SCAN Health Plan Wins Lawsuit Against CMS
SCANÂ succeeded in United States District Court after a federal judge agreed that the CMS improperly calculated its 2024 Star Ratings.
top of page
Latest News
Search
- Apr 8
- 8 min
CMS’s CY 2025 Final Rule: A Quick Summary
CMS’s CY 2025 Final Rule: A Quick Summary
847 views0 comments
- Apr 3
- 3 min
CMS’s CY 2025 Rate Announcement: Key Takeaways
The Centers for Medicare and Medicaid Services (CMS) published the Calendar Year (CY) 2025 Medicare Advantage (MA) Capitation Rates and...
215 views0 comments
- Apr 3
- 4 min
CMS’s Final CY 2025 Part D Redesign Program: The Big Five Takeaways
On April 1, 2024, CMS issued their Final Calendar Year (CY) 2025 Part D Redesign Program Instructions (draft instructions issued...
258 views0 comments
- Mar 21
- 1 min
Have Medicare Advantage Benefits Peaked?
We are pleased to invite you to our free webinar on April 3, 2024 from 1:00 to 2:30 pm EDT.Â
31 views0 comments
- Mar 14
- 1 min
Webinar: Medicare Prescription Payment Plan (M3P) of the Inflation Reduction Act (IRA)
Join our webinar on Mar 19, 2024 at 1:00 PM EDT. Registration Beginning in 2025 all Medicare Part D plans must offer the option to pay...
44 views0 comments
- Feb 28
- 2 min
Rebellis Group merges with Toney HealthCare
Press Release Toney Healthcare, a clinically oriented consultancy and provider of utilization management, care management and quality...
257 views0 comments
- Feb 26
- 5 min
Supplemental Benefits are a Hot Topic with CMS
New Guidance Released on Encounter Data Submission of Supplemental Benefits
115 views0 comments
- Jan 19
- 4 min
The Impact of the CMS Interoperability and Prior Authorization Final Rule
Seismic waves were felt across health plans this week with the finalization of the CMS Interoperability and Prior Authorization Final...
121 views0 comments
- Nov 21, 2023
- 4 min
CMS 4205-P Proposed Rule: Top Five Takeaways
On November 15, 2023, CMS issued a proposed rule that proposes revisions to regulations governing Medicare Advantage (MA or Part C), the...
619 views0 comments
- Sep 28, 2023
- 4 min
Risk Adjustment: Is Your Organization Ready For The Transition from V24 to V28?
Risk Adjustment: Is Your Organization Ready For The Transition from V24 to V28?
665 views0 comments
- Sep 19, 2023
- 3 min
GAO Report on Rebates in Medicare Part D Program
The United States GAO (General Accountability Office) released their report on Rebates in the Medicare Part D Program this month...
34 views0 comments
- Sep 12, 2023
- 4 min
AI: The good, the bad, and the ugly in Medicare Advantage
When most of us think about artificial intelligence (AI) in healthcare, we don’t usually think about an algorithm determining if our...
116 views0 comments
- Sep 1, 2023
- 1 min
Social Determinants of Health and the Updated D-SNP Health Risk Assessment Requirements
Beginning in contract year 2024, there will be CMS changes mandated to Special Needs Plans (SNPs) Health Risk Assessments (HRAs) to...
58 views0 comments
- Jul 26, 2023
- 2 min
The Inflation Reduction Act of 2022...Winter is Coming
Looking ahead to 2025 for Part D benefits, things don’t look too rosy for health plans. The Inflation Reduction Act of 2022 will be...
253 views0 comments
- Jun 26, 2023
- 3 min
What is the No Upcode Act?
A bipartisan bill has recently been introduced by Senators Bill Cassidy, MD (R-LA) and Jeff Merkley (D-OR) aimed at addressing risk...
130 views0 comments
- May 19, 2023
- 3 min
Utilizing the CMS MARx reports for compliance, revenue optimization and member satisfaction
Did you know that CMS provides nearly 100 different reports to Medicare Advantage and Part D plans? These reports cover membership,...
93 views0 comments
- May 9, 2023
- 2 min
2024 Final Rule: Top 5 Take Aways for Sales and Marketing Teams
Now that Medicare Advantage plans, FMOs, and other Third-Party Marketing Organizations (TPMOs) have had a chance to review the 2024 Final...
130 views0 comments
- May 3, 2023
- 3 min
CMS 2024 Final Rule: Top Takeaways
The Centers for Medicare and Medicaid Services (CMS) published Final Rule 4201-F (88 FR 22120) on April 12 revising the Medicare...
466 views0 comments
- Apr 26, 2023
- 3 min
It’s That Time Again: MTM Program Submission
2024 Submission The 2024 Medication Therapy Management Program (MTMP) submission date is June 7 and the MTMP attestations are due June...
70 views0 comments
bottom of page