Mastering Medicare Advantage Compliance: Insights and Best Practices One Year After the Two-Midnight Rule

Registration is now open

The 2024 Medicare Advantage final rule introduced key changes to inpatient coverage, particularly the enforcement of the “two-midnight rule.” Unlike traditional Medicare Part A, Medicare Advantage plans are not required to automatically approve inpatient status based on this rule, allowing for ongoing audits under provider contracts. One year after implementation, it is critical to adopt effective strategies to navigate these changes.

Join our 60-minute interactive panel discussion with expert speakers who will explore best practices for building strong partnerships between managed care organizations and payers, with a focus on Joint Operating Committee (JOC) meetings. The session will also cover optimizing Case Management and Utilization Review processes to ensure compliance and reduce denials, while highlighting the role of Physician Advisor Programs in bridging clinical and administrative teams. Finally, attendees will learn proactive, data-driven strategies to reduce claim denials, offering actionable insights for success in the evolving Medicare Advantage landscape.

Learning Objectives:

• Discuss strategies for strengthening partnerships between managed care organizations and payers, with a focus on Joint Operating Committee (JOC) meetings.
• Explore best practices for improving Case Management and Utilization Review to ensure rule compliance and reduce denials.
• Analyze the role of Physician Advisor Programs in supporting clinical documentation and bridging clinical and administrative teams.
• Examine data-driven approaches to reduce claim denials and help hospitals succeed in the Medicare Advantage environment.
• Delve into the best practices for crafting precise, clear, and aligned appeal letters to address denial objectives.

Speakers:

• Carolin Girgis, MD, Senior Director & Physician Advisor, Tenet Healthcare
• Miriam Davis, MBA, BSN, BA, ACM-RN, Vice President, Case Management & Continuing Care, Tenet Healthcare
• Kyle Mcelroy, VP Clinical Operations, Conifer Health Solutions