FacultyFaculty/Author Profile
Michael S. Adelberg

Michael S. Adelberg

Faegre Baker Daniels Consulting

Washington, DC, USA


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)
Michael S. Adelberg is associated with the following items:
MP3 Audio  MP3 Audio Health Care After Obama: A Trump Administration and GOP Congress Prepare to Unspool the Affordable Care Act , Monday, January 30, 2017
Revising the Affordable Care Act without Replacing It: The Trump Administration Regulates and Litigates the ACA , Wednesday, May 17, 2017
Health Care Update: The Trump Administration Heads Into ACA Open Enrollment with Shaky Markets and Powerful Discretion, Monday, October 16, 2017
Audio Only On-Demand Web  Audio Only On-Demand Web Health Care After Obama: A Trump Administration and GOP Congress Prepare to Unspool the Affordable Care Act - Health Care After Obama: A Trump Administration and GOP Congress Prepare to Unspool the Affordable Care Act , Monday, January 30, 2017
Revising the Affordable Care Act without Replacing It: The Trump Administration Regulates and Litigates the ACA - Revising the Affordable Care Act without Replacing It: The Trump Administration Regulates and Litigates the ACA , Wednesday, May 17, 2017
Health Care Update: The Trump Administration Heads into ACA Open Enrollment with Shaky Markets and Powerful Discretion - Health Care Update: The Trump Administration Heads into ACA Open Enrollment with Shaky Markets and Powerful Discretion, Wednesday, October 18, 2017
Transcripts  Transcripts Health Care After Obama: A Trump Administration and GOP Congress Prepare to Unspool the Affordable Care Act - Health Care After Obama: A Trump Administration and GOP Congress Prepare to Unspool the Affordable Care Act , Monday, January 30, 2017
Revising the Affordable Care Act without Replacing It: The Trump Administration Regulates and Litigates the ACA - Revising the Affordable Care Act without Replacing It: The Trump Administration Regulates and Litigates the ACA , Wednesday, May 17, 2017
Health Care Update: The Trump Administration Heads into ACA Open Enrollment with Shaky Markets and Powerful Discretion - Health Care Update: The Trump Administration Heads into ACA Open Enrollment with Shaky Markets and Powerful Discretion, Wednesday, October 18, 2017
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