New CMS Medicare Advantage Final Rule: Beneficiary Data, Agent Compensation, Behavioral Healthcare Access, and More
Recording of a 90-minute CLE video webinar with Q&A
This CLE webinar will guide healthcare practitioners through the Centers for Medicare & Medicaid Services' (CMS) CY 2025 Medicare Advantage and Part D final rule, effective Oct. 1, 2024, that significantly updates CMS policies to promote competition and equity in coverage, increase access to behavioral health services, protect individuals from inappropriate marketing, and improve supplemental benefits. The panel will offer best practices for navigating the final rule's requirements.
Outline
- Introduction
- Medicare Advantage Part C and Part D prescription drug plan marketing
- Agent and broker compensation
- Distribution of personal beneficiary data by TPMOs
- Improving access to behavioral healthcare providers
- Supplemental benefits
- Mid-year enrollee notification of available supplemental benefits
- New standards for special supplemental benefits for the chronically ill
- Annual health equity analysis of utilization management policies and procedures
- Other changes
- Practitioner takeaways
Benefits
The panel will review these and other important considerations:
- How does the final rule encourage competition?
- What impact will the final rule's requirements related to administrative fees and capped compensation have on agents/brokers?
- What is the status of the recent lawsuits filed to challenge these regulatory changes?
- In what ways does the final rule promote equity and access to healthcare?
- How will the final rule's requirements improve supplemental benefits available to enrollees?
- What are best practices for navigating the final rule's requirements and ensuring compliance?
Faculty
Christina Bergeron
Partner
Ropes & Gray
Ms. Bergeron provides strategic business and regulatory counsel to prominent health care and private equity... | Read More
Ms. Bergeron provides strategic business and regulatory counsel to prominent health care and private equity clients. She regularly advises on complex transactions across a wide range of health care industry sectors. Ms. Bergeron has been advising clients on a range of issues associated with the pandemic, including navigating financial relief provisions for health care providers under the Coronavirus Aid, Relief, and Economic Security Act (CARES Act).
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Helaine I. Fingold
Member
Epstein Becker & Green
Ms. Fingold’s practice focuses largely on the regulation of Medicare managed care (including Medicare Advantage,... | Read More
Ms. Fingold’s practice focuses largely on the regulation of Medicare managed care (including Medicare Advantage, Part D, dual eligibles, PACE, demonstrations), Medicaid managed care, commercial managed care products (including surprise billing), and behavioral health (including mental health parity). Her clients range from small start-ups to large corporate entities with multiple subsidiaries. They include Medicare Advantage, PACE, Medicaid, and other managed care plans; provider entities; vendors to providers and managed care companies (including administrative support entities, providers of software and online services, agents/brokers/field marketing organizations, and advertising/marketing entities). Before building her private practice, Ms. Fingold gained 20 years of experience in the federal government: 13 years at CMS, working on Medicaid, Medicare Advantage/Part D, and ACA implementation, and seven years at MedPAC.
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