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What Health Plans Can Expect from CMS in 2019

In 2018, The Centers for Medicare & Medicaid Services (CMS) announced regulatory changes that impacted how and when health plans must provide Evidence of Coverage (EOC) documents to members. Uncoupling the EOC from the Annual Notice of Change (ANOC) document mailing, allowing for electronic delivery of the EOC and extending the EOC delivery deadline to…

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PERSPECTIVES: Combining Medicare and Medicaid into One Program

The status quo of government-sponsored health programs is beginning to fail. The government recently reported that Medicare will run out of money in less than 20 years unless drastic changes are made. But how can our health care system be altered to correct deficiencies and adjust to changing conditions, avoid a huge financial crisis in…

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Dealing with Change in the Medicare World

The healthcare world and Medicare health coverage are in a state of rapid and uncertain change. What can health plans and those serving health plans, such as pharmacy benefit managers and even consultants, do to be ready for both anticipated and unanticipated changes? Here are some of the issues facing the industry in today’s turbulent…

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What Health Plans can Expect in 2018

With a new year right around the corner, we asked our team of experts: What can health plans expect in 2018? Listed below are a few issues health plans should be aware of and keep an eye on as we move into the new year. These cover the areas of compliance, technology, and member marketing…

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Are Your Materials Section 508 Compliant?

Any time health plans prepare an electronic document that will be posted online or distributed via e-mail, the material needs to meet current Section 508 standards of the Rehabilitation Act. This is true of both internal and external documents. Failing to meet these requirements can result in fines and sanctions from the Centers for Medicare…

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How a Medicare Advantage Voucher Program could be the Next Medicare Part D

With 10,000 Americans entering Medicare every day, the health plan industry continues to expand. In 2015, 55.5 million people were enrolled in Medicare. By 2020, that number is expected to increase to 64.4 million, and to balloon to 81.8 million by 2030. Yet, of the current 55.5 million Medicare beneficiaries, only a third are enrolled in…

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3 Ways Growing Health Plans can Avoid Adding FTEs

Health plans today are feeling more pressure than ever before to do more with less. This is especially true now that health plans have to operate within the federal minimum medical-loss ratio (MLR) requirement. The minimum MLR requirements leaves health plans with only 15 percent of their Medical revenue to spend on administration, marketing, and,…

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7 Tips for Recruiting your Magnificent 7

Building a strong team is an important aspect of any healthcare leadership role. Companies and even projects often fail because they don’t have the right mix of people in place. However, when the right talent does come together, truly magical things can happen – whether that is transforming a culture, introducing a new product or…

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Surviving the Attrition Blizzard of 2016

If there’s one thing that we can learn from Winter Storm Jonas, it’s that even a well-forecasted storm can wreak havoc if you are not prepared. This reminded me of another storm that is expected to hit corporate America this year, which I have appropriately named the “Attrition Blizzard of 2016.”

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Two New CodySoft® Modules Launch

Continuing to lead the charge in developing innovative solutions for health plan compliance issues, Cody Consulting recently launched two new CodySoft® modules: the Policy and Procedures Module™ and HPMS Memo Module™.

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