Are You Ready for the 2018 CMS Application Process?
The CMS application process is not for the faint of heart. Although CMS has shown efforts to streamline the process, it continues to be one mired in detail, precise documentation, and non-negotiable deadlines (even down to the minute!). Most applicants struggle to provide complete and appropriate documentation, in the form and content that CMS requires. Learn best practices for ensuring your 2018 application is submitted according to CMS’ exacting standards, thereby maximizing the opportunity for CMS approval. Hear from UL’s partner, Medicare Compliance Solutions, who are seasoned veterans of the application process for the past 20+ years and have successfully navigated numerous clients through this complex process.
This webinar will cover the current CMS application process:
CMS Timeline: CMS deadlines, description of the CMS review process, best practices for meeting timeline.
- Required documentation: what CMS is looking for
- Network requirements: understanding CMS network adequacy requirements, discussion of the tools CMS uses to evaluate network adequacy, completing the Health Services Delivery (HSD) tables; testing HSD tables in the Network Management Module (NMM) in the Health Plan Management System (HPMS), completing exception requests.
Julie Mason, Principal
MCS co-founder Julie Mason began her Medicare career more than twenty-five years ago when she joined the Centers for Medicare and Medicaid Services (then HCFA, the Health Care Financing Administration) in the Washington, D.C. office. In 1992, she joined CMS’s San Francisco Regional Office, where she spent the next 16 years as a leader in the Medicare managed care division. Julie has developed extensive knowledge of complex Medicare managed care laws, regulations, and policy guidance, applying it to monitor and audit numerous Medicare health plans. She has conducted dozens of CMS audits and new Medicare Advantage application reviews. A respected expert in the region, Julie was appointed as the San Francisco representative to many national CMS workgroups, and received numerous CMS and DHHS awards.
Mike Opich, Senior Vice President
Mr. Opich brings over twenty-five years of experience in health care. He has held executive positions in provider network development, contract negotiation, and reimbursement systems development in Medicare, Medicaid and commercial plan settings. Mike has extensive experience in contracting with individual hospitals, multi-hospital systems and large integrated delivery systems and has extensive expertise in facility reimbursement methodologies. Mike has worked with national clients developing commercial and Medicare Accountable Care Organizations, and has consulted with physician practices on contract financial performance analysis and revenue maximization engagements.
Date: December 14th, 2018
Time: 1:00PM EST