Rise

Medical directors and other executives from health plans and hospital networks that work with CMS and offer Part D benefits, executives in such areas as:

• Compliance
• Pharmacy operations
• Finance
• Vendor management
• FDR/ delegation oversight
• Coverage determinations, appeals, and grievances review
• Medicare auditing
• Information technology
• Claims and prescription drug event management

Pharmacy Benefit Managers (PBM) :

• Claim approvals/denials
• Compliance
• Claim and prescription drug event management
• Pharmacy operations

Other Professionals :

• CMS audit consultants
• CMS audit validation consultants
• Compliance auditors
• Legal consultants
• Data management/ software providers
• Health law attorneys

Join RISE for in-depth peer discussions and 18 well-structured, practical sessions offering expert advice on how to handle new CMS guidelines and regulations. Come with your peers to divide and learn more during two concurrent tracks covering delegation oversight, audit readiness, opioid management, and financial considerations.  

• Assess opioid management policies, protocols, and programs being deployed – and what’s working
  
  
• Understand the different PBM models and the impact to your contract strategy
  
  
• Identify common and surprising audit pitfalls
  
  
• Learn how various plans review cases and make coverage determination calls
  
  
• Discuss how to prepare immaculate universe data
  
  
• Gain insight from first-hand experience of recent audits
  
  
• Identify the most common Medicare noncompliance issues for MTMs and how to fix them
  
  
• Get concrete tools, benchmarks, best practices, and case studies of what works, as opposed to generalized information