in HHS’ effort to effectively implement the Patient Protection and Affordable Care Act. Dr. Torres earned his Doctorate of Podiatric Medicine from the New York College of Podiatric Medicine, a master’s degree in Community Health from Long Island University and a Bachelor’s of Science from Fordham University.

William Toby, Jr., is a 31-year veteran of the Federal Department of HHS and has been a private healthcare consultant since retiring in 1996 from his position as Regional Administrator of the US Health Care Financing Administration (HCFA) in New York. In that capacity, he directed the

nation’s Medicare and Medicaid programs in New York, New jersey, Puerto Rico and the Virgin Islands. He also served as the Acting HCFA Administrator/Deputy in Washington, DC, from March of 1992 to September of 1993. Earlier, he was Regional Commissioner of the former US Department of Health, Education and Welfare’s Social and Rehabilitation Service. Before that he was a top official of the National Urban League, where he held the position of Director of Training, reporting to the late Whitney Young, Jr.

Mr. Toby, who has been the recipient of many prestigious awards, holds a Masters Degree in Health Administration from Harvard University’s John F. Kennedy School of Government a Masters Degree in Social Work from Adelphi University, a Bachelor’s Degree in Spanish from West Virginia State University and holds advanced certificates in Spanish from the Universities of Leon and Toledo in Spain. In 1991, then President George Bush, on the recommendation of then Secretary of Health & Human Services Dr. Louis W. Sullivan, appointed Toby a US Delegate to the first and historic African-American Summit, which was held in Abidjan, Ivory Coast The Summit brought together the heads of four African nations with distinguished African-American leaders to discuss the Diaspora and how the American leaders couid assist their ancestral homeland.

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Our Speakers

PÉREZMr. Luis A. PérezSenior Vice-President, Abarca Health, LLC

Juan E. Hernández was appointed Director of the Puerto Rico Federal Affairs Administration and the Washington Representative of the Governor of the Commonwealth of Puerto Rico on January 2, 2013.

Luis is the Senior Vice President of abarca health, a leading PBM and applied Health IT Company in Puerto Rico. Luis is responsible for business development and client-facing operations with a focus on strengthening abarca’s value proposition. Before joining abarca, Luis was Area Director for Abbott Laboratories leading Market Access Strategy, Health Economics, and Strategic Health Initiatives for the LatAm region. He also has experience in the insurance sector having occupied management positions at a leading MBHO. Luis is a graduate of the School of Medicine and of the Graduate School of Public Health of the University of Puerto Rico, and has conducted biomedical research at the Mayo Clinic Foundation.

Mr. Juan E. Hernández Mayoral, Executive Director, Puerto Rico Federal Affairs Administration

HERNÁNDEZMr. Juan E. Hernández MayoralExecutive Director, Puerto Rico Federal Affairs Administration

Before joining the García Padilla Administration the Director served as a Senator from 2005 to 2012. During his eight years in the Senate of the Commonwealth of Puerto Rico, over forty bills that he introduced became law. Also he served actively in the National Conference of State Legislators (NCSL), National Hispanic Caucus of State Legislators (NHCSL) and the Council of State Governments (CSG).

Prior to being a Senator, the Director worked as a Consultant, Administrator of a law firm, Executive Director of a Gubernatorial Library Foundation, Producer, and National Advance man for two U.S. presidential campaigns. Director Hernández was born in Ponce, Puerto Rico on April 21, 1969. He studied communications at Sacred Heart University in the Commonwealth and is married to his wife Vivian.

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Our Speakers

SISCO

RIVERAEng. Ricardo A. Rivera CardonaExecutive DirectorPR Health Insurance Administration (ASES)

Mr. Antonio SiscoState Coordinator, PR Health Information Network

A graduate of Cornell University with an Engineering degree, Ricardo’s career took as a young management consultant for a major supply chain company in Venezuela. From there, his meteoric rise through multiple business sectors in several countries has given him the opportunity to work with and lead key entities in both the private and public sectors, including systems logistics, brand management, marketing, consumer sales, and healthcare management, among others.

