[Podcast] Healthcare Blame Game: Providers, Payers, or Us?

Listen along for a wide-ranging conversation on the Health Elevated podcast. The discussion covers aspects of the healthcare system, including operations, process improvement, financial management, and the role of data science in healthcare innovation. The conversation explores who holds responsibility within the healthcare system—providers, payers, or patients

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RADAR on Medicare Advantage | Despite Trump Transition Chaos, Medicare Advantage Plans Must ‘Keep Calm’

In the first few weeks of Donald Trump’s second presidency, Medicare Advantage plans faced a tremendous amount of uncertainty as the White House threatened to pause federal financial assistance activities, issued multiple executive orders outlining the new administration’s priorities, and targeted diversity, equity and inclusion (DEI) initiatives

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Regulatory Freeze: How Medicare Advantage Plans Can Balance Challenges with Opportunities for Growth

Charles Baker, VP, Compliance Solutions President Trump’s executive order to freeze federal regulations has left the healthcare industry, particularly the Medicare Advantage (MA) program, in a state of uncertainty. The freeze, which is intended to align current and proposed rules with the administration’s priority of “reducing the

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Transform Your HHS-RADV Outcome and Efficiency

ATTAC’s HHS-RADV Audit Expertise Delivered for Our Clients in 2024 ✨ Overall Validation Rate: 94.2% 🚫 Overall Non-Validation Rate: 5.8% 🔍 Our Enhanced Audit Efficiencies Include: 📌 >99% claims matching rate 📌 Experienced in-house, on-shore ACA coding team 📌 Dedicated and experienced audit managers 📌 Web-based reporting

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Qualified Health Plans Secret Shopper Requirements: Do You Have a Process to Survey Your Network and Capture Actionable Analytics by May 31?

Qualified Health Plans Secret Shopper Requirements: Do You Have a Process to Survey Your Network and Capture Actionable Analytics by May 31?

Are You Meeting CMS and State Access-to-Care Requirements? In the 2025 Final Rule, CMS released its expectations and reporting requirements to ensure timely access to care. Effective January 1, 2025, CMS requires issuers that offer Qualified Health Plans (QHPs), including stand-alone dental plans, to take specific actions.

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[Webinar Replay] Essential Risk Adjustment Insights for 2025-2026: How Plans and Providers Can Stay Ahead of Regulatory Changes and Compliance Challenges

[Webinar Replay] Essential Risk Adjustment Insights for 2025-2026: How Plans and Providers Can Stay Ahead of Regulatory Changes and Compliance Challenges

Watch The Essential Risk Adjustment Insights Webinar ATTAC Consulting Group’s risk adjustment experts presented an insightful webinar on risk adjustment planning for 2025 and 2026. We discussed a recommended risk adjustment calendar for both years, summarized best practices for health plans and providers, and outlined changes in

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Important Updates for CMS Calendar Year 2025 Evidence of Coverage (EOC) Models

Important Updates for CMS Calendar Year 2025 Evidence of Coverage (EOC) Models

On November 5, CMS updated URLs in the following CY 2025 EOC models: CY2025_1_HMO_MAPD_ISNP_CSNP_EOC_Correcting URLs_11042024 CY2025_2_PPO_MAPD_ISNP_CSNP_EOC_Correcting URLs_11042024 CY2025_3_DE_SNP_EOC_Correcting URLs_11042024 CY2025_4_Cost_Plan_EOC_Correcting URLs_11042024 CY2025_5_PFFS_EOC_Correcting URLs_11042024 CY2025_6_MSA_EOC_Correcting URLs_11042024 CY2025_7_HMO_MA_EOC_Correcting URLs_11042024 CY2025_8_PPO_MA_EOC_Correcting URLs_11042024 CY2025_9_PDP_EOC_Correcting URLs_11042024 The URLs required replacement due to an error in links of the previous models. For example,

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RADAR on Medicare Advantage | CMS’s $40B GLP-1 Proposal Offers Leeway for Part D Plans to Define Obesity

RADAR on Medicare Advantage | CMS’s $40B GLP-1 Proposal Offers Leeway for Part D Plans to Define Obesity

December 5, 2024 issue of RADAR on Medicare Advantage Acknowledging the growing prevalence of obesity in the U.S. and its existence as a chronic disease, CMS in its proposed Medicare Advantage and Part D rule for the 2026 contract year included a landmark provision to expand Medicare

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RADAR on Medicare Advantage | Biden Admin Seeks Broader Review of Marketing Materials, But Will Trump Admin See Overreach?

RADAR on Medicare Advantage | Biden Admin Seeks Broader Review of Marketing Materials, But Will Trump Admin See Overreach?

Dec 05, 2024 issue of RADAR on Medicare Advantage While the Joe Biden administration has applied many regulatory tweaks to the Medicare Advantage program in the name of improving the consumer experience, industry observers expect the incoming Donald Trump administration will take a more plan-friendly approach from

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