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Health Care Communiqué: 4Q - 2009
2010 Marketing Surveillance Plan Discussed at CMS Conference
CMS held a Medicare Advantage Industry Conference in Baltimore, MD on 10/19/09, during which they presented a number of new compliance issues for the coming year. A few highlights from the conference:
Marketing surveillance activities for 2010 would include secret shoppers at events and individual appointments, use of clipping service, marketing material and website review, calls to agents/brokers and calls to shopping event coordinators. A surveillance database has been created and CMs will use it to track issues. Plans will have three days to respond to issues from the time they are notified. Three vendors have been contracted by CMS for the surveillance program.
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New Course: Introduction to Pharmacy Benefit Management
The Pharmacy Benefit Management Institute (PBMI), has worked with Kaplan EduNeering to develop a new course entitled Introduction to Pharmacy Benefit Management, which introduces the aspects of drug benefit design and management. The course will be of value to PBMs and organizations, such as Medicare Advantage plans that contract with PBMs.
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About our Subject Matter Experts: Pelorus Management Consultants
PMC serves as the subject matter experts for a number of Kaplan EduNeering's Medicare, HIPAA and compliance courses. They also work with many Medicare and Medicaid health plans on a range of issues including start-up, expansion, training, CMS mock audits, corrective action plans, proposal responses and regulatory interaction.
Beginning in 2010 PMC will serve as external data auditors to address the new CMS requirement.
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