Rivera-Cardona’s service to Puerto Rico began in 2005, when he served as the Executive Director of the Puerto Rico Trade and Export Company as well the Secretary of the Department of Economic Development and Commerce. Mr. Rivera-Cardona’s commitment to Puerto Rico remains strong, as he is currently the Executive Director of the Health Insurance Administration (ASES, its Spanish acronym).

Mr. Antonio Sisco has ample experience with HIT & HIE inniciatives having led initiatives of similar complexity in the private sector with more than 10 years of management experience in multi-hospital information technology settings. Mr. Antonio Sisco also encompass comprehensive knowledge in HITECH ACT and the EMR adoption model. His technical skills also includes comprehensive experience in healthcare technology, Project Management, Clinical Systems, Data Communications and Network Design (LAN, WAN & WiFi) in support of client-server platform consolidation activities. Mr. Sisco is, in addition, a well-respected and seasoned HIT professional that believes in the importance of the HIE as a central piece in the Island’s health reform efforts, also Founding member for the HIMSS PR Chapter.

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Our Speakers

FERNÁNDEZMr. Antonio FernándezDirector, Regional Extension CenterPonce School of Medicine

Antonio Fernandez founded and directs the Health Information Technology Regional Extension Center (REC) at the Ponce School of Medicine and Health Sciences, where he also teaches Health Systems Administration at the Public Health Program and HIT to medical students. Mr. Fernandez is a Member of ONC’s Meaningful

Use Advisory Group, the National E-Health Collaborative for the Underserved (NHIT), and the HIMSS National Diversity Initiative. He served as United Healthcare’s President/CEO for PR, Senior VP for Ramsay HMO/CAC Health Plans, and VP for Miami Children’s Hospital. He completed his BA, MBA and a Health Services Administration Certificate from University of Miami.

HERNÁNDEZDr. Inés Hernández, M.D.Chief Medical Officer, MCS

Dra. Hernández is a family physician graduated from the University of Puerto Rico Graduate Medical Education Program. After graduation, she joined the Medical School faculty as an Assistant Professor of Family Medicine.

She joined MCS in 2005 as Medical Director of Quality an Education. Through the years, she has held several positions in MCS, developing various programs for member management, including Care Management, Community Outreach and the Palliative Care Program, among others. Currently, she holds the position of Chief Medical Officer.

Dra. Hernández is a Diplomate of the American Board of Medical Specialties, a Certified Health Insurance Executive and a Certified Professional Coder.

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Our Speakers

THORPE

RÍUS  

Kenneth Thorpe, Ph.D., is the Robert W. Woodruff Professor and Chair of the Department of Health Policy & Management, in the Rollins School of Public Health of Emory University, Atlanta, Georgia. Dr Thorpe is a

Dr. Kenneth E. Thorpe, PhDProfessor and Chair of the Department of Health Policy & Management, Rollins School of Public Health of Emory University, Atlanta, Georgia

member of the International Advisory Board for APCO Worldwide. In addition, he serves as the Chairman of the Partnership to Fight Chronic Disease (PFCD). As Chairman of PFCD), Thorpe works with an international coalition organizations consisting of patients, providers, community organizations, business and labor groups, and health policy experts to raise awareness of the negative impact chronic disease has on health and economy. He is also co-chair of the Partnership for the Future of Medicare, a bipartisan group designed to ensure the sustainability of the program. Dr Thorpe is also a member of the International Advisory Council for APCO Worldwide, a global communication firm.

In addition to holding a number of faculty positions, Thorpe was Deputy Assistant Secretary for Health Policy in the U.S. Department of Health and Human Services from 1993 to 1995. In this capacity, he coordinated all financial estimates and program impacts of President Clinton’s health care reform proposals for the White House. He also directed the administration’s estimation efforts in dealing with Congressional health care reform proposals during the 103rd and 104th sessions of Congress. As the Chairman of the PFCD and respected health care expert, Thorpe regularly testifies before numerous committees in the U.S. Congress and in front of governments around the world on the aspects of health care reform, including disease prevention, wellness and coordination of care. Thorpe received his Ph.D. from the Pardee Rand Graduate School, an M.A. from Duke University and his B.A. from the University of Michigan.

