Clover Care’s lawsuit against HHS raises a question that goes well beyond a technical dispute over measures: are Medicare Star Ratings simply a mirror that reflects performance, or have they become a steering wheel that directs the system itself?

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

2024 Submission The 2024 Medication Therapy Management Program (MTMP) submission date is June 7 and the MTMP attestations are due June 21. The 2024 annual MTM program cost threshold is $5,330 ($444.16 per month). Website Requirements The health plan website should have a separate page or section describing their MTM program using a font that is easily read and information that is easily understood. The website information should include: What the MTMP is, the purpose of the p

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...

CMS Star Ratings and Member Experience

Co-Authored by Jane Scott and Jennifer Beckett Just over a week ago CMS released the 2022 Medicare Advantage Star Ratings results. Over...