Medicare Advantage and Part D programs have become a dominant force in the managed care market.

Both represent a large and growing area of business for MCOs with nearly half of the Medicare eligible population enrolled in a Medicare Advantage plan, a figure that amounted to nearly 28 million people in 2022, and 49 million Medicare beneficiaries in a Part D plan. At the same time that the opportunity associated with this market is growing, federal oversight of these programs is also on the rise. MCOs with government lines of business must navigate a complex web of federal statutes, regulations, and sub-regulatory guidance in their administration. In this workshop, we will facilitate deep discussion of the key issues facing Medicare Advantage and Part D plans today. Come prepared to discuss:

• Current regulatory hot topics and key issues facing plans today, such as marketing, risk adjustment, and prior authorization, with strategies for managing risk and implementing new requirements; and
• Current and upcoming implementation challenges, including implementing key prescription drug pricing provisions in the Inflation Reduction Act and preparing for the changes proposed in the Contract Year 2024 Policy and Technical Changes to the Medicare Advantage program.