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CMS Issues Final Rule to Hold MAOs Accountable for Risk Adjustment Practices

On January 30th, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS),...

How Medicare Advantage Plans Will or Will Not Succeed, With Betsy Seals

Here’s a big thing that Betsy Seals makes clear in this show: Big companies can be successful in Medicare Advantage (MA)—and I mean...

Part D Benefit Administration Testing (BAT)

Part D Pharmacy Directors and Formulary administrators, Rebellis is ready to assist you with your 2023 BAT testing! Benefit...

SNP MOC Audit Readiness: Is your team prepared?

CMS Program Audits are in full swing this summer, but are you truly prepared? If you are a Special Needs Plan (SNP) and you are not quite...

CMS 2021 Audit & Enforcement Report

On June 7, 2022, The Centers for Medicare & Medicaid Services (CMS) announced the release of the 2021 Part C and Part D Program Audit and...

CMS 2023 Final Rule: Top 5 Takeaways

The Centers for Medicare and Medicaid Services (CMS) published a preliminary Final Rule on April 29 revising Medicare Advantage (MA)...

2023 MA and Part D Final Rate Announcement Includes 8.5% Revenue Boost, Increased Star Ratings

The Centers for Medicare and Medicaid Services (CMS) published the Announcement of Calendar Year (CY) 2023 Medicare Advantage (MA)...

Have you Implemented and Tested the 2022 Audit Protocols?

Now that we are through the gates of AEP/OEP season, it’s time to focus on key upcoming events: Program Audits and Timeliness Monitoring...