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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Compliance Isn’t Just Compliance Anymore: Three Ways Medicare Advantage Teams Can Shift From Retrospective Oversight & Deliver Strategic Value 

Compliance Isn’t Just Compliance Anymore: Three Ways Medicare Advantage Teams Can Shift From Retrospective Oversight & Deliver Strategic Value 

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

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