Deloitte at 2017 AHIP's National Conferences on Medicare, Medicaid & Duals

Provider Network Adequacy and Directory Accuracy

September 26, 2017 | 8:00 AM/ET | JW Marriott | Washington, DC

Session overview:

​The Centers for Medicare and Medicaid Services (CMS) has recently sharpened its focus on Medicare Advantage (MA) network adequacy and the accuracy and completeness of MA organizations' provider directories. CMS is now reviewing one-third of all organizations' directories each year and initial findings from the first round of reviews shows there is room for improvement. CMS also now requires an MA plan to submit information on its contract's entire network as part of its service area expansion application. CMS is in the process of developing and piloting a new audit module to evaluate network adequacy. CMS' increased oversight, coupled with its more frequent reviews of network adequacy, underscores the importance of having complete and accurate information about the providers in your network and a robust provider data management processes. This session will explore CMS' requirements regarding provider directory accuracy and completeness and results of recent audits. Speakers will discuss Medicare Advantage network adequacy requirements and the importance of complete and accurate health service delivery tables. Learn about the role of provider data management in supporting compliance efforts and leading industry practices.


Event details:

Date and Time:

Tuesday, Sept. 26, 2017
8:00 AM/ET

JW Marriott at 1331 Pennsylvania Ave, NW, Washington, DC 20004

Ed Vela, Health Plans Senior Marketing Manager

Learn more about AHIP National Conferences on Medicare & Medicaid and Dual Eligible Summit

Meet the leader

Lucia Giudice

Lucia Giudice

Managing Director | Life Sciences & Health Care

Lucia is Deloitte Consulting LLP’s Government Programs leader. She assists health plan clients with strategy, product implementations, policy and procedure development, performance improvement, traini... More