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Save the Date for August 2022

Save the Date for the 
 2022 RISE Part D Master Class

CMS audit readiness, claims data management, 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, such as such as the new CMS integrity audit, the massive program audit protocol changes, transparency and interoperability requirements, OMS guidance, as well as best practices for contracting, formulary design, and achieving desired quality measures. Through highly researched topics, this conference is curated to provide a unique opportunity for pharmacists, PBMs, compliance, claims data, vendor oversight, audit, and all other Part D professionals to gain a wide scope of knowledge and practicable tactics to ensure plan success and the best outcomes for members.

Who Should Attend

Medical directors and other executives from health plans and hospital networks that work with CMS and offer Part D benefits, executives in such areas as:

  • 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

Join RISE for in-depth peer discussions and well-structured, practical sessions offering expert advice on how to handle regulatory changes. Bring your team for hands-on learning, covering audit readiness, formulary design, payment reconciliation, PDE error management, and opioid management for member outcomes. 

  • Get ahead of it: hear in-depth analysis of CMS protocol changes for contract year 2022 MA and Part D program audits

  • Master best practices in PDE management to avoid stress during the annual DIR reconciliation

  • Flag PBM contract language vulnerabilities that can sink financial performance

  • Assess various methodologies used to meet layered CMS interoperability requirements and due dates

  • Review 2021 OMS guidance and its potential impact to CY2022

  • Learn from recently audited health plans and what they overlooked in their prep

  • Contain specialty pharmacy cost through innovative utilization management, retrospective audits, and pharmacy network and prescription oversight strategies

Thank You to Our 2021 Sponsors