Agenda

 

Thursday, April 17, 2008
DAY ONE:
7:30 a.m. – 5:00 p.m.	Registration and Information
8:00 a.m. – 9:00 a.m.	Special Workshop (Open to all paid attendees.) Private-Fee-For-Service Plans: Addressing Operational Priorities and Challenges This session will address current issues related to Private-Fee-For-Service plans and highlight key PFFS program guidance for the upcoming contract year. Issues that will be discussed include but are not limited to, compliance and oversight of PFFS plans, provider education and outreach, and training and testing of brokers and agents. Moderator Candace Schaller, Senior Vice President, Federal Programs, America’s Health Insurance Plans (AHIP) Faculty David Lewis, Director, Medicare Advantage Group, Centers for Medicare & Medicaid Services
9:15 a.m. – 10:15 a.m.	General Session Welcome and Keynote Address CMS Priorities for 2009: Looking to the Future of the Part D and Medicare Advantage Programs The Medicare Advantage and Part D programs continue to deliver quality and value to Medicare beneficiaries, and the CMS Call Letter for 2009 provides key information and operational reminders that demonstrate the agency’s strategy to further this success. In this session, Abby Block will highlight CMS’ priorities for the CY 2009 contract year. Moderator Candace Schaller, Senior Vice President, Federal Programs, AHIP Faculty Abby Block, Director, Center for Beneficiary Choices, Centers for Medicare & Medicaid Services
10:30 a.m. – 11:30 a.m.	General Session Medicare Advantage and Part D Compliance and Audit Requirements Speakers will discuss CMS’ strategy for plan oversight, reviews, and compliance monitoring including strategy for site visits, audits and corrective action; development of new Medicare Advantage reporting requirements; development of new Part D quality measures; revisions to audit review guides; and compliance plan requirements. Moderator Stephen Walker, Senior Vice President, Blue Cross Blue Shield of Tennessee Faculty Christopher Eisenberg, Program Oversight and Accountability Group, Centers for Medicare & Medicaid Services
11:30 a.m. – 1:00 p.m.	Opening Luncheon Session Delivering Essential Information: Beneficiary Communications and Marketing Activities Providing timely information to Medicare Advantage and Part D plan members and prospective members is critically important to ensuring that they can take maximum advantage of their benefits. This session will address oversight of plan marketing through brokers and agents and plan marketing staff, CMS’ plans for updating and streamlining the Medicare Marketing Guidelines, as well as the agency’s efforts to improve key model and standardized materials, and streamline review and approval processes. Moderator Kathie Metzger, Senior Director, Medicare Medicaid Programs, Fallon Community Health Plan Faculty Camille Brown, Medicare Advantage Marketing Lead, Centers for Medicare & Medicaid Services Jerry Mulcahy, Director, Division of Policy, Analysis and Planning, Centers for Medicare & Medicaid Services
1:30 p.m. – 2:30 p.m.	Concurrent Session I Special Needs Plans: Meeting the Unique Needs of Special Populations Special Needs Plans have unique opportunities to implement innovative programs to meet the “special” needs of their members. Speakers will discuss CMS’ expectations for Special Needs Plans, including development and implementation of appropriate models of care for the targeted populations they serve, relationships with States, and development of quality measures. Moderator Caron R. Cullen, CHS, Vice President of Compliance and Regulatory Affairs, Affinity Health Plan Faculty Teresa DeCaro, Deputy Director, Medicare Advantage Group, Centers for Medicare & Medicaid Services Michael Fiore, Director, Division of Enrollment and Eligibility Policy, Medicare Enrollment and Appeals Group, Centers for Medicare & Medicaid Services Concurrent Session II Enrollment and Appeals Rules: What You Need to Know Speakers will highlight key enrollment and appeals policy rules under the Medicare Advantage and Part D programs as well as practical issues plans address in implementing these requirements. This session will also include a discussion of creditable coverage period determinations and the reconsideration process. Moderator Michael Burke, Director, Medicare Operations, Capital District Physicians’ Health Plan Faculty Danielle R. Moon, JD, MPA, Deputy Director, Medicare Enrollment and Appeals Group, Center for Beneficiary Choices, Centers for Medicare and Medicaid Services Lynn Orlosky, Technical Advisor, Division of Enrollment & Eligibility Policy, Medicare Enrollment and Appeals Group, Centers for Medicare & Medicaid Services Arrah Tabe-Bedward, Director, Division of Appeals Policy, Centers for Medicare & Medicaid Services
