Rita Isnar, JD, MPA
Managing Senior ConsultantCorporate Headquarters
5911 Kingstowne Village Parkway
Alexandria, VA 22315
Ms. Isnar joined Strategic Management in 2003 and is responsible for client fulfillment activities including regulatory research analysis, compliance program development and implementation, and compliance program evaluations for health care organizations. Ms. Isnar has over 10 years of healthcare regulatory compliance consulting experience. She specializes in compliance advisory services including corporate compliance program development and implementation, evaluation of compliance program effectiveness, as well as conducting work related to Corporate Integrity Agreements. Her hands on knowledge and compliance experience includes: Managed Care, Part C & D Compliance Program Development and Implementation, Sarbanes Oxley (SOX), HIPAA, government enforcement initiatives (e.g., Recovery Audit Contractors (RACs)), quality of care issues, Stark Laws, False Claims, and Anti-Kickback regulations. Furthermore, she assists clients in developing internal controls and fulfilling their obligations under Corporate Integrity Agreements (CIAs) with the Department of Health and Human Services Office of Inspector General (OIG). She has worked with various institutions in assessing compliance program effectiveness, development and implementation, and a broad range of specific compliance risks.
Ms. Isnar has regulatory compliance experience in serving a number of different healthcare stakeholders including hospitals, hospital systems, physician practices, pharmaceutical organizations, and managed care organizations. More recently, she has focused on assisting managed care organizations (MCOs) in various settings. She has extensive experience reviewing and analyzing contractual, statutory and regulatory requirements that MCOs are obligated to meet. She has experience reviewing and assessing internal policies and procedures that have been implemented by organizations to meet applicable regulatory requirements (i.e., marketing, enrollment and disenrollment, member benefits, etc.). Ms. Isnar has also conducted retrospective and real-time reviews of Medicaid enrollment applications to determine their compliance with state requirements and to identify errors based on internal, contractual, statutory and regulatory requirements. She has also assisted organizations with interpreting regulatory requirements of the Medicare Advantage and Prescription Drug Benefit including Part D and PACE organizations in addition to providing guidance on how to develop effective compliance initiatives. She provides consulting services to managed care organizations related to their contractual arrangements with downstream contractors, including pharmaceutical benefit managers and other healthcare entities; which include the development and implementation of accountable care organizations.
In addition, she currently spends much of her time leading engagements relating to Corporate Integrity Agreements (CIAs) with the Department of Health and Human Services Office of Inspector General (OIG) for managed care organizations. She assists clients in developing internal controls and fulfilling their obligations under high-profile CIAs and has worked with various institutions in assessing compliance program effectiveness, development and implementation, and a broad range of specific compliance risks. She has served as the Project Lead for independent review organization (IRO) engagements for national managed care organizations. She has overseen multi-team and multi-state IRO engagements and worked to facilitate complex annual work plans. Part of her responsibilities includes liaising with all stakeholders including the organization and the OIG.
She has presented on various topics such as quality of care issues and Recovery Audit Contractors. She has authored books and articles in industry and trade publications such as those of the American Health Lawyers Association and Health Care Compliance Association. Ms. Isnar’s regulatory and compliance experience in the healthcare industry included work at the New York State Office of the Attorney General in Syracuse, New York and working with a private regulatory compliance firm to perform research and analysis. Her article topics include “Taking Control of the CMS Managed Care Audit Process,” “Medicare Part D Compliance: A Day of Reckoning Approaches,” and “Verifying Compliance Program Effectiveness in Managed Care,” and “A Glimpse of the Future of Compliance Oversight by CMS: Part D Plans Cast Study.”
Previous Work Experience
Prior to joining Strategic Management, Ms. Isnar’s regulatory and compliance experience in the health care industry included interning at the New York State Office of the Attorney General in Syracuse, New York and working with a regulatory compliance firm to perform research and analysis on HIPAA related issues.