ATTAC and mPulse co-presented this comprehensive webinar and discussion that aims to empower attendees to: Debunk myths related to the TCPA, consent, and the healthcare exemption Get the background on the TCPA’s purpose, history, terminology, and requirements Understand existing and recent TCPA litigation related to the healthcare
Read More →by Jon Rogers, Sr. Consultant, Risk Adjustment As we reach the midpoint of 2024, managed care organizations (MCOs) must take a close look at their In-Home Health Assessment (IHHA) programs, which play a critical role in managing the health of Medicare Advantage and Affordable Care Act populations.
Read More →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
Read More →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
Read More →Charles Baker, VP, Compliance Solutions Read in .pdf here The Centers for Medicare & Medicaid Services (CMS) ushered in a new era for the Medicare Advantage Part C and Prescription Drug Benefit programs with the unveiling of the Contract Year 2025 Final Rule. This comprehensive regulatory overhaul
Read More →ATTAC’s Clinical and Compliance Experts Will Help Your Plan Prepare for a UM-Focused Audit We Also Provide Post-Audit Corrective Action and Remediation Support CMS UM-focused audits for Medicare Advantage are here. As part of the 2024 Medicare Advantage and Part D Final Rule, CMS announced that utilization management (UM)-focused
Read More →Reprinted with AIS Health permission from the 4/4/24 issue of Radar on Medicare Advantage Thanks to a final rule published just one year ago, Medicare Advantage plans as of Jan. 1 were expected to meet new constraints when it comes to applying their utilization management (UM) policies, including
Read More →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
Read More →– Charles Baker, VP, Compliance Solutions The transition of Medicare-Medicaid Plans (MMPs) to Dual-Eligible Special Needs Plans (D-SNPs) by the end of 2025 marks a significant change in healthcare delivery. This shift demands a comprehensive approach due to the complex regulatory ecosystem; it’s essential for health plans to
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 →