Every year, the Centers for Medicare and Medicaid Services (CMS) updates its Plan Benefit Package (PBP) Software that Medicare Advantage (MA) and Part D plans use as part of their bid submissions. The PBP Beta Software is released in late January to allow plans to test and provide feedback before the full version is available…

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Merger will combine deep experience of healthcare industry veterans nationwide TAMPA, Fla. (Jan. 27, 2021) – CODY®, a Tampa, Fla-based healthcare technology and consulting firm, has acquired Madena™ in a transaction valued at $7.3 million. Madena, a recognized consulting and software leader with an emphasis on enrollment, billing and reconciliation, is best known for its…

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As the Centers for Medicare and Medicaid Services (CMS) increases its scrutiny and escalates enforcement, Compliance managers are on guard to ensure regulatory standards are met—and fines, sanctions, or even termination from CMS programs, are avoided. How can Compliance and Operations managers mitigate compliance risk and improve operations? The best way to avoid compliance errors…

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Policies and procedures are essential tools for any organization. By clearly articulating the requirements established by external oversight bodies and internal standards, they are an effective control to support consistency, accountability, and compliance. To be effective, policies and procedures should be: Designed as tools that help employees make decisions related to their assigned tasks/responsibilities; Clear,…

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It’s no secret that Star Ratings can have a significant impact on a health plan’s membership and bottom line. As competition increases, it’s essential to have strategies in place to elevate or maintain a 4+ star rating. The Centers for Medicare and Medicaid Services (CMS) recently released Highlights of Contract Performance in 2021 Star Ratings.…

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Julie Hughes expands leadership position with health plan compliance expertise CODY®, a Tampa, Fla.-based healthcare technology and consulting firm, has hired health plan compliance expert Julie Hughes as Chief Compliance Officer. In this role, Hughes will lead CODY’s internal compliance program and deliver compliance consulting services to clients. She will be instrumental in working across the organization…

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Deb Mabari’s chapter covers payer privacy issues in the Health Care Compliance Association’s latest edition of “Health Care Privacy Compliance Handbook” TAMPA, Fla. (Oct. 27, 2020) – Deb Mabari, chief executive officer of CODY®, a Tampa, Fla.-based healthcare technology and consulting firm, has authored a chapter in the Health Care Compliance Association’s newest edition of…

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In today’s rapidly changing environment, health plans operating in silos or with dated legacy systems are struggling to keep up. As competition increases and technology evolves, companies are searching for answers—should they purchase software applications individually or buy a suite or bundle? IT purchasing managers face difficult challenges as business needs grow, software solutions change,…

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Artificial Intelligence (AI) will become a larger factor in all facets of life soon… …in everything from self-driving cars to industrial manufacturing to the way we entertain ourselves. These changes will impact every part of healthcare also, from diagnosis through treatment and even into administrative and operational functions. CMS has started two initiatives directly related…

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Health plans are wondering “where are my updated Medicare Communications and Marketing Guidelines (MCMG)?” For the second consecutive year, the Centers for Medicare & Medicaid Services (CMS) stated that there will be no updated MCMG for CY2021. Instead, plans are instructed to use the existing MCMG and related memos from CY2020. How will changes be…

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