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

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...

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 Enforcement Report. The report provides information on the program audit process, a current snapshot of the program audit landscape, a summary of the 2021 program audits, as well as CMS' enforcement actions. One of the most notable takeaways from the report is the largely continued trend of improved scores across each of CMS’ audit protocol

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

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

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...

Rebellis Academy offers online training to suit all organizational needs. Select from our out-of-the box courses, provide your own, or...

Rebellis Group's Betsy Seals and John Selby were recently interviewed by AIS regarding CMS's take on third party marketers and the...

Co-Authored by Debra Devereaux and Roxanne Newland Where Medicare programs are concerned, no platitude could be more relevant. CMS...

Co-Authored by Jennifer Young and Wendy Karsten Sign-up for our newsletter and we will send you a copy of our best practice CMS Readiness...

Co-Authored by Betsy Seals, CEO and Martha Goodlin, RN Over the past several years, we have seen an increase in CMS, OIG, and DOJ activity around recouping “improper” payments in the Medicare Program. With the new administration, the focus on identifying and recouping improper payments is almost palpable. Most recently, on August 30th, the DOJ and Sutter Health settled on Sutter paying $90 Million to Settle False Claims Act Allegations of Mischarging the Medicare Advantage Pr