Medicare Plan Finder 2027 Rule: How to Prepare for CMS’s New Provider Directory Accuracy Requirements

Medicare Plan Finder 2027 Rule: How to Prepare for CMS’s New Provider Directory Accuracy Requirements

CMS Finalizes Medicare Plan Finder 2027 Rule: What Health Plans Need to Know In one of the most consequential transparency updates in recent years, CMS has finalized new requirements that will make Medicare Advantage (MA) provider directories publicly available on Medicare Plan Finder beginning with plan year 2027.  This change marks a

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Notification of Supplemental Benefits and Data Integrity: How Will CMS 2025 Final Rule Requirements Affect Your Medicare Advantage Plan?

Notification of Supplemental Benefits and Data Integrity: How Will CMS 2025 Final Rule Requirements Affect Your Medicare Advantage Plan?

Charles Baker, VP, Compliance Solutions and Tammy Hall, Senior Consultant, Compliance Solutions Medicare Advantage (MA) plans offering supplemental benefits have reported enrollee underutilization of many of these benefits. Supplemental benefits may include hearing, dental, vision, fitness programs, over-the-counter drugs, transportation for medical appointments, and other services that address

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The Battle For Medicare Advantage Star Ratings: SCAN and Elevance Victories Provide a Roadmap for Plans to Challenge CMS Methodologies

The Battle For Medicare Advantage Star Ratings: SCAN and Elevance Victories Provide a Roadmap for Plans to Challenge CMS Methodologies

By Charles Baker, VP, Compliance Solutions In the world of Medicare Advantage, the calculation of Star Ratings is more than a measure of quality – it’s a pivotal marker that can significantly sway federal funding and market competitiveness. Against the backdrop of high financial stakes and rigorous

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2025 Medicare Advantage Reforms: A Comprehensive Shift Towards Equity, Transparency and Patient-centered Care

2025 Medicare Advantage Reforms: A Comprehensive Shift Towards Equity, Transparency and Patient-centered Care

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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