About This Webinar
CMS is implementing numerous compliance changes for plan year 2025 that will impact Medicare Advantage plans. CMS Program Audits and Utilization Management Compliance Audits for Medicare Advantage (MA) Plans will likely focus on several critical areas. Our session will examine the key focus areas and lessons learned from 2024 that are likely to continue in 2025.
In addition, The Inflation Reduction Act of 2022 includes several important changes that need to be operationalized in 2025. "The Medicare Prescription Payment Plan" (M3P) requires plans to offer enrollees the option to pay out-of-pocket prescription drug costs in the form of capped monthly installment payments instead of all at once at the pharmacy. Plans will need to identify, track, and communicate all aspects of this to the member, the pharmacy, and CMS.
Join our interactive panel featuring industry experts as we explore the latest regulatory requirements. This session will highlight essential compliance updates, revisions to universe tables, and critical information regarding appeals and grievances. Designed specifically for compliance and appeals leaders, this is your chance to position your organization for success in 2025.
Attendees Will Learn About
- What to proactively review for internal audits and monitoring for compliance with the 2025 CMS Final Rule and Preparing for Prior Authorization Utilization Management Audits
- What to expect for ODAG Table 7 (unpublished) for those who did not have a Program Audit in 2024
- How to operationalize the Medicare Prescription Payment Plan (M3P) in your Appeals & Grievances department
