No other subject raises the ire faster among providers than a discussion of Medicare Advantage Plans. Day after day, in email exchanges, conference calls, and provider listserves there's a barrage of complaints about the egregious behavior by some Medicare Advantage Plans. And, in too many cases, the common rejoinder— "it's in the contract." And the problem is likely to acerbate with the growth of Medicare Advantage Plans. The Henry J. Kaiser Family Foundation reports that in 2019, one-third (34%) of all Medicare beneficiaries – 22 million people – are enrolled in Medicare Advantage plans. One industry expert, Andrew Kadar of L.E.K. Consulting, was quoted in Forbes saying that Medicare enrollment will rise to 38 million or a 50% penetration by the end of 2025.
That is why this exclusive RACmonitor webcast, led by Laurie Hartman, JD, a subject matter expert on managed care contracting, is the best last resort to leveling the playing field when it comes to negotiating with Medicare Advantage Plans. This presentation will provide an overview of what Medicare Advantage plans are, how they compare to coverage offered through the original Medicare program, regulatory content that the plans must include in provider agreements, the role that preemption plays in determining the applicability of state laws, and common contract terms that are negotiable.
You will better understand which laws, regulations and other sources of regulatory requirements govern these plans and, importantly, when and how these plans can make changes to their contracts or operations. Also during this webcast, you will learn about requirements relating to First Tier, Downstream and Related Entities (FDR) compliance training and to disclosures of ownership and control. The goal of this webcast is to help you understand the limitations inherent in the contracting process so that you are better equipped when you come to the negotiation table.
Why This is Relevant:
This timely and crucially important webcast is relevant in that it helps hospitals better understand the legal requirements in a Medicare Advantage plan; and allows hospitals to proactively discuss these agreements, instead of treating it as a take-it-as-is proposition that goes along with negotiation of the commercial plan.
As a result of your attending this webcast led by Laurie Hartman, you will…
- Understand what a Medicare Advantage plan is;
- Learn how Medicare Advantage plans are regulated;
- Know how to identify required provider contract regulatory content;
- Learn the limitations in the contracting process; and
- Understand the opportunities relating to negotiable terms.
Who Should Attend:
Those who are most likely to benefit from this important webcast include chief financial officers; hospital administrators, physician advisors, in-house counsel, RAC coordinators, and appeal specialists and the contracting/managed care contracting staff.