Medicare Advantage and Part D: Compliance for actuaries

The Patient Protection and Affordable Care Act and a growing number of rules and regulations added each year have ballooned the complexity and associated compliance burden for the health insurance companies that sell and administer Medicare Part C and Part D. This paper focuses on one relatively narrow area of rules that is sometimes loosely referred to as actuarial compliance, and serves as a primer for actuaries or other professionals who are tasked with understanding and following these rules.