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
Read More →– 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
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 →Amanda Brown, Vice President, Compliance Solutions 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
Read More →Charles Baker, VP, Compliance Solutions The recent CMS Plan Preview 2 brought a collective gasp across the Medicare Advantage world. With many healthcare plans still celebrating high Star Ratings from 2022 and 2023, CMS applying the Tukey Method of analysis that resulted in adjusted cut points felt
Read More →Charles Baker, VP, Compliance Solutions Compliance belongs at the strategic decision-making table to ensure the seamless integration of regulatory guidelines into the fabric of effective programs. For years, compliance in the health insurance sector, especially regarding government programs, has been synonymous with regulatory oversight. Compliance departments have
Read More →Baker is a distinguished leader in the healthcare industry, known for strategic expertise in health plan compliance and operational excellence ATTAC Consulting Group, a national leader in providing consulting, auditing, business operations and technology solutions to Medicare Advantage, Medicaid, commercial health insurers, and risk-bearing provider organizations, announced
Read More →The Centers for Medicare & Medicaid Services (CMS) took a significant step towards advancing health equity with the finalization of Parts C and D Enrollment Guidance. This strategic move aligns with CMS’s ongoing commitment to prioritize health equity, a dedication outlined in its comprehensive strategic plan and Framework for
Read More →On July 27, 2023, CMS released the HPMS memorandum “Announcement of the Part D Formulary and Benefit Administration Validation Audit” which will impact Medicare Advantage Prescription Drug Plans. The CMS training is presented by the Medicare Part C and D Oversight and Enforcement Group, Division of Audit
Read More →Per the CY 2023 Final Rule published on May 9, 2022, CMS requires applicants to demonstrate a sufficient network of contracted providers to care for beneficiaries before approving their application. Additionally, for CY 2024, CMS adopted regulations explicitly stating that applications may be denied if network adequacy
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