Two key individuals from the Centers for Medicare & Medicaid Services (CMS) Program Compliance and Oversight Group discussed the recent CMS compliance audits and explored CMS compliance expectations, common Medicare Advantage (MA) and Part D compliance program issues, and best practices, with particular focus on what MA and Part D sponsors need to know.
- Brenda Tranchida, JD, a member of the Senior Executive Service, is the director of the Program Compliance and Oversight Group within the Center for Medicare at CMS. In this role, Brenda is responsible for overseeing the development and implementation of the audit and enforcement oversight program for Medicare Advantage and Prescription Drug plan sponsors, including playing a key role in developing CMS' mandatory compliance plan policy requirements and the compliance plan "effectiveness" audits of these entities.
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Marianne Bechtle, JD, is a Health Insurance Specialist in the Division of Compliance and Enforcement within the Program Compliance and Oversight Group at CMS. In addition to assisting with the recent compliance plan audits, Ms. Bechtle has been involved in CMS activities related to recent marketing and enrollment sanctions against several MA and Part D Sponsors.
We would like to thank MA and Part D Affinity Group Co-Chairs Janice Ziegler, Esquire (SNR Denton, Washington, DC), and Lyn Amor Macaraeg, Esquire (CareMore Health Plan, Cerritos, CA), for planning this call.