Jul 6, 2023 | Legislative Update
Here is a summary of legislative and regulatory developments and challenges for the second quarter of 2023 and their practical implications:
State Consumer Privacy Laws:
Several states (CO, CT, FL, IA, IN, MT, OR, TN, TX & UT) enacted consumer privacy laws, joining California and Virginia, whose legislation was described in earlier Legislative Updates. These statutes follow a pattern:
Requirements:
Adoption of reasonable administrative, technical, and physical data security practices to protect the confidentiality, integrity, and accessibility of personal data.
Effective notice to consumers plus consumer consent regarding non-transactional uses of consumers’ personal data, including selling to third parties.
Prompt compliance with consumers’ requests to review or delete personal data.
Applicability thresholds: Applies to companies that annually control or process data of a large number (typically 100,000) state residents or annually sell data of a large number (typically (25,000) state residents and derive a significant part of their revenue (typically 50%) from these sales.
Protected class: Applies only to “consumers” who are natural persons acting in their individual or household context, excluding natural persons acting in a commercial or employment context.
Exemptions: Not subject to the laws are financial institutions that are regulated by the Gramm-Leach-Bliley Act and sensitive personal information that is subject to HIPAA
Implications: Recent statutes have been enacted in both conservative and progressive states, suggesting that these measures may have bipartisan support for adoption of similar laws in additional states. And while these statutes have similarities, there are a few that are distinctly different. For example, the Florida Digital Bill of Rights, while targeting large companies engaging in automated consumer marketing or software app sales, requires a broad range of companies that collect information from Florida residents to obtain consumers’ consent before selling sensitive data. The Texas Data Privacy and Security Act, as another example, broadly applies to all for-profit companies that process or sell personal data and which are not classified as a “small business.”
Relaxation of Nevada In-State Records & Claim Administration Requirements:
In what must be a relief to claim managers, the Nevada legislature recently removed a statutory requirement that WC insurers and TPAs maintain an in-state claim office in order to provide access to claim files, which must be physically maintained at that office. Senate Bill 274, signed by Governor Joe Lombardo on June 16, permits claim handlers to make claim files available for inspection and reproduction by electronic means and to keep physical claim records at a location outside Nevada if those records are made available electronically for inspection and reproduction.
Implications: The new law makes clear that claim office accessibility requirements have not been relaxed: adjusters who are permitted to work from an-out-of-state location must maintain their availability “to communicate in real time with the claimant or a representative of the claimant Monday through Friday, 9 a.m. to 5 p.m. local time in this State” excluding legal holidays. Further, the measure empowers the Insurance Commissioner to discipline TPAs who don’t comply with the new out-of-state access requirements. The statute takes effect January 1, 2024, except that rulemaking entities can adopt rules for implementation immediately.
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Jun 7, 2023 | Company News
Learn about Aubrie’s award-winning success:
Background
As Senior Vice President of Pricing and Business Intelligence, Aubrie Cunningham is the data analytics expert of MedRisk, the leading provider of managed physical medicine services for the workers’ comp industry and related market sectors.
Cunningham joined MedRisk as a Customer Service Professional in November 2013, a little over nine years after completing her Bachelors of Health Science from Drexel University in Philadelphia, PA. During this time, she was also obtaining her Master of Health Administration (MHA) with a concentration in Health Informatics at St Joseph’s University.
Shortly after, Cunningham moved into the role of Account Representative, supporting the executive account management team through data, analytics and reporting. During this time, she became more involved with a variety of client-facing projects and meetings, helping handle one of the company’s largest clients. In July 2015, she moved into a position as a Junior Process Engineer.
In the years that followed, Cunningham developed the Reporting team from a task-based team of three people to a business unit consisting of over 20 people from the US and overseas, specializing in Consultative Analytics and Business Intelligence. She was named Employee of the Year in 2019.
With her in-depth knowledge on the business, its processes, and workflows and her experience across multiple departments, Cunningham grew at an accelerated trajectory, allowing her to expand her role quickly from Supervisor, to Manager, to Director, to Vice President, and ultimately, Senior Vice President.
Today, Cunningham leads MedRisk’s department of data experts, a fundamental team that helps the organization make strategic business decisions based on data and trends.
Client Service
As Senior Vice President of Pricing and Business Intelligence, Aubrie Cunningham fully supports an international operation of over 1,000 employees for an organization that generates over $700M in revenue. As part of this role, she also spearheads the development and support of all internal analytics projects including day-to-day business support reporting, workflow and process transparency reporting, issue resolution reporting, trends reports, all client/provider pricing reports, revenue/margin/financial reporting, and health of organization reports.
