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CMS’s CY 2025 Final Rule: A Quick Summary

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Have Medicare Advantage Benefits Peaked?

Mar 211 min read

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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.

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

Mar 141 min read

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...

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Supplemental Benefits are a Hot Topic with CMS

Feb 265 min read

Supplemental Benefits are a Hot Topic with CMS

New Guidance Released on Encounter Data Submission of Supplemental Benefits

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CMS 4205-P Proposed Rule: Top Five Takeaways

Nov 21, 20234 min read

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...

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Sep 28, 20234 min read

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

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Sep 19, 20233 min read

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...

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

Sep 12, 20234 min read

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...

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

Sep 1, 20231 min read

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...

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

Jul 26, 20232 min read

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...

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Jun 26, 20233 min read

What is the No Upcode Act?

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

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May 19, 20233 min read

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,...

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May 3, 20233 min read

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...

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It’s That Time Again: MTM Program Submission

Apr 26, 20233 min read

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...

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Apr 7, 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...

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Jan 31, 20232 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),...

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How Medicare Advantage Plans Will or Will Not Succeed, With Betsy Seals

Dec 1, 20221 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...

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Aug 16, 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...

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SNP MOC Audit Readiness: Is your team prepared?

Aug 9, 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...

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Jul 15, 20224 min read