In 2018, the cost of non-compliance to Plan Sponsors was more than $2 million dollars in civil money penalties (CMPs). While this is a precipitous drop from 2017’s cumulative assessment to the…
New Medicare Opioid Management Initiatives
The Centers for Medicare & Medicaid Services (CMS) held a webinar on December 27, 2018, to help providers understand the new guidance for prescribing opioids to Medicare beneficiaries – and if you…
CMS Program Audit Frequently Asked Questions – What Did We Learn?
On February 8, 2019, the Centers for Medicare & Medicaid Services (CMS) published its Audit Program Frequently Asked Questions (FAQs) document. Until now, CMS did not share key questions and answers with…
How Will the Final Parts C and D Appeals & Grievances Guidance Impact You?
The Centers for Medicare & Medicaid Services (CMS) published its final combined Parts C and D grievances and appeals guidance, along with related Frequently Asked Questions (FAQs), on February 22, 2019. As…
Proposed Star Ratings Changes in 2020 CMS Draft Call Letter
Proposed Star Ratings changes reinforce CMS commitment to private sector innovation and creativity by incenting plans via quality bonus payments to continue the hard work required to achieve the Triple Aim. In…
HHS Proposed Bill Could Revolutionize Current Rebate Pricing Model
Removal of Drug Rebate Safe Harbor Protection The U.S. Department of Health and Human Services (HHS) issued the proposed rule to remove the safe harbor protection rebates involving prescription pharmaceuticals on January…
The 2020 Advance Notice and Final Call Letter for MA & Part D
On January 30, 2019, the Centers for Medicare & Medicaid Services (CMS) released Part II of its Advance Notice of Methodological Changes for Calendar Year (CY) 2020 for Medicare Advantage (MA) Capitation…
