Handouts
Tuesday, December 9
8:30 – 9:30am
General Session: Medicare Part D Compliance
& Oversight Overview
Brenda
Tranchida, Program Compliance and
Oversight Group, Center for Drug and Health Plan Choice, Centers for
Medicare and Medicaid Services
Handout
- Compliance Activities in the Medicare yy Part
D program
- Expectation as to oversight from the agency
perspective
- What plans can anticipate in 2009 from CMS
9:45 – 10:45am
General Session: Hot Topics from the
OIG
Julie K.
Taitsman, MD, JD, Chief Medical
Officer, U.S. Department of Health and Human Services, Office of the
Inspector General
Handout
- Update on Medicare Part D
- Recent OIG oversight activities
- Compliance challenges
- OIG enforcement priorities
11:00 am – 12:00 pm
Breakout Sesions
501 Pharmacy Audits: A Part D
Perspective
Joseph
Feliciani, Pharmacy Audit Supervisor,
Independence Blue Cross
Handout
- CMS Chapter 9 regulations on Pharmacy Audit
- Pharmacy Audit—levels and programs
- Applicable tools and markers to look for in
claims
- Industry standards—good and bad
- Effective program outcomes and examples
502 Performance Monitoring: An Industry Best
Practice
Marcella
Jordan, Director, National Medicare
and Federal Program Compliance, Kaiser Permanente
Michael Fletcher,
Director, California Medicare Compliance, Kaiser
Permanente
Handout
- Background—why have a monitoring program?
- Approach/Implementation for program
- Monitoring design/methodology
- Functional level reporting and plan review of
results
- Lessons learned and benefits achieved
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