Jennifer Rogalla

Jennifer Rogalla is a Senior Consultant in Compliance Solutions with Gorman Health Group. Her background includes over 25 years of experience with Medicare regulations, medical billing and health insurance programs. Jennifer has provided assistance with CMS audit preparation, audit assistance and remediation in the areas of compliance, appeals and grievances. Additionally, Jennifer is experienced with application filings, compliance program development and implementation, marketing material and provider contract review and as well as Part D operations compliance. Most recently she assisted plans with interim leadership positions to support the development of process improvements for Star ratings.

2021 Medicare Advantage Readiness Checklist

CMS recently released their 2021 Medicare Advantage Readiness Checklist. GHG’s Jennifer Rogalla highlights key focus areas that may be new or expanded upon in 2021.

CMS’ Proposed Addendum to Part C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance

On July 7, 2020, CMS distributed a draft addendum to address changes required for Integrated DSNPs for Unified Appeal and Grievance processing in the Parts C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance. Noteworthy changes are summarized here.