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Melissa J. Hulke

Office:
Phoenix, AZ
Phone:
+1.602.528.8039
Contact:

Melissa Hulke is an Associate Director in the Healthcare Compliance & Investigations practice segment. Melissa is a healthcare expert and Certified Public Accountant who applies her finance and accounting expertise in all three healthcare market segments: Payer, Provider and Life Sciences. She is highly experienced in litigation, investigations and compliance matters. She specializes in the synthesis of complex financial and transactional data.

Melissa’s healthcare experience includes investigating False Claims Act and Qui Tam allegations; Medicare, Medicaid, and other government payer billing and coding reviews; reimbursement between managed care companies and provider networks; pharmacy benefits management; Medicare Part D legislation; and property tax exemption of not-for-profit hospitals. Melissa has authored and presented on the impact of the Affordable Care Act’s medical loss ratio (MLR) regulations.

Melissa has a decade of experience in litigation support in addition to experience as a senior manager at a publisher of medical news and information to pharmaceutical executives and physicians. Melissa has led many engagements in state and federal proceedings involving hundreds of millions to billions of dollars in at risk activity as well as very large data and discovery repositories.


Articles by Melissa Hulke

It’s Time for Employers to Distribute MLR Rebates: Does Your Company Know How and to Whom?

Medical loss ratio (MLR) rebates from health insurance issuers will be a reality by August 1, 2012. Employers must be prepared to address the issues around distributing and calculating rebates.

 Article
Medical Loss Ratio in Group Markets: Will Many Plan Participants Receive Rebates?

Recent data indicates that $700 million in medical loss ratio (MLR) rebates will be going to only a small percentage of participants. Navigant’s Sonya Kwon and Melissa Hulke co-authored this article with Wayne Jacobsen, partner at O’Melveny & Myers.

 Article / White Paper
A Pivotal Year for Medical Loss Ratio

In this article for the American Health Lawyer’s Association (AHLA) Payors Plans & Managed Care Newsletter, Melissa Hulke and Ernest Dixon discuss the complexities of Medical Loss Ratio (MLR) regulations and potential reporting, regulatory oversight, and litigation issues.

 Article
Medical Loss Ratio: Overview, Key Considerations and Risks

Navigant experts provide an overview of Medical Loss Ratio and outline key considerations and risks for payers, providers and employers.

 Article / White Paper
Medical Loss Ratio Rebates in August 2012: Has the Burden of Distribution Been Shifted to Employers?

Navigant’s Sonya Kwon and Melissa Hulke and Wayne Jacobsen from O’Melveny & Myers examine the regulations and guidance relating to health insurance issuers’ MLR and what employers need to be aware of

 Article
HHS Announces $2.1 Billion Savings Due to ACA as First Round of MLR Audits Begins

In this article for the American Health Lawyer’s Association (AHLA) Melissa Hulke and Ernest Dixon discuss the Medical Loss Ratio (MLR) regulations and key updates as a result of recent HHS announcements.

 Article / White Paper
Medical Loss Ratio: New Developments and What’s to Come

Navigant presented during an AHLA webinar providing a brief background of the Medical Loss Ratio (MLR), an analysis of the preliminary data on MLR rebates, and a discussion of the nuances of the MLR regulations to consider when analyzing or reporting MLR data.

 Webcast

Education

  • BS, Economics; MBA, Arizona State University

Licenses

  • CPA
  • CFF
  • ABV

Industry Specialization

  • Healthcare
  • Pharmaceuticals and Life Sciences

Functional Expertise

  • Forensic Accounting
  • Litigation Support
  • Qui Tam
  • Due Diligence

MLR Event

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