Name
Medicare Advantage: Government Oversight, Key Contract Terms, and Securing Contracts
Description
Beginning in the 1970s and continuing up to about 15 years ago, DME suppliers focused on billing traditional Medicare. This has changed. Today, about 54% of Medicare beneficiaries are covered by Medicare Advantage Plans (“MAPs”) …and this percentage will continue to increase. In working with MAPs, not only must suppliers be aware of Medicare regulations, they must also navigate the rules imposed on them by the MAPs themselves. This program will focus on the most important issues faced by DME suppliers in the Medicare Advantage space, including: (i) how federal and state government oversight of MAPs is increasing, (ii) steps that suppliers can take in response to unfair tactics by MAPs, (iii) the most important provisions in managed care contracts, and (iv) steps that a DME supplier can take to increase its odds of being added to a managed care panel.
Proposed Learning Objective (1)
Analyze the increased state and federal governmental scrutiny of Medicare Advantage Plans.
Proposed Learning Objective (2)
Identify the steps to take when a Medicare Advantage Plan engages in unfair tactics.
Proposed Learning Objective (3)
Evaluate the most important provisions in a contract with a Medicare Advantage Plan.