Hon. Ana del Carmen Ríus Armendáriz, MDSecretary of HealthCommonwealth of Puerto Rico

Dr. Ana Rius Armendariz was nominated by the Governor of Puerto Rico and confirmed by the Senate as Secretary of the Puerto Rico Department of Health (PRDoH) in November 11, 2013. Dr.

Rius has broad experience in Public Service having served in multiple roles within Puerto Rico’s HealthCare sector.

Dr. Rius is a practicing Anesthesiologist and has been a Professor of Anesthesiology for the School of Medicine of the University of Puerto Rico for the past 28 years. Prior to her appointment as Secretary, Dr. Rius was appointed in January 2013 as Executive Director of the Puerto Rico Medical Services Administration (ASEM) and previously served in that role from November 2002 until February 2009. She brings to bear many years of practical, academic and public health experience to contribute to the development, enhancement and improvement of Puerto Rico’s healthcare and service delivery. She has served on many public health boards and has played key roles leading efforts geared towards improving the quality of life of all within our community.

Under Secretary Rius’ leadership, PRDoH is committed to maintain a strong focus on individual and community efforts for Prevention; strong and effective health Promotion, development of policies and enforcement of health care Protection; practice with groups and communities Population based medicine and assure the Commonwealth is constantly focused on its Preparedness for bioterrorism, natural disasters and pandemics that may affect Puerto Rico.

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CRESPO

PIZARRO

Our Speakers

Mrs. Waleska Crespo Rivera, MHSAExecutive Director, Cardiovascular Hospital of Puerto Rico

Mr. Luis Eduardo Pizarro Otero, Esq., LLM,AVP Government Affairs and PolicyMedical Card System, Inc

Waleska Crespo Rivera is Executive Director of the Cardiovascular Center for Puerto Rico and the Caribbean. She has a Bachelor Degree and internship in Nutrition and Dietetics with specialty training in diabetes and obesity management, with experience in both hospital and primary care. Since completing her Master Degree in health services administration in 2000, she has conducted evaluation projects on the Government Health Plan, health literacy research in diabetes and hypertension, consulting for managed primary care organizations, and served as administrator in a large acute care hospital. She currently serves on the boards of the Puerto Rico Hospital Association and the Puerto Rico Comprehensive Cancer Center and is adjunct professor in the Health Services Administration Program of the University of Puerto Rico, where she is also completing a Doctor of Public Health in Health Systems Analysis.

Luis is a graduate from The George Washington University in Washington, DC, and the Inter-American University of Puerto Rico, School of Law. He also has a Masters in Law (LLM) in Health Care Law, from the Beazley Institute of Health Law and Policy, in Loyola University Chicago, School of Law. Luis is admitted to practice law by the Puerto Rico Supreme Court and the Federal District Court for the District of Puerto Rico. At MCS, Luis leads the company policy program and legislative affairs, evaluating public policy, healthcare reforms and their impacts to the Private Insurance, Medicaid and Medicare segments in Puerto Rico. In addition, he provides corporate strategic planning support, business implications analysis, as well as legal advice, on a wide array of health care issues to foster effective relations with federal and local government branches. Luis participates in various professional and business associations such as the Puerto Rico Chamber of Commerce, the American Bar Association and the American Health Lawyers Association. He is a frequent speaker on conferences related to the Affordable Care Act and health care legislation in Puerto Rico.

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WEYNEOur Speakers

Mrs. Angela Weyne Roig, Esq.Commissioner of InsuranceOffice of the Commissioner of Insurance of Puerto RicoWas appointed by Governor Alejandro Garcia Padilla to serve as Commissioner of Insurance for the Commonwealth of Puerto Rico on January, 2013. With more than 40 years of experience in the insurance and banking sectors, Weyne has accomplished an award-winning career

in insurance, including management of a premium finance company, a managing general agency, a claims adjusting firm, presidencies of life and of property and casualty companies and the presidency of the largest bank owned insurance agency in Puerto Rico. She was also president of the first reinsurance company incorporated in Puerto Rico and served as President of two health maintenance organizations.

