Rise

Medical directors and other executives from health plans and hospital networks that work with CMS and offer Part D benefits with the following job functions:

• 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 (PBMs):

• 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

There is a reason attendees return to this event year after year. Your peers are attending in 2025 to:

• Understand how IRA-driven changes to Part D benefits impact actuarial forecasting, plan design, and member experience
• Balance member access, cost containment, and compliance amid ongoing policy shifts and market pressures
• Explore key takeaways from the CMS Final Rule and Call Letter, and what they mean for plan compliance and operations in 2025 and beyond
• Operationalize compliance improvements using real-time tracking tools, internal dashboards, and effective system strategies
• Strengthen clinical and financial forecasting to accurately account for high-cost therapies, pipeline products, and shifting plan liabilities
• Hear directly from beneficiaries about what’s working (and what’s not) in their Medicare Part D experiences—from choosing plans to medication affordability
• Manage rising costs of GLP-1s and gene therapies while maintaining clinical excellence and financial sustainability
• Identify Part D measures that most influence Star Ratings, including adherence, MTM, and CMR completion
• Benchmark best practices and network with industry peers to remain competitive in a rapidly transforming market
• Discover real-world examples of how successful plans tackled formulary changes, OOP cap implementation, and audit readiness