On March 30, 2020, CMS released the interim final rule with comment period (IFC) to address a variety of payment and provider practice needs in response to the COVID-19 pandemic. Read the key takeaways for Star Ratings, Provider Flexibilities, and Telehealth.
Tag: CMS
What’s New in the 2021 Final Rate Announcement for Medicare Advantage and Part D Plans?
The 2021 Medicare Advantage and Part D Rate Announcement finalizes the payment methodology and policies previously proposed by the Advance Notice. What’s been confirmed? Read this article for details.
On Demand Webinar: Four Trends in Supplemental Benefits for 2021 Success
In a recent webinar, GHG shared the critical trends in supplemental benefits from the AEP results data that health plans need to know going into 2021 bids. Read a summary of the key takeaways and view the webinar recording on demand.
GHG Responds to Common Questions About CMS’ Proposed Star Ratings Changes
On March 30, 2020, CMS announced temporary regulatory waivers and new rules to help the U.S. healthcare system continue operating through President Trump’s COVID-19 emergency declaration. With this new information, GHG’s Star Ratings expert, Melissa Smith, answers many of the FAQs we’ve received over the last few weeks.
COVID-19 Star Ratings Changes: What Do We Know? What Remains Unknown?
CMS has announced significant temporary changes to Star Ratings in response to the COVID-19 pandemic to provide some relief to healthcare organizations, but we still have many unanswered questions. Here’s what we know so far.
What You Should Know: CMS 2021 Advance Notice & New 2021 & 2022 Proposed Rule
CMS has published key information regarding 2021 MA Part C & D bids, payments and rules in a series of documents released 2/5/2020. Here’s what you should know.
OIG Cracks Down on Chart Reviews in Medicare Advantage Risk Adjustment
The Office of Inspector General (OIG) report on the use of chart reviews in Medicare Advantage risk adjustment raises a number of concerns for Medicare Advantage Organizations (MAOs). How can plans mitigate risk from chart review submissions and stay compliant with CMS risk adjustment guidelines to ensure complete and accurate reimbursement?
Rejected Claims Review: Just As Important As Ever In 2019
Are you confident in your current process to review and identify non-compliant rejected claims? Rejected…
2020 Readiness Checklist
On October 3, 2019 the Centers for Medicare & Medicaid Services (CMS) released the 2020…
Blending Network Strategy & Product Strategy
As more and more health systems and provider organizations successfully manage the shift from volume-based…