Commissioner Weyne received her bachelor’s degree in mathematics from the University of Puerto Rico and has been recipient of many awards through her professional career, such as the Top Management Award of the Sales and Marketing Association, Outstanding Women in Business of the Puerto Rico Chamber of Commerce and Woman of the Year from the Professional Women’s Association of Puerto Rico. Commissioner Weyne is an active member of the World Presidents Organization (WPO) and served as Chair of the local chapter. Among the entities where she has served as board member are the Puerto Rico Chamber of Commerce, the Puerto Rico Association of Insurance Companies, the Friends of El Yunque Foundation, Central Caribbean University and the Trust of the Supreme Court of Puerto Rico. Currently, Commissioner Weyne serves as board member of the Puerto Rico State Insurance Fund Corporation, the Automobile Accidents Compensations Administration and the Health Insurance Administration. She is also member of various committees of the National Association of Insurance Commissioners (NAIC).

MÚJICAMr. Héctor Mújica-Trenche, JD-LPRPPR Chamber of Commerce Health Committee Member

Héctor Mújica-Trenche is the Public Affairs VP for Mújica Group, an Integrated Communications and Special Events marketing firm located in Bayamón, Puerto Rico. Prior to his new role for Mújica Group he was the Public Affairs Director for Humana, Puerto Rico.

Mújica has a BBA in Marketing from the University of Puerto Rico and a Juris Doctor Degree from Interamerican University School of Law. He’s also a Licensed Public Relations Practitioner and a Certified Lobbyist in both the House and Senate of Puerto Rico.

In addition to his experience as a lobbyist, Mújica has several years experience in the public relations, advertising and crisis management fields having worked as Managing Partner for more than twenty years for his own communications company, Public Affairs Consultants. Prior to that experience, he was also a Special Aide to the Secretary of Justice and a former Director of the Press and Communication Department for the Puerto Rico Department of Justice.

He’s a former President of the Puerto Rico Insurers Association (ACODESE) and the Puerto Rico Film Festival (Cinemafest). He’s also a member of the American College of HealthCare Executives (ACHE), the Medicaid and Medicare Advantage Products Association (MMAPA) and the Puerto Rico Chamber of Commerce.

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Our Speakers

WOOD

Mr. Stephen WoodSenior Vice-President, Universal American CorporationStephen Wood is a Senior Vice President at Universal American Corporation. His responsibilities include leading partnering programs combined with management services offerings to provider organizations and health plans. He leads the UAM and partner organizations response to changing market conditions, evaluating high risk populations such as dually eligible Medicare and Medicaid beneficiaries, design and

implement care management approaches as well as offering the full continuum of management services organization capabilities. Previously Mr. Wood was a Senior Vice President and Partner at Ingenix and Reden & Anders where he led the Government Programs Management and Strategy practice.

Stephen is a leader in managed care, governmental programs, senior markets and strategic consulting in the health insurance industry. He has worked extensively with issues related to health care reform, Medicare payment reform and Medicaid expansion; Medicare Advantage and PDP market and business strategies; Dual integration, operational gap assessments; and disease management programs. He has worked with PPO feasibility and demonstration application assistance, and institutionalized Medicare product evaluations. Additionally, Stephen has experience in the development of Medicaid managed care programs and RFP assistance and management.

In addition to his business and consulting experience, Stephen has held positions in capital finance at the American Hospital Association as well as finance director and director of patient accounts at a medical group practice.

CANDELASMr. Omar Candelas, CPAVice President of Finance, Millennium Medical and Center for Integrated Services

Mr. Omar A. Candelas Morales is Partner of COO Millennium Medical and the CDT Centro de Servicios Médicos Integrados, Inc. He is responsible for overseeing the daily operations and finance activities of 6 Independent Physicians Associations (IPA’s) and providing services to a population of over 40,000 members with 120 contracted physicians. He has been an Instructor in various healthcare seminars for the Puerto Rico Society of Certified Public Accountant and in 2010 Chaired the Health Committee of the Puerto Rico Society of Certified Public Accountants. Mr. Candelas holds a Bachelor in Science in Accounting with a minor in Finance from the University of Puerto Rico, Cayey Campus. He is a Certified Public Accountant and a Chartered Global Management Accountant, and is affiliated to the Puerto Rico State Society of Certified Public Accountants, the American Institute of Certified Public Accountants and the Financial Management Association.

