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Apr 33 min read
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...
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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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Sep 28, 20234 min read
Risk Adjustment: Is Your Organization Ready For The Transition from V24 to V28?
Risk Adjustment: Is Your Organization Ready For The Transition from V24 to V28?
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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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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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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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Apr 12, 20223 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)...
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Oct 13, 20212 min read
Improper Payments in Government Programs: Has The Other Shoe Already Dropped?
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...
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