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
- 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
- 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
- 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
- Provider Networks Oversight Trends Across Markets
National Webinar, Health Plan Alliance, May 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
- Provider Networks Take Center Stage: Emerging Trends and Oversight
National Webinar, Practicing Law Institute (PLI), Washington, D.C., 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
- After Good Faith Compliance: Incorporating Exchange Compliance Into Your Overall Government Program Compliance Structure
Co-presenter, Managed Care Compliance Conference, Health Care Compliance Association (HCCA), Las Vegas, Nevada, February 1, 2016
- 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
- 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
- Health Insurance Exchange: Dental Plan Operations and Policy
Converge: National Association of Dental Plans, Scottsdale, Arizona, 2012
- Medicare Advantage and Part D Compliance and Audit Requirements
Medicare Operations, Bidding and Compliance Conference, America’s Health Insurance Plans, Baltimore, Maryland, 2009
- Results of the 2009 Contract Year Marketing Surveillance
National Health Policy Forum, America’s Health Insurance Plans, Washington, D.C., 2008
- Annual Medicare Advantage and Part D Conferences
Centers for Medicare and Medicaid Services, Baltimore, Maryland, 2007-08
- Medicare Advantage/Part D Progressive Compliance Model
Medicare Compliance Conference, Healthcare Compliance Association, Baltimore, Maryland, 2007
- Struggling to Stabilize: 3Rs Litigation and the Future of the ACA Exchanges
Co-author with Nicholas Bagley, Health Affairs Blog, August 2016
- Regulators React to Debate Over Narrow Networks
Managed Healthcare Executive, May 2016
- 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
- Medicare Desk Reference
U.S. Government Printing Office, 1997
- Medicare & You Handbook
U.S. Government Printing Office, 1996