Medicare Advantage and Prescription Drug Plan Compliance and Oversight

, , Babette Edgar

Helaine Fingold, Senior Counsel, Lynn Shapiro Snyder, Senior Member of the Firm, and Babette Edgar, a Strategic Advisor at EBG Advisors, will present "Medicare Advantage and Prescription Drug Plan Compliance and Oversight," a webinar hosted by Health Plan Alliance MAC. 

This webinar will discuss the unique risks of having the federal government as a customer, including the range of federal enforcement tools used by CMS, DHHS OIG, and the Department of Justice, for noncompliance by the health plan or by one of the health plan's first tier, downstream, or related entities. Speakers will also discuss effective risk management tools, with a focus on effective auditing and monitoring of compliance, including how to prioritize areas for auditing and monitoring, as well as addressing those areas that have been the focus of recent federal enforcement activities. Finally, the speakers will discuss actions Medicare Advantage plans should take before CMS audits them, and upon identifying potential non-compliance. 

This presentation is designed to assist attendees in:

  • Understanding CMS’s and other federal stakeholders’ compliance and enforcement tools, targets, and historical actions
  • Structuring and prioritizing plan compliance activities and what a plan should be doing to prevent CMS Corrective Action Plans and sanctions