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It’s That Time Again: MTM Program Submission
2024 Submission The 2024 Medication Therapy Management Program (MTMP) submission date is June 7 and the MTMP attestations are due June...
Apr 26, 20233 min read
Calendar Year 2024 Rate Announcement
On March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) issued its Announcement of Calendar Year (CY) 2024 Medicare...
Apr 7, 20233 min read
Call Center Optimization Has Major Impacts on 2023 Star Ratings
In 2020, when CMS shifted the star rating system from being heavily weighted on clinical care and health outcomes to one that was...
Mar 7, 20233 min read
CMS Issues Final Rule to Hold MAOs Accountable for Risk Adjustment Practices
On January 30th, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS),...
Jan 31, 20232 min read
CMS 4201-P Proposed Rule: The Big Five Takeaways
On December 14, 2022, CMS issued a proposed rule that puts forth revisions to regulations governing Medicare Advantage (MA or Part C),...
Jan 13, 20232 min read
2023 Program Audit Updates
2023 CMS Program Audit Updates
Dec 6, 20222 min read
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...
Dec 1, 20221 min read
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...
Oct 18, 20223 min read
2023 Star Ratings: Is Member Experience Your Achilles Heel?
CMS Star Ratings and Member Experience
Oct 10, 20222 min read
Part D Benefit Administration Testing (BAT)
Part D Pharmacy Directors and Formulary administrators, Rebellis is ready to assist you with your 2023 BAT testing! Benefit...
Aug 16, 20222 min read
SNP MOC Audit Readiness: Is your team prepared?
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...
Aug 9, 20222 min read
CMS 2021 Audit & Enforcement Report
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...
Jul 15, 20224 min read
Medicare Advantage is Growing: Are you Ready?
The growth of Medicare Advantage (MA), by almost every measure, is continuing at an explosive rate with no end in sight. The...
May 26, 20221 min read
CMS 2023 Final Rule: Top 5 Takeaways
The Centers for Medicare and Medicaid Services (CMS) published a preliminary Final Rule on April 29 revising Medicare Advantage (MA)...
May 15, 20223 min read
What is your Medication Therapy Management Program really doing for your members?
Since the Comprehensive Medication Review (CMR) completion rate became a Star measure, Part D sponsors have devoted internal and vended...
Apr 29, 20222 min read
2023 MA and Part D Final Rate Announcement Includes 8.5% Revenue Boost, Increased Star Ratings
The Centers for Medicare and Medicaid Services (CMS) published the Announcement of Calendar Year (CY) 2023 Medicare Advantage (MA)...
Apr 12, 20223 min read
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...
Mar 29, 20221 min read
Rethinking Formularies
The majority of Medicare Advantage Part D (MAPD) health plans utilize a “template formulary” configured by their PBM (Pharmacy Benefit...
Mar 23, 20223 min read
Model of Care: Evaluate Your Plan’s Evaluation Process!
Co-Authored by Anita McCreavy It is that time of year when plans evaluate their Quality Improvement Program and Model of Care successes...
Mar 14, 20222 min read
Rebellis Group is Pleased to Offer a Comprehensive MA and Part D Training Solution
Rebellis Academy offers online training to suit all organizational needs. Select from our out-of-the box courses, provide your own, or...
Mar 7, 20221 min read
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