fbpx
Icon of person sitting at computer desk

Date

10/08/2026

-

10/08/2026

Location

CATEGORY

Join Our Webinar: What Regulators Want Health Plans to Understand About AI

Historically, network adequacy meant meeting a filing requirement and passing a periodic review but that’s no longer how state regulators see it. Attestations have given way to continuous, data-driven accountability, and artificial intelligence is already shaping how regulators review networks and how health plans should be building them.

A new survey of 103 payer executives, conducted by Becker’s Healthcare and Quest Analytics, reinforces that health plans see AI as critical to network adequacy and accuracy: network accuracy and directory integrity ranked as the single highest priority for AI investment over the next one to three years.

Join us for a candid conversation about where regulatory oversight of network adequacy is headed, and what AI can and cannot do to help health plans keep up. You’ll hear directly from a regulator’s perspective on what’s actually driving more frequent reviews, where AI genuinely accelerates better decisions, and where it can’t replace judgment or accountability.

Walk away with a clearer view of what regulators expect today, where the guardrails around AI in network management are heading, and practical steps to build a data foundation that holds up over time, not just for the next filing.

Attendees Will Learn

  • Why regulators now treat compliance as the floor, not the ceiling, and what’s replacing it as the real bar
  • Where AI genuinely helps regulators and health plans catch problems faster, and where it can’t replace human judgment or accountability
  • What’s driving increased regulatory review activity, and the data trends behind it
  • How to build a higher-fidelity data foundation that holds up over time

Presenters

Eric Headshot Picture

Eric Roberts

Director of Targeted Oversight, SC Department of Health and Human Services

Eric Roberts is a Medicaid operations leader with experience in managed care oversight, network adequacy, and regulatory compliance. He currently serves as Director of Targeted Oversight for South Carolina DHHS, where he leads oversight of five Managed Care Organizations, focusing on encounters processing, provider network performance, provider disputes, subcontractor arrangements, and member grievance and appeals.
Previously, Eric supported statewide regulatory monitoring and major oversight procurements for SCDHHS, advancing CMS aligned initiatives and data driven methodologies that strengthened transparency and plan accountability. His background also includes hospital operations leadership at MUSC Florence Medical Center, where he contributed to ICU expansion, CMS TEAMs quality initiative, and emergency management operations.
Eric holds a Master of Health Administration from the Medical University of South Carolina and a BA from the University of South Carolina Aiken. He is committed to building thoughtful, collaborative oversight approaches that improve access, strengthen accountability, and support better outcomes for Medicaid members.
ScottCal-211208

Scott Westover

Chief Corporate Development and Government Business Officer, Quest Analytics

Scott is a seasoned executive with deep experience across the payer, provider, and regulatory space. Most recently, he served as market president for AmeriHealth Caritas New Hampshire, where he led the plan’s strategic direction, growth, and leadership. His prior experience includes working at Anthem, Inc. as a vice president of provider joint ventures and national accounts, and he has also held senior roles within leading healthcare providers, directing a Medicaid health plan, and driving national health strategy for multiple Fortune 50 corporations.

Recommended Resources

The Totally Adequate Podcast
Initiating conversations on the latest trends, network adequacy and provider data accuracy policy updates, and healthcare provider network management innovations. Subscribe to The Totally Adequate Podcast Spotify Apple Youtube How...
-
Days
-
Hours
-
Minutes
-
Seconds