Off-Cycle MOC Submissions – Is It Time?

Anita McCreavy

Remember, your plan must be operating from an approved Model of Care (MOC).

The off-cycle submission process allows for substantial changes such as fundamental organizational changes essential to the MOC process and functions; for example, changes to an organization’s MOC narrative that occur between approval periods (e.g., year 2 of a three-year approval) and have not expired.

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Influencing Your 2019 Star Ratings: Every Day Matters

Melissa Smith

With last week’s release by the Centers for Medicare & Medicaid Services (CMS) of draft 2018 Star Ratings …

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Congressional Inaction Puts Government Health Programs in Jeopardy

Olga Walther

The packed agenda for Congress promised us a whirlwind of a month, and it certainly came with its …

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Creating Your Plan for the Readiness Checklist

Julie Billman

In 2017, the Centers for Medicare & Medicaid Services (CMS) moved from a Readiness Attestation to a Readiness …

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Benefit Administration Testing – From a Compliance, Audit, and Best Practice Perspective

Miru Monte

In 2016, 41 million individuals (72 percent of all Medicare beneficiaries) were enrolled in Medicare Part D. Of …

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Bernie’s “Medicare for All” Proposal Is DOA

John Gorman

I worked on single-payer healthcare legislation for US Rep. John Conyers (D-MI), my hometown Congressman from Detroit and …

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Senate Kicks Off Substantive ACA Fix Hearings

Olga Walther

On Wednesday, September 6, the Senate HELP Committee kicked off a series of hearings on a possible bipartisan …

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