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Compliance Insights December 2013

In this issue of Compliance Insights, we bring you important regulatory information from recent HPMS memos and other sources including:

  • Part C Reconsideration Dismissal Procedures – Required Model Dismissal Notice Now Available
  • CMS educational session for Medicare Advantage (MA) organizations offering Special Needs Plans (SNP) on January 13, 2014
  • CMS request for comments on the updates to Chapter 5 of the Medicare Managed Care Manual
  • CMS request for comments on the proposed enhancements to the Star Ratings for 2015 and beyond, including a detailed summary of the proposed enhancements and changes
  • HHS request for comments on the proposed Quality Rating System for Qualified Health Plans offered through Exchanges
  • CMS request for comments on the Comprehensive Medication Review (CMR) standardized format (MTM Program)
  • Updates to the 2013 Part D Reporting Requirements and Overutilization Monitoring Systems (OMS)
  • 2014 Readiness Checklist, specifically Daily Cost Sharing and Auto-Ship Refill Programs

To read more please click here.

Marc Ryan

Marc S. Ryan serves as MedHOK’s Chief Strategy and Compliance Officer. During his career, Marc has served a number of health plans in executive-level regulatory, compliance, business development, and operations roles. He has launched and operated plans with Medicare, Medicaid, Commercial and Exchange lines of business. Marc was the Secretary of Policy and Management and State Budget Director of Connecticut, where he oversaw all aspects of state budgeting and management. In this role, Marc created the state’s Medicaid and SCHIP managed care programs and oversaw its state employee and retiree health plans. He also created the state’s long-term care continuum program. Marc was nominated by then HHS Secretary Tommy Thompson to serve on a panel of state program experts to advise CMS on aspects of Medicare Part D implementation. He also was nominated by Florida’s Medicaid Secretary to serve on the state’s Medicaid Reform advisory panel.

Marc graduated cum laude from the Edmund A. Walsh School of Foreign Service at Georgetown University with a Bachelor of Science in Foreign Service. He received a Master of Public Administration, specializing in local government management and managed healthcare, from the University of New Haven. He was inducted into Sigma Beta Delta, a national honor society for business, management, and administration.

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