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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December 5, 2024 issue of RADAR on Medicare Advantage Multiple industry experts say the current administration’s last major Medicare Advantage and Part D rulemaking attempt was largely “business as usual,” with CMS expanding on policies of the Joe Biden presidency and digging further into persistent issues like
Read More →Justin Murakami, JD, CHC, is a highly accomplished healthcare compliance expert with more than 14 years of experience with Medicaid, Medicare, commercial health plans and provider organizations, specializing in California’s complex regulatory landscape. He is known for his leadership in regulatory audits, compliance program development, and risk
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Charles Baker, VP, Compliance Solutions | Victoria Nadzam, MSN, RN CMS has announced significant revisions to Medicare Advantage Part C and Prescription Drug plans. These changes, related to enrollee grievances, organization/coverage determinations, and appeals guidance, will take effect on January 1, 2025 and will affect plans nationwide.
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Nov. 7, 2024 issue of RADAR on Medicare Advantage Based on a review of select diagnosis codes submitted by Medicare Advantage plans for risk-adjusted reimbursement dating back to 2015, the HHS Office of Inspector General (OIG) estimates that 34 MA contracts received at least $801.3 million in
Read More →Victoria Nadzam, MSN, RN, is an accomplished healthcare professional with expertise in clinical operations management, process and performance improvement, and accreditation and regulatory compliance. She has a proven track record of driving compliance with NCQA standards and optimizing healthcare delivery across diverse sectors, including Medicare, commercial ACA,
Read More →Jennifer Eidam is a seasoned sales professional with extensive experience in healthcare, SaaS, and pharmaceutical industries. In her years of working with payers, she has demonstrated exceptional leadership and business development skills. In her role with ATTAC Consulting Group, Jennifer provides tailored, strategic guidance to clients, helping
Read More →Healthcare Industry Leader Brings Decades of Expertise in Healthcare Payer Solutions and Strategic Growth ANN ARBOR, MI (Sept. 30, 2024) – ATTAC Consulting Group announced today that Kenneth McNeal has joined the firm as an SVP and Chief Revenue Officer. ATTAC is a national healthcare consulting firm that
Read More →Catch the webinar replay for expert insights on impacts of the CMS Final Rule. We discuss: Mental Health Parity | Significant changes will impact provider network operations and reimbursement. Provider Network Requirements | Tightened network adequacy standards are intended to ensure that plans provide beneficiaries with timely
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By Jocelyn Bayliss The 2025 Final Rule from CMS outlined expectations and reporting requirements related to timely access to care. Effective PY 2025, CMS requires that all states with Medicaid and the Children’s Health Insurance Program (CHIP) develop, conduct, and enforce independent secret shopper surveys to evaluate
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