Three MA Experts to Explain CMS’s New and Revised Network-Adequacy Initiatives in Nov. 15 AIS Webinar
Atlantic Information Services, Inc. (AIS) - November 4, 2016 - Washington, DC

In recent years, provider-network adequacy has become a top-tier regulatory priority for both CMS and many states, and it has a major bottom-line impact on Medicare Advantage (MA) and Medicaid plans. In “CMS’s Crackdown on Network Adequacy: Strategies for Medicare Advantage and Medicaid Insurers,” an upcoming webinar from Atlantic Information Services, Inc. (AIS), three experts from a variety of organizations will analyze the implications of heightened regulatory activity for both MA and Medicaid plans, and offer strategies to deal with them.

In this Nov. 15 program, Michael Adelberg, Senior Director at FaegreBD Consulting, Helaine Fingold, a Senior Counsel in the Health Care and Life Sciences practice at Epstein Becker Green, and Michelle Kitchman Strollo, DrPH, Associate Director at NORC’s Health Care Department, will offer valuable guidance on key questions such as:

  • What new requirements are being deployed by federal and state regulators to assure provider-network adequacy and transparency in Medicare Advantage and Medicaid?
  • To what extent are government and private researchers, empowered by mapping software and newly required “machine readable” provider directories, gaining major new insights into provider networks?
  • How has CMS started to enforce the requirement that insurers reduce problems with inaccuracies in provider directories? What steps should plans take to meet the standards?
  • How has CMS started using its authority to reject service-area expansions unless MA plans either improve network adequacy in “legacy” counties or withdraw from those counties with network-access problems?
  • To what extent will CMS allow higher-quality, smaller networks to be a substitute for larger, lower-quality ones? What other measures of provider-network size and performance might CMS consider?
  • To what extent will CMS permit telehealth to be used in network-adequacy determinations for MA and Medicaid plans?
  • What new network-adequacy reporting requirements is CMS imposing — in 2016 and 2017 — including dealing with midyear, no-cause provider terminations? How should plans change their processes in response?
  • What will the final Medicaid managed care rule’s first-ever federal mandate for state network-adequacy standards regarding time and distance mean for Medicaid plans? What steps should they take to comply?

Visit https://aishealth.com/marketplace/c6a25_111516 for more details and registration information.

About AIS
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for nearly 30 years. It develops highly targeted news, data and strategic information for managers in hospitals and health systems, health insurance companies, medical group practices, purchasers of health insurance, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, databases, websites, looseleafs, strategic reports, directories, webinars, virtual conferences and training programs. Learn more at http://AISHealth.com.

Contact
Atlantic Information Services, Inc.
Shelly Beaird-Francois
sbeaird-francois@aishealth.com
202-775-9008 ext. 3064

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