Medicare Advantage and Part C and D Primer

Healthcare attorney Melissa Wong will be a speaker at the American Health Law Association Fraud and Compliance Forum in a session titled "Medicare Advantage and Part C and D Primer." Whether you are brand new to Medicare managed care or just need a refresher, this session will provide an overview of the basic structure and reimbursement mechanism of the Medicare Advantage/Part C and Medicare Part D programs, while focusing on key areas that are critical in addressing fraud, waste and abuse concerns. Topics will include:

• Medicare Parts C and D plan benefit design, required coverage and supplemental benefits, utilization management tools
• managed Medicare risk-sharing principles, including Medicare Advantage (MA) risk adjustment and Part D risk corridors, coverage gap and catastrophic coverage
• current trends and new developments in MA and Part D, including prescription drug provisions in the Inflation Reduction Act of 2022 
• Centers for Medicare and Medicaid Services (CMS) audit areas and risks affecting MA and Part D, such as coding issues, improper sales and marketing practices
• things to know (and common misconceptions) about fraud and compliance in the MA and Part D space