Regulatory and Policy Related Services

reg-policy

Services include but are not limited to reviewing and designing health plan fraud policies, programs, and claims edits, consulting on health care reform policies and inititiatives at the state and federal level, health information technology and policy, pharmaceutical benefit analysis and design, and formulary/PDL program and policy evaluation. Some of these services include:

  • Health care reform policies and inititiatives at the state and federal level
  • Health information technology, regulatory and policy related services
  • State and federal regulatory and reimbursement policies for Medicare and Medicaid programs
  • Litigation  support services in the areas of Medicaid policy reimbursement, and claims analysis
  • Legislative strategic planning and language drafting
  • Pharmaceutical benefit analysis and design
  • Evaluation and development of internal operational and reimbursement policies and procedures for plans
  • Review and design of health plan fraud policies and programs
  • Review and design of health plan claims edits
  • Formulary/PDL program and policy evaluation