CMS recently released the 2021 Program Audit Memo announcing that it will start sending engagement letters in March 2021, but health plans should remain diligent about audit preparation and their PBM oversight activities.
Tag: Medicare Advantage
GHG recently hosted a webinar with Pareto Intelligence and Episource to discuss the best strategies to deploy to ensure that your upstream encounter data is accurate, complete, compliant, and ready for submission. Read a synopsis of the topics covered and watch the webinar recording on demand.
As MA plans continually search for opportunities to grow enrollment, it’s critical to approach the expansion process in a fiscally responsible way. Read our tips for evaluating your growth opportunity.
CMS recently released the 2022 Advance Notice Part 1, with a heavy emphasis on the shift from RAPS to EDS to calculate risk scores. Here’s what you should know.
It’s network development season, and CMS’ recent changes to network adequacy requirements merit taking a closer look at where new MA plans can take root, and where existing plans can further expand their service areas.
CMS recently released the 2021 Chapter 2 Enrollment Changes. GHG’s VP of Sales, Marketing & Strategy, Diane Hollie, summarizes the key changes here.
A global pandemic and Presidential election year have created uncertainty surrounding this year’s AEP. However, there are a few things we know for certain and this year, health plans should be prepared with an intentional OEP strategy.
CMS’ recent network adequacy updates will open doors for plans to provide services in counties that would have otherwise proven difficult to meet network adequacy requirements.
On July 7, 2020, CMS distributed a draft addendum to address changes required for Integrated DSNPs for Unified Appeal and Grievance processing in the Parts C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance. Noteworthy changes are summarized here.
GHG recently held a virtual roundtable with leaders from Blue Cross and Blue Shield of Louisiana, HPOne, and Senior Market Sales discussing AEP sales strategies during a pandemic and presidential election. Read a synopsis of the topics covered and watch the webinar recording on demand.