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Our Speakers

ORTIZMr. Néstor OrtizDirector Commercial & Goverment Affairs, AbbVie Corp.

Néstor Ortiz is the Director of Commercial & Government Affairs for AbbVie (formerly Abbott) in Puerto Rico. Former Vice President of the Colegio de Farmaceúticos de Puerto Rico, Chairman of the Government Affairs committee of the

Pharmaceutical Industry Association (PIA), Vice Chairs of PhRMA’s Puerto Rico Task Force and an active member of Industry and Academia Consortium (INDUNIV).

Within AbbVie Nestor led the Integrated Managed Healthcare operations and Health Policy teams. He has been responsible for the development of Patient Support Programs that improve Adherence, Health Literacy and Self-Care, among others empowerment skills to enhance the patient journey.

He also has a highly active philanthropic agenda that include a position in the Executive Committee and leader of the Policy committee of Fondos Unidos de Puerto Rico.

Nestor earned his BS in Pharmacy from University of Puerto Rico and is currently working toward obtaining his Juris Doctor from the Interamerican University.

Ms. Marileny Lugo is a healthcare leader with over 24 years of strong experience in Healthcare and Pharmacy Benefit Management (PBM) segments. Ms. Lugo is MC-21’s Operations Vice President and is currently responsible for the successful execution of MC-21 business plan regarding management of the PBM operational areas including Account Management, Design and Plan Set Up, Clinical Services, Pharmacy Services, and Customer Satisfaction.

Ms. Lugo has made significant contributions as one of the key players in the growth and success of MC-21 Corporation. Under her strategic management leadership role, planning, management, and implementation of corporate operations, strategic goals and objectives have been executed as designed and planned.

Ms. Lugo holds a Bachelor’s Degree in Pharmaceutical Sciences, Magna Cum Laude, from Massachusetts College of Pharmacy in Boston.

LUGOMs. Marileny LugoVice President of Operations, MC-21, Inc.

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Our Speakers

Carlos De Jesús is currently Auxiliary Vice President of Medicare Advantage Product Development for Medical Card System, Inc. Prior to that, Mr. De Jesús served as Business Development Director for the Company. Prior to joining MCS, Mr. De Jesús served as Corporate Banking Relationship Manager for Banco Popular from 2005-2010. He has a Bachelor’s Degree in Computer and Systems Engineering from Rensselaer Polytechnic Institute (RPI) and a Master’s Degree in Business Administration from the University of Miami. He is a past president of the Association of Financial Professionals, Puerto Rico Chapter, and a friend and supporter of the Puerto Rico Chamber of Commerce.

DE JESÚSMr. Carlos Iván De JesúsPR Chamber of Commerce Health Committee Member

ULLMANNDr. Steven G. UllmannDirector of Programs and the Center for Research in Health Sector Management and Policy, School of Business Administration, University of Miami

Dr. Ullmann is also a Professor in the Departments of Management and Economics in the School of Business Administration, and a Professor in the Departments of Epidemiology & Public Health and

Family Medicine & Community Health, in the Miller School of Medicine, specializing in the areas of health care management and health care economics. He has also served as Vice Provost for Faculty Affairs and University Administration, Dean of the Graduate School and Director of Academic Programs in Health Administration.

He has been on the faculty at the University of Miami since 1979 and previously served as a research associate with two consulting firms. Dr. Ullmann holds a Bachelor’s Degree with honors in Economics from the University of California, Berkeley, and his Masters and Ph.D. degrees in Economics from the University of Michigan, Ann Arbor. He has also received training and certification in Bioethics and Advanced Bioethics from the Kennedy Institute of Ethics at Georgetown University.

Dr. Ullmann has been the recipient of twenty-five awards for excellence in teaching since coming to the University of Miami. He has served on governing boards and ethics boards of a number of health care providers and has served as a consultant to the health care industry. With the recent issues of healthcare reform, Dr. Ullmann’s expertise has been sought after for interview, commentaries and panel discussions by various local and national media sources including: CNN, Nightly Business Reports, CBS, Fox Business News and The Miami Herald.

