Description
Medicare providers and beneficiaries have long grappled with challenges associated with Medicare Advantage (MA) plans. In 2024, the Centers for Medicare & Medicaid Services (CMS) implemented a final rule aimed at elevating care standards for beneficiaries and alleviating burdens on providers. This pivotal action represents a significant shift in the landscape of MA and Part D.
Join us for an in-depth exploration of the key highlights of the 2024 final rule. Our discussion will encompass critical elements, including the limitation of MA plans' internal coverage determinations, the establishment of new authorization standards, and the implementation of oversight protocols for utilization management programs and AI integration. These changes mark a paradigm shift in health care delivery, fostering enhanced efficiency and effectiveness.
Additionally, we will delve into the updated benefits under Part D and their positive implications for beneficiaries. We'll also scrutinize potential modifications that CMS is considering to optimize MA plan operations. Don't miss this opportunity to gain profound insights into the evolving landscape of MA and Part D and how these transformative changes are shaping the future of home care. Dream, believe, and achieve with us as we navigate the path forward together.
Speakers/Course Authors - Nanette Smith
Objectives
Course Objectives:
-
Attendees will be able to express how the new authorization rules and utilization guidelines are being applied to Medicare Advantage plans.
-
Attendees will be able to identify how the Medicare Advantage plans may review and audit post-payment claims.
-
Attendees will be able to recognize inappropriate marketing tactics employed to sell Medicare Advantage plans and strengthen network adequacy.
-
Attendees will be to infer the changes to Part D benefits and the new low-income subsidies making prescriptions more affordable.
-
Attendees will recognize upcoming rules that CMS is considering regarding Medicare Advantage plans.
Certificate
By completing/passing this course, you will attain the certificate HCAF Course Certificate
Learning credits
Shopping Cart
Your cart is empty