Managed Care

32 Entries
 
 
7 months ago
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one year ago
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10 years ago
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This tool is designed to engage operational managers in developing departmental auditing/monitoring metrics.

#Communication #InternalControls #HealthCare

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10 years ago
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#Government #partD #Medicare #medicarepartD #HealthCare #managedcare

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12 years ago
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Overview:
• CMS Compliance/Oversight Structure
• Oversight Strategy
• Oversight Activities
• Alignment of Audit Approach
• Statutory & Regulatory Updates
• Compliance Plans/Programs
• ...

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12 years ago
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Topics:

-Key recent developments in federal criminal and civil investigations and enforcement

-Key areas of concerns and risk

-Impact of these developments on your compliance ...

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12 years ago
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Table of Contents
I. Introduction and Overview 2
II. Enrollment and Disenrollment 5
III. Marketing Guidelines 12
IV. Low Income Subsidy (LIS) Provisions 23
V. PBM Delegation and ...

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12 years ago
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Contents:
Important Notes
The Well-Intentioned Whoops
Separating Fact From Fiction
Question Authority
Example 1
Audit Results
“If it isn’t written, it wasn’t done.”
Role of ...

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12 years ago
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Overview:
• New CMS Compliance/Oversight Structure
• Oversight Strategy
• Oversight Activities
• Alignment of Audit Approach
• Statutory & Regulatory Updates
• What’s on the Horizon?


#D ...

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12 years ago
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The Centers for Medicare & Medicaid Services (CMS) has received numerous inquiries regarding the changes to 42 C.F.R. § 422.503(b)(4)(vi) and 42 C.F.R. § 423.504 (b)(4)(vi) that became ...

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