AHIP Webinar: Understanding The Network Adequacy Changes In The MA Final Rule
The CMS Final Rule for CY 2023 brings with it new network adequacy requirements and implications for your 2024 contract year Medicare Advantage application. Join Quest Analytics, the nation’s foremost assessor of provider networks, as we breakdown the rule and the provided allowances, walk through strategies for compliance and discuss its potential influence on future oversight and regulations for all health insurance providers.
Meet the Presenters
Scott Westover, SVP Network and Regulatory Strategy, Quest Analytics
Scott is a seasoned executive with deep experience across the payer, provider and regulatory space. Before Quest Analytics, he served as market president for AmeriHealth Caritas New Hampshire, where he was responsible for the plan’s strategic direction, growth, and leadership. His prior experience includes working at Anthem, Inc. as a vice president of provider joint ventures and national accounts, and he has also held senior roles within leading healthcare providers, directing a Medicaid health plan, and driving national health strategy for multiple Fortune 50 corporations.
Michael Adelberg, Principal – Healthcare Providers & Plans Practice Lead, Faegre Drinker Consulting
Michael leads the Healthcare Strategy Practice at Faegre Drinker, an AmLaw Top 50 Law Firm. He spent 15 years at CMS, during which time he held senior management positions setting policy for and overseeing the provider networks of Medicare Advantage and health insurance exchange providers. He also held VP positions at a multi-state health plan that operated Medicare Advantage and managed Medicaid plans.
Explore Our Resource Hubs
Medicare Advantage
Compliance may not be our name, but it’s definitely our game. Our relationship with CMS—the people who set the standards we all follow—means we can help you be compliant. Visit our CMS Resource Hub to find guides, videos, and more!
Provider Directory Accuracy
Stay ahead of the game with help from our Surprise Billing Resource Hub. You’ll find the latest insights, videos, guides and more to help you be compliant with the provider directory verification requirements.
QHP Certification
New network adequacy requirements for Qualified Health Plans (QHPs) on the Federal Exchange. Go to our QHP Marketplace Resource Hub to get all the details on what’s new and how you can prepare today!
Find the Solution that’s right for you
QES Adequacy & Accuracy
Get industry-leading compliance capabilities that enable you to meet numerous federal and state healthcare mandates, including the No Surprises Act and Medicare Advantage.
Medicare Advantage
CMS Network Adequacy Compliance year-round. With QES Adequacy, you measure your network as CMS will – giving you a superior way to maintain compliance for current and future networks.
Federal & State Templates
Say goodbye to manual project set-up and say hello to peace of mind. Our pre-built Federal and State templates allow you to skip the manual work and measure your network as regulators will.
QES Access Reporting
Generate multiple access reports in minutes! Plus, quickly report on any size business, giving your Sales Team a competitive advantage in the Small Group Market.
Commercial Networks
Helping you create competitive advantages in the marketplace. Plus, measure your network for URAC and NCQA network adequacy accreditation.
Dental Networks
Quest Enterprise Services provides complete and automated visibility into your network, allowing you to make informed decisions quickly.
