Industry News and Perspectives From The Rebellis Group Team

communication-infographic-innovation-people-technology-abstract-background.jpg

Latest News

Dec 162 min read

Secret Shopper Calls: Are Your Call Centers Prepared for CMS Monitoring?

The Centers for Medicare & Medicaid Services (CMS) secret shopper program is an essential compliance check for Medicare Advantage and...

27 views0 comments

Nov 262 min read

CMS Notifies 60 Medicare Advantage Contracts of RADV Audits

On November 14, 2024, the Centers for Medicare & Medicaid Services (CMS) initiated Payment Year (PY) 2018 Risk Adjustment Data Validation...

171 views0 comments

Nov 223 min read

Dr. Mehmet Oz's Nomination as CMS Administrator: What It Means for the Future of Medicare and Medicaid

President Trump’s nomination of Dr. Mehmet Oz to lead the Centers for Medicare and Medicaid Services (CMS) could signal significant...

284 views0 comments

Oct 172 min read

Get Ahead of CMS Readiness: Stay Compliant and Prepared for 2025

As the Arizona heat finally dips below 100 degrees, it’s starting to feel like Fall—my favorite season. Halloween is just around the...

89 views0 comments

The Impact of GLP-1s Medications on Health Plans

Sep 272 min read

Part D

The Impact of GLP-1s Medications on Health Plans

Recent statistics from the CDC show more than 38 million people in the US have diabetes and up to 9 million of that number as...

41 views0 comments

Jun 53 min read

SCAN Health Plan Wins Lawsuit Against CMS

SCAN succeeded in United States District Court after a federal judge agreed that the CMS improperly calculated its 2024 Star Ratings.

226 views0 comments

CMS’s CY 2025 Final Rule: A Quick Summary

Apr 88 min read

Compliance

CMS’s CY 2025 Final Rule: A Quick Summary

912 views0 comments

CMS’s CY 2025 Rate Announcement: Key Takeaways

Apr 33 min read

Strategy

CMS’s CY 2025 Rate Announcement: Key Takeaways

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

231 views0 comments

Apr 34 min read

Part D

CMS’s Final CY 2025 Part D Redesign Program: The Big Five Takeaways

On April 1, 2024, CMS issued their Final Calendar Year (CY) 2025 Part D Redesign Program Instructions (draft instructions issued...

278 views0 comments

Have Medicare Advantage Benefits Peaked?

Mar 211 min read

Marketing

Have Medicare Advantage Benefits Peaked?

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

34 views0 comments

Webinar: Medicare Prescription Payment Plan (M3P) of the Inflation Reduction Act (IRA)

Mar 141 min read

Part D

Webinar: Medicare Prescription Payment Plan (M3P) of the Inflation Reduction Act (IRA)

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...

44 views0 comments

Rebellis Group merges with Toney HealthCare

Feb 282 min read

Press Releases

Rebellis Group merges with Toney HealthCare

Press Release Toney Healthcare, a clinically oriented consultancy and provider of utilization management, care management and quality...

315 views0 comments

Supplemental Benefits are a Hot Topic with CMS

Feb 265 min read

Risk Adjustment

Supplemental Benefits are a Hot Topic with CMS

New Guidance Released on Encounter Data Submission of Supplemental Benefits

142 views0 comments

Jan 194 min read

The Impact of the CMS Interoperability and Prior Authorization Final Rule

Seismic waves were felt across health plans this week with the finalization of the CMS Interoperability and Prior Authorization Final...

122 views0 comments

CMS 4205-P Proposed Rule: Top Five Takeaways

Nov 21, 20234 min read

Compliance

CMS 4205-P Proposed Rule: Top Five Takeaways

On November 15, 2023, CMS issued a proposed rule that proposes revisions to regulations governing Medicare Advantage (MA or Part C), the...

627 views0 comments

Sep 28, 20234 min read

Risk Adjustment

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

1,473 views0 comments

Sep 19, 20233 min read

Part D

GAO Report on Rebates in Medicare Part D Program

The United States GAO (General Accountability Office) released their report on Rebates in the Medicare Part D Program this month...

34 views0 comments

AI: The good, the bad, and the ugly in Medicare Advantage

Sep 12, 20234 min read

Compliance

AI: The good, the bad, and the ugly in Medicare Advantage

When most of us think about artificial intelligence (AI) in healthcare, we don’t usually think about an algorithm determining if our...

119 views0 comments

Social Determinants of Health and the Updated D-SNP Health Risk Assessment Requirements

Sep 1, 20231 min read

Compliance

Social Determinants of Health and the Updated D-SNP Health Risk Assessment Requirements

Beginning in contract year 2024, there will be CMS changes mandated to Special Needs Plans (SNPs) Health Risk Assessments (HRAs) to...

58 views0 comments

The Inflation Reduction Act of 2022...Winter is Coming

Jul 26, 20232 min read

Part D

The Inflation Reduction Act of 2022...Winter is Coming

Looking ahead to 2025 for Part D benefits, things don’t look too rosy for health plans. The Inflation Reduction Act of 2022 will be...

254 views0 comments

Latest News

Home

Privacy Policy

Careers

Subscribe

Contact