2:45 p.m. – 3:45 p.m.	General Session Payment Reconciliation and PDE Reporting This session will discuss key payment reconciliation processes that are high priorities for plans and CMS, including the Part D payment reconciliation, and plan to plan reconciliation. This session will also address the processes for submission of Prescription Drug Event (PDE) data. Speakers will discuss critical elements of CMS’ guidance and strategy in these and related areas. Moderator Julie May, Vice President, Medicare Part D Operations, Coventry Health Care Faculty Jeff Grant, Director, Medicare Payment Systems, Centers for Medicare & Medicaid Services Jim Slade, Special Assistant, Medicare Plan Payment Group, Centers for Medicare & Medicaid Services
4:00 p.m. – 5:00 p.m.	General Session Medicare Part D: Addressing Operational Priorities and Challenges CMS and Part D plans continue to work on the evolution of Part D program operations across a spectrum of issues including, benefit design, formulary review and approval, and other issues. Speakers will highlight current CMS requirements as well as requirements for the CY 2009 contract year. Moderator Bob Donnelly, Vice President, Public Policy and Regulatory Affairs, Universal American Faculty Judy Geisler, RPh, Director, Division of Finance and Operations,Medicare Drug Benefit Group, Centers for Medicare & Medicaid Services Vikki Oates, Director, Division of Clinical and Economic Performance, Medicare Drug Benefit Group, Centers for Medicare & Medicaid Services
5:00 p.m. – 6:00 p.m.	Conference Reception
Friday, April 18, 2008
DAY TWO:
7:30 a.m. – 1:30 p.m.	Registration and Information
8:30 a.m. – 9:30 a.m.	General Session CY 2009 Medicare Advantage Plan Benefit Package Requirements Speakers will address Medicare Advantage CY 2009 benefit design requirements, including cost sharing package requirements, and Plan Benefit Package (PBP) changes. Moderator Kim McDonnell, Vice President, Medicare Regulatory Affairs, Wellcare Faculty Jane W. Andrews, MA, MHS, Director, Division of Benefits, Medicare Advantage Group, Centers for Medicare & Medicaid Services
9:45 a.m. – 10:45 a.m.	General Session Updates and Changes: CY 2009 Medicare Advantage and Part D Bidding and Negotiation Procedures and Requirements Speakers will discuss CY 2009 MA and Part D bidding rules and requirements, including rebate re-allocation, negotiation, and audit issues. Moderator Debbie Sather, Executive Director, Medicare Finance, Group Health Cooperative Faculty Paul Spitalnic, Director, Parts C & D Actuarial Group, Centers for Medicare & Medicaid Services
11:00 a.m. – 12:00 p.m.	General Session MA and Part D Risk Adjustment Models and Payment Issues This session will focus on key issues regarding ongoing implementation of the Medicare Advantage and Part D risk adjustment models and changes in the payment methodologies for the 2009 contract year. Moderator Kris M. Hopko, Senior Manager, Health Partners, Inc. Faculty Sean Creighton, Medicare Plan Payment Group, Centers for Medicare & Medicaid Services Tom Hutchinson, Director, Medicare Plan Payment Group, Centers for Medicare & Medicaid Services
12:15 p.m. – 1:30 p.m.	Closing Luncheon Session Employer Group Plans: Part D and Medicare Advantage Opportunities This session will focus on the key rules and requirements applicable to Medicare Advantage and Part D plans offered to employer and union groups, including the broad range of employer group waivers approved by CMS. Moderator Amy B. Hafey, JD, Senior Counsel, Legal and Government Relations Department, Kaiser Foundation Health Plan, Inc. Faculty Brenda Tranchida, Director, Employer Policy and Operations Group, Centers for Medicare & Medicaid Services
1:30 p.m.	Adjournment