Compliance
Navigating the Medicare Landscape: Implications of the Latest Rule Changes for Healthcare Organizations
The Centers for Medicare & Medicaid Services (CMS) has recently unveiled significant proposed changes to Medicare Advantage (MA), Medicare Prescription Drug (Part D), and Medicaid programs. Announced on November 26, 2024, these updates aim to enhance affordability, transparency, and equity in healthcare delivery. The implications of the latest CMS rule changes are vast, presenting both…
Read MoreExpert Q&A: The HEDIS details all health plans need to know
With HEDIS certification season quickly approaching, we sat down with MedeAnalytics experts Melissa Linder, Director of Product Management, and Lori Jacobsen, Quality Subject Matter Expert, to discuss the ins and outs of HEDIS. Q. To get us started, can you provide a summary of what HEDIS is? A. HEDIS stands for The Healthcare Effectiveness Data…
Read MoreProviders: Are you ready to be audited?
By Donna Kennedy In 2020, regular audits conducted by CMS and other payers were paused or significantly reduced as the COVID-19 pandemic took priority. Though we are not entirely ‘out of the woods’ of this health crisis yet, regulatory compliance teams have begun experiencing the resurgence and ramping up of provider reviews. Importantly, these audits…
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