The RISE Part D Master Class | A RISE Health Conference

Rise

 The RISE Part D Master Class

CMS Audit Readiness, Formulary Design, and Clinical Intervention for Better Member Outcomes

The RISE Part D Master Class is the only available opportunity for health plan executives to combine learnings on essential Part D issues, best practices for contracting, formulary design, and achieving member experience quality measures. Join us to gain insight on essential Part D and Part B drug issues, such as the Senior Savings Model, closure of the coverage gap, and CMS audit readiness.

Through highly researched topics, this conference is curated to provide an opportunity for pharmacists, PBMs, and professionals working in compliance, claims data, vendor oversight, audit, and other related Part D functions, to gain a wide scope of knowledge and practical tactics to ensure plan success and the best outcomes for members. Hear from industry-leading experts on topics such as PBM negotiations, audit readiness, rebate and cost saving strategies, and important changes in Part D.

Who Should Attend

Medical directors and other executives from health plans and hospital networks that work with CMS and offer Part D benefits with the following job functions:

  • Compliance
  • Pharmacy operations
  • Finance
  • Vendor management
  • FDR/ delegation oversight
  • Coverage determinations, appeals, and grievances review
  • Medicare auditing
  • Information technology
  • Claims and prescription drug event management

Pharmacy Benefit Managers (PBM) :

  • Claim approvals/denials
  • Compliance
  • Claim and prescription drug event management
  • Pharmacy operations

Other Professionals :

  • CMS audit consultants
  • CMS audit validation consultants
  • Compliance auditors
  • Legal consultants
  • Data management/ software providers
  • Health law attorneys

Top Reasons to Attend

At our last event, attendees were able to:

  • Review considerations related to the 2024 CMS Advance Notice 

  • Understand provisions of the IRA related to reducing the drug costs of vaccines and insulin 

  • Discuss changes to the 2024 quality bonus program 

  • Review the goals set out by CMS to highlight health equity 

  • Identify key strategies for audit preparations 

  • Discuss how to efficiently communicate Part D changes to your members 

  • Discover new ways to optimize your compliance strategies 

  • Outline strategies for improving patient outcomes with MTMs 

  • Gain insights on managing costs and achieving higher Star ratings 

  • Identify ways to improve member outcomes and remain compliant 

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