On Friday, June 13th, CMS officially initiated PY2019 Medicare Advantage RADV audits , marking a significant escalation in oversight and...

CMS’s CY 2025 Final Rule: A Quick Summary

The Centers for Medicare and Medicaid Services (CMS) published the Calendar Year (CY) 2025 Medicare Advantage (MA) Capitation Rates and...

New Guidance Released on Encounter Data Submission of Supplemental Benefits

Risk Adjustment: Is Your Organization Ready For The Transition from V24 to V28?

A bipartisan bill has recently been introduced by Senators Bill Cassidy, MD (R-LA) and Jeff Merkley (D-OR) aimed at addressing risk...

On March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) issued its Announcement of Calendar Year (CY) 2024 Medicare...

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

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...

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

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...