Michael S. Adelberg

Principal - Faegre Baker Daniels Consulting

简介

Mike Adelberg brings unique insights into the processes, policies and people driving the public programs that finance or subsidize health care coverage. Mike has 25 years of progressive experience with Medicare, Medicaid and the Health Insurance Exchanges that provide health care coverage for well over 100 million Americans.

Government Agency Experience

Before joining Faegre Baker Daniels Consulting, Mike held several senior positions within the Centers for Medicare and Medicaid Services (CMS), including concurrently serving as the director of the Insurance Programs Group and the acting director of the Exchange Policy and Operations Group in the Center for Consumer Information and Insurance Oversight (CCIIO). In these roles, Mike was responsible for establishing Affordable Care Act policy and implementing critical Affordable Care Act (ACA) operations in multiple areas, including health plan management, eligibility and enrollment, and health insurance exchange operations. While in CCIIO, Mike led a team of 125 staff and oversaw a $300 million annual operating budget. Prior to that, Mike was the Director of Medicare Advantage Operations, where he supervised the annual cycle for review and award of Medicare Advantage contracts and led monitoring of Medicare Advantage contractors. He also served as the associate regional administrator for Medicare operations (Chicago Region) and the director of education and assistance programs.

Private Sector Experience

Mike served as vice president of public policy and government affairs with the Universal American Corporation — a medium-sized health insurer focusing primarily on the senior market. He was also a senior manager and senior advisor with international consultant BearingPoint (now part of Deloitte), where he co-led a successful health policy and program evaluation practice.

 

Personal Interests

In his spare time, Mike is an author and historian. He has authored three novels, two non-fiction books, several scholarly journal articles or book chapters, more than sixty book reviews, and other publications.

Mike is a consulting professional within Faegre Baker Daniels Consulting, and does not act as a lawyer for clients. Learn more about the Faegre Baker Daniels Consulting practice.

资质

教育

Northern Illinois University
M.P.P. Human Services, American Society for Public Policy Outstanding Student Award (1994)

Rutgers University
M.A. American History, Garden State Fellowship (1991)

Manhattanville College
B.A. History and Political Science, cum laude (1989)