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Our Speakers

MALDONADO

ZETINAMr. Eduardo ZetinaPrincipal, Qinetix Group

Mr. Luis O. Maldonado Irizarry, FSA, MAAAConsulting Actuary, Milliman

Eduardo obtained his bachelor’s degree in Mathematics from the University of Texas at Austin with concentrations in Business Administration, Finance and Actuarial Science. He has spent the last 20 years working in the health insurance industry in Puerto Rico, having held such positions as Chief Underwriter of Triple-S, Inc. and Vice President of Actuarial & Underwriting of MCS, Inc. During his career, Eduardo has contributed innovations to the Commercial, MI Salud and Medicare Advantage market segments, and continues to do so as an independent Actuarial Consultant. In 2012, along with three other health insurance professionals, Eduardo launched Qinetix Group, a technology company which developed and operates the first and only private Health Insurance Exchange in Puerto Rico serving both the large group and individual markets.

Luis is a Consulting Actuary and joined Milliman in 2009 to open the San Juan, Puerto Rico office. While working at Milliman, Luis has assisted clients from different spectrums of the the healthcare industry. This includes work with insurance carriers, hospitals, IPAs, employer group, brokers and PBMs. His projects have involved calculating premiums, reviewing capitation contracts, analyzing benefit changes and financial projections, among others. By having exposure to such a variety of clients, Luis is able to leverage his understaning of all stakeholders in order to bring significant insight into managed care projects.

Prior to joining Milliman, he served as Assistant Vice President at a leading health insurance carrier. In this position, Luis gained a solid background in claims reserving and valuation, pricing management, product development, group underwriting, statistical data reporting and analysis, and financial forecasting, among others. Prior to that experience, Luis worked as a Financial Analyst for the Acquisitions and Corporate Investments at one of the top 50 largest banks in the United States. His role included active participation in the evaluation and structuring of M&A activity.

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DÍAZ

ORTIZ

Our Speakers

Ms. Elena M. Díaz MolinaVice President of Sales & Account ManagementTriple-S Salud, Inc.

Mr. Eddie Ortiz, MDVice President of Medical AffairsFirst Medical Health Plan, Inc.

Dr. Eddie Ortiz is Vice President of Medical Affairs for First Medical Health Plan and he oversees corporate medical management and quality programs to ensure the provision of proven effective care to more than 320,000 medical members around the island. Dr. Ortiz has responsibilities in both First Medical’s lines of business; Commercial and Medicare Advantage.

Prior to joining First Medical, Dr. Ortiz served as Medical Advisor and Medical Director in McKesson PR, Humana Health Plan, and Amedisys, Inc. He was also Vice President of Medical Affairs in MCS. He earned his medical degree and his specialty in Family Medicine from the University of PR Medical School.

Ms. Elena M. Diaz is Vice President of Sales & Account Management Division of Triple-S Salud, Inc.

For the past 27 years she has worked in the Health Insurance Industry in various management positions related to Risk Assessment, Product Development, and Marketing & Sales.

Ms. Diaz was President of the Association of Life and Disability Guaranty. She has lectured at various forums related to Insurance Industry. She is also the executive liaison of Triple-S Salud with the Blue Cross Blue Shield Association in regards to the implementation of the various initiatives of the Affordable Care Act that have been in implementation at national and local level since its inception in 2010.

Ms. Diaz holds a Master in Economics from the University of Puerto Rico and specialized courses in Marketing from Wharton School of Business, University of Pennsylvania.

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ORTIZ

HERNÁNDEZ

Our Speakers

Mr. Julio OrtizPartner, FULCRO Insurance, Inc.: Puerto Rico in Atlanta and Dominican Republic

Mrs. Rosa Hernández, R. PhPresident, MC-21: Puerto Rico in Colombia

Rosa M. Hernández, R.Ph. is President of MC-21 Corporation, Puerto Rico’s first locally-owned pharmacy benefits management company, which she helped establish in 1996.

