Medicare Advantage and Part D Changes: Benefits Flexibility, Payment Rules, and Decreased Administrative Burdens
Recording of a 90-minute CLE webinar with Q&A
This CLE course will guide healthcare counsel on significant developments to Medicare Advantage (MA) and Part D. The panel will provide an overview of the changes, discussing how these changes will impact healthcare payers. The panel will also offer insight into what payers and their counsel must do to ensure compliance with the new regulations.
- Reducing Burdens in the MA and Part D Programs
- Preclusion List
- FDR training and oversight
- Marketing and open enrollment
- Lengthening mandatory timeframes
- MLR reporting
- Benefits Flexibility for MAOs
- Uniform benefits
- Supplemental benefits
- Value-based insurance design
- Changes in MA Payment and Quality Measurement
- New Star Rating regulations
- Changes to MA risk adjustment model
- Encounter data
The panel will review these and other vital questions:
- What type of compliance training requirements does an MAO or Part D sponsor need to impose on its FDRs?
- How does the new “preclusion list” work?
- What types of health conditions can MAOs identify for targeted supplemental benefits?
- Can MAOs provide supplemental benefits that affect social determinants of health?
- How has the calculation changed for the risk adjustment model? What does it mean for MAOs and Part D sponsors?
- How has CMS changed its Quality Star Ratings policies and which changes are significant?
Mimi Moll Alexandre
McDermott Will & Emery
Ms. Alexandre works with clients across all sectors of the healthcare industry, with particular focus on providing... | Read More
Ms. Alexandre works with clients across all sectors of the healthcare industry, with particular focus on providing regulatory advice regarding managed care, provider reimbursement, and pharmaceutical and medical device issues. In this regard, she has a range of advocacy experience, including representing clients in matters before the Provider Reimbursement Review Board and drafting written comments for submission to various government agencies. Ms. Alexandre also counsels clients on transactional matters and has experience in transactions involving hospitals and health systems, insurance companies, clinical research organizations, and pharmaceutical and medical device manufacturers.Close
McDermott Will & Emery
Ms. McDonald focuses her practice on transactional and regulatory counseling for clients in the healthcare industry,... | Read More
Ms. McDonald focuses her practice on transactional and regulatory counseling for clients in the healthcare industry, with particular focus on federal and state healthcare government programs and the intersection between healthcare payors and providers. She regularly advises health insurers, HMOs, healthcare government contractors, healthcare providers and other clients on compliance with healthcare laws and regulations, particularly in connection with Medicare Advantage, Medicare Part D, Medicaid managed care, the Affordable Care Act, state insurance laws, and state licensure and professional practice regulations.Close
Annie Hsu Shieh
Senior Compliance Counsel
Central Health Plan of California
Ms. Shieh specializes in healthcare laws, reimbursement, compliance, fraud and abuse, privacy, antitrust, and... | Read More
Ms. Shieh specializes in healthcare laws, reimbursement, compliance, fraud and abuse, privacy, antitrust, and contractual issues. She develops corporate-wide policies and procedures, administers HIPAA/HITECH privacy and compliance training, conducts internal audits, investigates complaints, and interprets Centers for Medicare & Medicaid Services, Department of U.S. Health & Human Services, Office of the Inspector General, managed care, Medicare, and Medicaid regulations and guidance.Close