见解和活动

其他角度
  • ACHP Discussion of New MPA/Part D Flexibilities
    ACHP, Alliance of Community Health Plans Webinar, May 2018 
  • Taking Advantage of New Regulatory Flexibility
    2nd National Medicare Advantage Summit, Better Medicare Alliance, May 2018
  • Fraud's Newest Hot Spot: The Opioid Epidemic and the Corresponding Rise of Unethical Addiction Treatment Providers
    Co-author, April 25, 2018, Health Affairs Blog
  • Working With Brokers; CSR Lawsuits
    2018 Marketplace Meeting, Association of Community Affiliated Plans, March 2018
  • Health Plans Prepare for 2018 Another Year of Uncertainties
    AHIP National Conference on Individual & Small Group Markets, March 2018
  • The Potential Premium Impact of an Essential Health Benefits Benchmark Change in Four States
    Co-author, Health Affairs Blog, January 4, 2018
  • Pivoting With Shifts in ACA Regulations: Managing Your On and Off Exchange Approach
    Co-presenter, Health Plan Alliance Webinar, January 2018
  • Provider Network Oversight: Adequacy, Accuracy, and the Spread of Automated Review Spreads Across Markets
    Health Plan Alliance, November 2017
  • Legal Concerns in the Marketplace Arena
    Association of Community Affiliated Plans, November 2017
  • Cost-Sharing Reduction Payments Litigation & Opportunities
    Association of Community Affiliated Plans, October 2017
  • Plan Year 2018 for ACA Marketplaces
    Practising Law Institute, September 2017
  • A New Administration Slowly Gets Its Sea-Legs Regulatory Trends at CMS
    Delta Dental Plans Association, September 2017
  • Plan Year 2018 for ACA Marketplaces
    Health Plan Alliance, August 2017
  • What Can Health Plans Do if the Trump Administration Stops Making CSR Payments?
    Executive Memo, Indiana Manufacturers Association, August 2017
  • CMS's Medicaid Managed Care Rule: The "Mega-Reg" and Its Uncertain Future
    Health Plan Alliance, July 2017
  • The Road to Replacing Obamacare
    Practising Law Institute, May 2017
  • Risk Corridors: Litigation and Opportunities
    Association of Community Affiliated Plans, March 2017
  • From Machine-Readable Provider Directories, A Preview Of A Revolution
    Co-author, Health Affairs Blog, February 2017
  • How Narrow is Too Narrow? Regulators Respond to Narrow Network Health Plans
    HCCA Managed Care Conference, January 2017
  • Health Care After Obama: A Trump Administration and GOP Congress Prepare to Unspool the ACA
    PLI Webinar, January 2017
  • Marketplace Volatility and Reasons for Hope
    National Webinar, AHLA Managed Care Contracting Affinity Group, November 2016
  • The Medicaid Managed Care Regulation: The Mega-Reg
    Converge: The National Association of Dental Plans, San Antonio, Texas, September 2016
  • Struggling to Stabilize: 3Rs Litigation and the Future of the ACA Exchanges
    Co-author with Nicholas Bagley, Health Affairs Blog, August 2016
  • QHP Audits: Preparing for Them, and What to Expect When It Comes to Enforcement Actions
    Health Plan Alliance Conference, Columbus, Ohio, May 2016
  • Recent Developments With Narrow Networks for Consumers and Insurers
    Moderator, The Future of Health Insurance Exchanges in the Direct to Consumer Market, Leonard Davis Institute of Health Economics, Philadelphia, April 2016
  • ACA Co-Ops: Struggling Startups With Industry-Wide Implications
    National Webinar, Practicing Law Institute (PLI), Washington, D.C., February 2016
  • Health Insurance Exchanges: Where We Are Today and What Could Come Next
    Employee Benefits Committee Meeting, U.S. Chamber of Commerce, Washington, D.C., February 2016
  • Health Care Trends and Issues
    Panelist, NOLHGA Legal Seminar, San Francisco, July 2015
  • The Federal Perspective
    National Association of State Health Care Co-Operatives, Denver, Colorado, 2015
  • Qualified Health Plan Certification Conferences
    Centers for Medicare & Medicaid Services, Bethesda and Baltimore, Maryland, 2013-15
  • Key State Options in a Federally-Facilitated Health Insurance Marketplace
    National Governors Association, Washington, D.C., 2014
  • Key Decisions for Plan Management
    Workshop on Federal and State Partnership Health Insurance Exchanges, National Governors Association, Baltimore, Maryland, 2013
  • Examining Health Plan Interactions With Exchanges
    Preparing for the Exchanges Conference, America’s Health Insurance Plans, Washington, D.C., 2013
  • Plan Management Forums
    National Association of Insurance Commissioners, Atlanta, Kansas City and Washington, D.C., 2012-14
  • Health Insurance Exchange Forums
    Blue Cross Blue Shield Association, Bethesda, Maryland, 2012-13
  • How Did We Get Here? A Brief History of Health Care Regulation in the United States
    Healthcare Compliance Today, July 2007
  • The Quiet Revolution in Healthcare Regulation
    The RPM Report, December 2006, pp. 43-45

领导力和社区

职业协会

  • Psoriasis Phototherapy Payer Partner Committee (PCORI Grant) — Committee Member

市民活动

  • Veterans Administration, Arlington, Virginia — Network Adequacy Expert Panel, 2017
  • Medicare Advantage News, Washington, D.C. — Editorial Board
  • Robert Wood Johnson Foundation — Policy-Relevant Insurance Studies Project Advisor, 2014
  • Care Continuum Alliance, Washington, D.C. — Medicare Committee Member (Chair, 2010-11)
  • National Technical Expert Panel, Baltimore, Maryland — Part D Medication Measures Co-Chair, 2005-06
  • Mature Market Resource Center, Libertyville, Illinois — National Mature Media Awards Judge, 2002-03
  • Baltimore County Department of Aging, Towson, Maryland — Commissioner, 1998-2002

荣誉

  • Commonwealth Fund, Washington, D.C. — Grant Awardee, 2017
  • Department of Health and Human Services, Washington, D.C. — Secretary’s Certificate for Distinguished Service (twice)
  • Center for Medicare and Medicaid Services, Baltimore, Maryland — Administrator’s Achievement Award (twice)
  • Council for Excellence in Government, Washington, D.C. — Fellow
  • Office of Personnel Management, Washington, D.C. — Presidential Management Fellow
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