AGENDA: PRECONFERENCE
WEDNESDAY, MAY 16, 2018
PRECONFERENCE: THE NEW MEDICARE ADVANTAGE RULE
- Overview, including focus on deregulation and additional flexibility
- Marketing provisions
- Enrollment provisions, including additional open-enrollment period
- New supplemental benefits policy
- Telehealth developments
- Changes in medical loss ratio determinations
- Changes in quality improvement programs
- Changes in benefit design
- Changes in compliance programs
- Changes in star-rating methodology
- Changes regarding stop-loss methodology
1:00 pm
Welcome and Introduction
John Gorman
Founder and Executive Chairman, Gorman Health Group; Former Assistant to the Director of Health Care Financing Administration’s Office of Managed Care, HCFA, Washington, DC
John Gorman is Founder & Executive Chairman at Gorman Health Group (GHG). In this role, he has led the development of the industry’s leading consulting practice and several entrepreneurial ventures in government health programs. John’s work focuses on Medicare, Medicaid, and Affordable Care Act strategy, governance, and turnaround of distressed health plans. Prior to founding the firm, John served as Assistant to the Director of Health Care Financing Administration’s Office of Managed Care, where he provided day-to-day management and served as the external liaison for the Medicare and Medicaid managed care programs. During the 1993 debate on national healthcare reform, John was chief lobbyist on healthcare financing issues for the National Association of Community Health Centers, an organization of federally-funded primary care clinics for the medically underserved. John’s career in Washington began as Press Secretary and Staff Director for U.S. Representative John Conyers, Jr. (D-MI), then Chairman of the Government Operations Committee.
Leslie Mullins, MBA
Senior Consultant, Gorman Health Group, Washington, DC
Leslie Mullins is a Senior Consultant at Gorman Health Group (GHG). In this role, she develops feasibility studies for the viability of Medicare Advantage plans as well as operational analyses to improve financial and operational performance. Leslie brings GHG clients more than 25 years of multi-faceted expertise in Medicare, Medicaid, and specialty managed care. Her specialties involve cost control and cost-saving strategies through financial and operational analytics. Leslie has extensive managed care experience, including care management, call center operations, project management and implementation. Leslie has served in diverse leadership positions – including Vice President of Operations for a Special Needs Plan, Division President for a carve out managed care organization and CFO for a specialty managed care company. Leslie has assisted new plans in applying for and receiving state licensure and has successfully led large workforces in clinical operations, call center operations, and community health workers.
5:00 pm
Adjournment