In addition to internal projects, Cunningham is also the driving force behind the development and support of all external analytics projects. This includes stewardship presentations, an annual probe into each MedRisk client’s portfolio, evaluating performance, identifying trends, and determining opportunities. Moreover, she leads the creation of monthly/quarterly/annual performance reporting packages, trending details, and additional opportunity/leakage reporting.
Across the different roles she held in the organization, Cunningham has been actively involved in external client meetings, where she brings in an analytics approach on metrics being presented and discussed. By constantly working directly and engaging with clients, she is able to identify their specific reporting needs and gaps in metrics. In addition, she provides each of them with consultative support, allowing clients to expand their business intelligence dashboards as a method to better provide transparency for their program.
Expertise
Throughout her career in MedRisk and as its current principal resource in data and analytics, Aubrie Cunningham has been instrumental to the growth of the organization’s reporting capabilities.
With the intention of having a dedicated “one-stop shop” for MedRisk’s internal and external businesses, she led the formation and support of the company’s business intelligence unit. Working together with this team, Cunningham paved the way for the creation of several business intelligence dashboards that have been pivotal in providing insights for strategic decisions for clients. Among the dashboards developed were for Revenue Operations Insights (start-to-finish transparency into revenue operations cycles with distribution of work to employees and performance metrics), Provider Management Insights (provider monitoring including health of client, trends, and outcomes), Financial Reporting Metrics (supporting the organization’s Finance and Executive team in identifying trends, financial metrics, and decision-making), Account Management Performance Dashboard (insurer/TPA/employer monitoring including health of client, trends, and outcomes), Human Resources Insights (employment, tenure, and performance), Core Operations Insights (start-to-finish transparency into core operations cycles with distribution of work to employees and performance metrics), and KPI Insights (full internal business insights).
Furthermore, Cunningham advanced the addition of data science roles within MedRisk and improved modeling/predictive capabilities, including the creation of its Patient Risk Scoring model and Provider SmartMatch model.
Leadership
In her nine years with MedRisk, Aubrie Cunningham has had a successful journey across various roles and departments, including operations, account management, and IT. Joining the company first as a Customer Service Professional, she later moved on into the roles of Account Representative, Junior Process Engineer, Supervisor of Data Analytics, Manager of Data Analytics, and ultimately, as Senior Vice President of Pricing and Business Intelligence.
Across the different roles she held, Cunningham displayed exemplary performance. Her experiences as a Customer Service Professional, Account Representative, and Junior Process Engineer contributed to building her knowledge of the business, creating a solid, well-versed foundation that allows her to view projects with multiple lenses.
As she moved on to larger roles as Supervisor of Data Analytics, Manager of Data Analytics, and now, as MedRisk’s Senior Vice President of Pricing and Business Intelligence, Cunningham has utilized her expertise and business acumen to manage multiple teams and pilot several successful projects. From report provision, to gap and opportunity identification, to consultative support for both internal and external clients, she has made great contributions to creating the structure for the organization’s data capabilities and expanding them in the long run.
Today, Cunningham serves as the forefront of the MedRisk’s growing data team and supports an international operation of over 1,000 employees and numerous external partners. Grounded in strong business knowledge and her sharp analytical approach, she continues to lead with clear purpose and strategy in mind.
Apr 6, 2023 | Uncategorized
MedRisk is sponsoring the 2023 Kids’ Chance of America National Conference, May 4-6, 2023.
At the 2023 Kids’ Chance of America National Conference, representatives of state Kids’ Chance organizations will learn best practices and strategies for raising scholarship funds, increasing student engagement, managing a non-profit, marketing, and establishing corporate partnerships. Attendees will also meet scholarship recipients and hear their stories.
The 2023 Kids’ Chance of America National Conference will be held at The Alexander Hotel in Indianapolis, Indiana on May 4-6. More information is available here.
About Kids’ Chance of America
Kids’ Chance of America is a 501(c)(3) organization that provides a forum for state Kids’ Chance organizations to discuss best practices, share resources, and collaborate on projects at a national level. There are 43 state organizations, and collectively, Kids’ Chance organizations have awarded more than 6,500 scholarships across the country, totaling over $20 million. For more information, please see www.kidschance.org.
About MedRisk
Based in King of Prussia, Pennsylvania, MedRisk is the largest managed care organization dedicated to the physical rehabilitation of injured workers. One of the Inc. 5,000 fastest growing companies, MedRisk counts over 162,000 providers in its network and serves over one-half million injured workers every year. The company holds direct contracts with more than 90 percent of the nation’s top workers’ compensation insurers and third-party administrators. MedRisk, which has successfully completed a SSAE 16 Type II examination, ensures high quality care and delivers outstanding customer service. To that end, all customer service professionals, healthcare advocates and physical therapists are based in the U.S. For more information, visit www.medrisknet.com or call 800-225-9675.
