The Centers for Medicare & Medicaid Services (CMS) recently released its 2027 ACA Notice of Benefit and Payment Parameters Final Rule, introducing significant changes aimed at reducing costs, strengthening program integrity, cracking down on fraud, and increasing state flexibility across ACA Exchanges.

Health plans are under increasing scrutiny as CMS intensifies its focus on financial integrity, particularly through One Third Financial Audits. Recent enforcement actions highlight a consistent pattern: issues with cost sharing accuracy and maximum out-of-pocket (MOOP) compliance are not isolated events, but systemic risks embedded within claims processing and configuration even among well-established health plans.

We are pleased to invite you to our free webinar on April 3, 2024 from 1:00 to 2:30 pm EDT.

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...

Did you know that CMS provides nearly 100 different reports to Medicare Advantage and Part D plans? These reports cover membership,...

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

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...