Charles Baker, VP, Compliance Solutions The Centers for Medicare & Medicaid Services (CMS) continues to build upon its strategy to support person-centered, value-based care through the 2025 Medicare Advantage and Part D programs proposed rule. These proposals, a bold stride towards enhancing health equity, transparency, and patient-centric
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– Charles Baker, VP, Compliance Solutions The transition of Medicare-Medicaid Plans (MMPs) to Dual-Eligible Special Needs Plans (D-SNPs) by the end of 2025 marks a significant change in healthcare delivery. This shift demands a comprehensive approach due to the complex regulatory ecosystem; it’s essential for health plans to
Read More →– by Jocelyn Bayliss, Program Lead, Provider Network Management & Tina Gallagher, Market Manager, Provider Network Management In April 2023, CMS issued a final rule that added two new specialty types, clinical psychology and clinical social work, to network adequacy standards. Addition of Specialty Types and Amendments
Read More →– by Lynn Kryfke, MSN, RN, Sr. Consultant, Risk Adjustment | Jon Rogers, Sr. Consultant, Risk Adjustment The CDC defines Health Equity as the state in which everyone has a fair and just opportunity to attain their highest level of health. Despite progress, health disparities remain a
Read More →![[Webinar Replay] How Providers and Health Plans Can Collaborate to Maximize Revenue and Quality](https://www.attacconsulting.com/wp-content/uploads/2022/06/provider-network-contracting-570x172_c.jpg)
In this webinar, we discuss the critical role providers play in the success of improved health outcomes, Star ratings, HEDIS measures and risk adjustment. We dive into: – What provider organizations should know about the latest trends in Star ratings, HEDIS measures and risk adjustment – Risk
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Charles Baker, VP, Compliance Solutions The issue of Medicare Advantage (MA) plans paying administrative fees to field marketing organizations (FMOs) and agents is a hot topic. This is particularly true in light of recent congressional oversight hearings and the newly released 2025 Medicare Advantage Part D proposed
Read More →– by Lynn Kryfke, MSN, RN, Sr. Consultant, Risk Adjustment | Jon Rogers, Sr. Consultant, Risk Adjustment In 2022, CMS launched the National Quality Strategy, a long-term initiative that aims to promote the highest quality outcomes and safest care for all individuals. The strategy focuses on a
Read More →The HPMS memo released yesterday is a significant signal for changes to come, especially when viewed through the lens of the 2024 MAPD Final Rule (CMS-4201-F) and the recently released 2024 Readiness Checklist. It’s a call to action for all compliance officers and Utilization Management (UM) departments
Read More →– by Lynn Kryfke, MSN, RN, Sr. Consultant, Risk Adjustment | Jon Rogers, Sr. Consultant, Risk Adjustment How do we capture the health of an individual, population and community, in a complete and accurate manner? According to the American Information Management Association (AHIMA), the current approach to
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Health plans and issuers need to ramp up compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA) in response to the new proposed rules from the Departments of Labor, Health and Human Services. The proposed rules represent a significant shift in compliance measures, and plans
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