Under her leadership, MC-21 has developed vast experience, extensive resources, excellent account management services, industry leading clinical programs, world class IT systems and an impeccable reputation of integrity, transparency and reliability. Also, MC-21 has expanded its recipients base to over 2.2 million lives, that accounts for more than half of the island’s total population; widely surpassing initial goals and, in the process, helping to redefine the local healthcare services field. Rosa M. Hernández has been the helm of MC-21 since its inception. Her responsibilities include developing and implementing cost effective pharmacy benefit management programs for Medicaid lives of the Government of Puerto Rico’s wide-reaching health reform system, as well as the island’s largest health insurers.

A recognized industry leader for over two decades, Hernández was also co-founder and President of MOVA Laboratories, Inc., MOVA Pharmaceutical Corporation’s former marketing and distribution business. Hernández is an active member of the Puerto Rico College of Pharmacists (PRCP), the Puerto Rico Chamber of Commerce, the Sales and Marketing Executives Association (SME), the Academy of Managed Care Pharmacy (AMCP) and the Pharmacy Benefit Management Institute (PBMI). Also Hernández has been member of The Pharmaceutical Care Management Association (PCMA) Board of Directors, the most important national association representing America’s pharmacy benefit managers (PBMs); where Hernández contributed to develop and support the implementation of public policy for the benefit of the Healthcare Industry in the U.S. and the Puerto Rico markets. She has received multiple recognitions through her career including the Salvador “Chiry” Vasallo Award, recognition of Puerto Rico Products Association to honored the Puerto Ricans entrepreneurs legacy and their contribution for the economic development and industrial evolution of our Island. She obtained a Bachelor’s degree Magna Cum Laude in Pharmaceutical Sciences from the University of Puerto Rico, and has conducted post graduated studies in Marketing, Finance and Business Administration.

JULIO C. ORTIZ, MHP,HIA

Julio C. Ortiz is Partner in charge of the Benefits Practice. He managed the group and health division in Puerto Rico office of a major international insurance company. He holds the Health Insurance Association Professional and the Managed Health Care Professional designations. He studied Business Administration in the University of Puerto Rico and has over 30 years of experience in the medical and life insurance fields.

Julio C. Ortiz is Partner in charge of the Employee Benefits Practice. Ortiz managed the group and health division for a major international insurance company’s Puerto Rico office. He holds the Health Insurance Association Professional and the Managed Health Care Professional designation. He studied Business Administration in the University of Puerto Rico and has over 30 years experience in the medical and life insurance fields.

CHÉVERE

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Our Speakers

Exhibitors

Mr. Francisco Chévere Mouriño, Esq.Executive Director, Puerto Rico Trade & Export CompanyMr. Chévere is currently the Executive Director of the Puerto Rico Trade Company (Compañía de Comercio y Exportación de Puerto Rico), as appointed by Honorable Alejandro García Padilla, Governor of the Commonwealth of Puerto Rico. The main goal for Mr. Chévere in his

current position is to strengthen local businesses, particularly the small- and medium-size business sector, by offering tools and incentives that promote their growth, job creation, and exports.

He earned a Bachelor of Arts in economics, cum laude, at Georgetown University in Washington, D.C., including studies in economics at the University of Sussex in England. In addition, he holds a Juris Doctor degree from the University of Pennsylvania School Law with a concentration in labor law. Prior to his current government appointment, Mr. Chévere worked for over 28 years at McConnell Valdés, LLC, a leading corporate law firm in Puerto Rico. He was Vice-Chair of the firm’s labor and employment law practice group. Moreover, Mr. Chévere held a varied law practice representing some of the practice group’s main clients and comprising: counseling on commencement of business operations, local and federal employment law litigation, collective bargaining, labor arbitration, unfair labor practices, proceedings before the National Labor Relations Board, and labor relations counseling, among others. He is the author of multiple published articles, frequent lecturer at seminars, leading panelist in many public affairs symposia, and member of multiple professional and trade associations. Mr. Chévere is a member of the Executive Committee (1996 to present) and Affirmative Action Director (2000 to present) of the Democratic Party of the Commonwealth of Puerto Rico. In addition, he has participated as Delegate or Standing Committee Member in five Democratic National Conventions.

• BDO• ClinicalMedicalServices• InmediateHealthGroup• MCS• UniversityofMiamiSchoolofBusinessAdministration

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