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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,...

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...

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...

Annual Election Period: Key Trends

Co-Authored by John Selby and Diane Hollie This Annual Enrollment Period will definitely be one to watch. The key themes emerging from...

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...

Medicare Advantage and Part D Proposed Rule

Co-Authored by Debra Devereaux and Roxanne Newland CY2023 Medication Advantage and Part D Proposed Rule (CMS-4192-P) Proposed provisions...