HHS announced that the Public Health Emergency (PHE) for COVID-19 will end on May, 11, 2023. During the PHE, CMS used a combination of emergency authority waivers, regulations, enforcement discretion, and sub-regulatory guidance to ensure easier access to care during the PHE for healthcare providers and their beneficiaries.
Read More →It’s crucial that all contracting organizations accurately report parent organization status and legal entity name to CMS. All current and prospective MA, PDP, Cost, PACE and MMP organizations are requested to conduct annual reviews of the parent organization and legal entity name as listed in the Health
Read More →The Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) audit is a vital process conducted by CMS to ensure the correctness of payments to MA plans. CMS determines monthly payments based on the health and demographic characteristics of each member, as determined by the Hierarchical Condition Category
Read More →Highlights from HCCA 2023 Managed Care Compliance Conference Presentation by Anne Crawford, ATTAC Consulting Group | Sandra J. Durkin, Strategic Health Law Click here to see full presentation
Read More →Highlights from HCCA 2023 Managed Care Compliance Conference Presentation by Amanda Brown, ATTAC Consulting Group | Bailey Wendzel, Epstein, Becker Green Click here to see full presentation
Read More →Medicare Advantage organizations may not have gotten the outcome they were hoping for in CMS’s recently finalized Risk Adjustment Data Validation rule, but industry experts say they weren’t surprised by the position CMS ultimately took after years of pressure to close out RADV audits and recover identified
Read More →It’s time for plans to transition from a waiting period to a move-forward moment After five years of waiting, Medicare Advantage plans now know CMS’s position on CMS and OIG audit extrapolations. It’s time for plans to transition from a waiting period to a move-forward moment, and to
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