Skip to main content

Health Care Update: The Trump Administration Heads into ACA Open Enrollment with Shaky Markets and Powerful Discretion


Speaker(s): Michael S. Adelberg, Tricia A. Beckmann
Recorded on: Oct. 16, 2017
PLI Program #: 228785

Mike Adelberg has 20 years of progressive experience with Medicare, Medicaid and the Health Insurance Exchanges that provide health care coverage to more than 100 million Americans. He is a thought leader in reforming the health care and health insurance oversight processes. Mike brings unique insights into the processes, policies and people behind the public programs that finance or subsidize health care coverage.

Before joining FaegreBD 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 setting policy and implementing critical Health Insurance Exchange operations in multiple areas, including plan management, eligibility and enrollment, the small-business health options program (SHOP), and the Co-Op loans. 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. His other senior roles at CMS included serving as the associate regional administrator for Medicare operations (Chicago Region) and the director of education and assistance programs.

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

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

Faculty Positions

  • Adjunct Instructor of History and English — Various Colleges, 1991-2000

Honors

  • 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

Civic Activities

  • 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

Presentations

  • New CMS Rules on Exchanges: Impact on Health Plans, Providers and Brokers
    Co-presenter, Atlantic Information Services (AIS) Webinar, January 2016
  • Enhanced CMS Oversight of Network Adequacy: Strategies for Medicare Advantage Plans
    Atlantic Information Services (AIS) Webinar, November 2015
  • Health Care Trends and Issues
    Panelist, NOLHGA Legal Seminar, San Francisco, July 2015
  • Qualified Health Plan Certification Conferences
    Centers for Medicare & Medicaid Services, Bethesda and Baltimore, Maryland, 2013-15
  • Annual CEO Meeting
    National Association of State Healthcare Co-Operatives, Washington, D.C., 2015
  • Plan Management Forums
    National Association of Insurance Commissioners, Atlanta, Kansas City and Washington, D.C., 2012-14
  • State Exchange Best Practices Forums
    National Governors Association, Washington, D.C., 2012-14
  • Health Insurance Exchanges Conferences
    America’s Health Insurance Plans, Washington, D.C., 2013-14
  • Health Insurance Exchange Forums
    Blue Cross Blue Shield Association, Bethesda, Maryland, 2012-13
  • Converge: Annual Conference
    National Association of Dental Plans, Scottsdale, Arizona, and Orlando, Florida 2012-14
  • Annual Medicare Advantage and Part D Conferences
    Centers for Medicare and Medicaid Services, Baltimore, Maryland, 2007-08
  • National Health Policy Forum
    America’s Health Insurance Plans, Washington, D.C., 2008
  • Medicare Compliance Conference
    Healthcare Compliance Association, Baltimore, Maryland, 2007

Published Articles

  • Narrow Network Health Plans: New Approaches to Regulating Adequacy and Transparency
    Compliance Today, October 2015
  • After King v. Burwell, Viable Exchanges are ACA's Next Challenge
    Modern Healthcare, June 5, 2015
  • 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

Education

  • Northern Illinois University
    Master of Public Policy in Human Services, American Society for Public Policy Outstanding Student Award (1994)
  • Rutgers University
    Master of Arts in American History, Garden State Fellowship (1991)
  • Manhattanville College
    B.S. in History and Political Science, cum laude (1989)


Tricia Beckmann is a director with Faegre Baker Daniels Consulting’s health and biosciences practice. She works with clients throughout the health care industry on state and federal health care regulatory issues.

Tricia has cultivated in-depth knowledge of the health care industry — and particularly the industry’s relationship with regulatory bodies — through positions with both government agencies and health care stakeholders. She spent four years with the Centers for Medicare and Medicaid Services (CMS), where she reported directly to agency leadership responsible for the health insurance Marketplaces and private insurance market reforms that are at the center of the Affordable Care Act (ACA). She helped shape policy in several areas including Section 1332 State Innovation Waivers, Section 1557 non-discrimination rules, consumer assistance programs, and health plan disclosure requirements such as the summary of benefits and coverage.

Prior to joining FaegreBD Consulting, Tricia served as an in-house attorney for a progressive, rapidly growing managed services firm that supports hospital and physician organizations in their adoption of value-based care and population health management. While in such role, Tricia advised on a wide range of state and health care regulatory issues, such as managed care state regulation and licensing, ACA implementation and health information privacy. Tricia also has prior in-house government relations experience working for a not-for-profit managed care health plan in California and authorizing benefits for the Social Security Administration. Tricia serves as a board member of the institutional review board for both George Washington University and the University of Maryland.

Tricia 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.

Honors

  • Secretary’s Award for Distinguished Service — Marketplace Enrollment Team
  • CMS Administrator’s Special Citation Award — Special Enrollment Period Team
  • Emory University School of Law — Dean’s Award, Law in Public Health
  • Emory University School of Law — Pro Bono Medal Recipient
  • University of Wisconsin-Madison — Germaine Mercier Scholarship (French Department Distinction)
  • University of Wisconsin-Madison — William F. Allen Writing Prize (Outstanding History research)

Civic Activities

  • George Washington University Institutional Review Board — Board Member, 2013-present
  • University of Maryland Institutional Review Board — Board Member, 2013-present
  • AmeriCorps National Civilian and Community Corps — Corps Member, July 2006-May 2007

Presentations

  • Current Marketplace Issues
    CMS Marketplace Assister In-Person Trainings, Chicago, Illinois; Dallas, Texas; Tampa, Florida; July - August 2014

Personal Interests

Tricia is a former college radio dee-jay who enjoys traveling, swimming and her community-supported agriculture (CSA) farm share.

Services & Industries

  • Faegre Baker Daniels Consulting
    • Health & Biosciences Consulting
    • Digital Health
  • Health Care
    • Medical Technology
    • Reimbursement
    • Research Institutions

Education

Emory University School of LawJ.D. (2010)

University of Wisconsin, Madison
B.A., History and French, cum laude, Phi Beta Kappa (2006)