Managed Care and Medicare Part D Forum

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    MA Consultants

    Good afternoon, all. I am looking for a consulting group that can help stand-up a new MA plan in an existing MCO as well as help with a future application to renew its MCO contract with the State. All suggestions will be appreciated! Mike ...

  • Is there anyone that has knowledge of I-SNPs that would be available for me to pick your brain?  I have a few questions regarding the Compliance Risk Assessment process. ------------------------------ Stefani Geter Compliance Program Manager American ...

  • Hi Karen, We are a Health Plan, but for government exclusions checking, we check our Medicare Advantage First Tier Entity vendors as organizations prior to contracting and monthly. We then require them, via an annual attestation, to check their employees, ...

  • Hi Team,  Medicare compliance program guidelines (MMCM Ch.21) require pre-contractual and monthly OIG/GSA screenings of downstream entities. When the contracting party is a vendor, we screen the vendor. When the contracting party is a provider group/practice ...

  • Hello, The DV Training has been posted and is now available. ​The 2021 Data Validation web-based training is available on cms.gov on the MLN page: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-NetworkMLN/MLNProducts/WebBasedTraining   ...

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