Learning Objectives:
- Identify longstanding policy clarified by 2024 Medicare Advantage Final Rule policy
- Recognize MA plan requirements reinforced by 2024 Medicare Advantage Final Rule
- Describe the circumstances when MA plans can develop their own internal coverage criteria to make medical necessity determinations
- Describe the restrictions surrounding how MA plans may develop coverage criteria in the limited circumstances in which they are permitted
- Discuss common scenarios when internal criteria are used, common payor interpretations and guidance from the Final Rule
- Discuss strategies to respond to MA plan improper coverage criteria use
Speaker:
Richelle Marting, Attorney
Release Date: 06/26/2024
On-Demand Access Available: 06/27/2024
CCB CEUs: Up To 1.5
CCB Continuing Education UnitsThis webinar and on-demand recording has been approved for CCB CEUs. Once you complete your participation either in person or the recording you will receive a certificate with a code that you can use to claim your CEUS on the SCCE & HCCA portal. Learn More about Certification
NASBA/CPE: The Health Care Compliance Association is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE sponsors for group-live activity in the recommended field of study of Specialized Knowledge. Sponsor Identification No: 105638.
Only live webinars are approved and will generate NASBA CPE certificates. The education level for this activity is considered basic. No prerequisites are required for this education. On demand (non-live) learning will not have NASBA CPE offered.
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Purchase Options |
Members | Non-Members |
| Live Webinar | 49 | 99 |
| On-Demand | 49 | 99 |
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