Are you Prepared for an Audit of your HPMS Memos?

If the Centers for Medicare and Medicaid Services (CMS) reviewed your procedures around Health Plan Management System (HPMS) memos tomorrow – would you be happy with the outcome? Unfortunately for many health plans, the answer is, “No.” With anywhere from 10 to 20 HPMS memos distributed each week, there’s a heavy burden on compliance departments…

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For MA Plans: Increased Payments will mean Increased Compliance

By now, it is safe to assume that health plans across the nation have thoroughly read and examined CMS’ Final Medicare Advantage (MA) Rate Announcement and Call Letter for 2016. I think we all heard a collective sigh of relief with the announcement that reimbursements would increase, rather than decrease, in the coming year.

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Cody Experts Share Insights on Increased Government Oversight in MHPA Webinar

In September, Cody Consulting hosted the webinar “Increasing Federal Government Oversight…And How Medicaid Plans Can Prepare” as part of the Medicaid Health Plans of America (MHPA) Wednesday Webinar series. The presentation, which can now be viewed on the MPHA website, shared with attendees an overview of the type and level of oversight that the states…

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Surviving the 2015 AEP Materials Creation Process – Part 2 of 2

Medicare plans are mid-way through the process of creating Annual Election Period (AEP) materials – namely, Annual Notification of Change (ANOC) and Evidence of Coverage (EOC) documents – that are due to members by the end of September. At this stage of the game, tension is running high. By now, many health plans have likely…

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Surviving the 2015 AEP Materials Creation Process – Part 1 of 2

The Centers for Medicare & Medicaid Services (CMS) recently released its model documents for the 2015 Annual Enrollment Period (AEP). The rigorous, highly complex rules and regulations for member marketing materials wreak havoc on health plans year after year – and the clock is now ticking. Medicare plans must create, print and deliver AEP materials,…

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How Medicaid Plans can Prepare Compliance Efforts for Increased CMS Oversight

The writing is on the wall. There are well-documented issues of a lack of uniformity and accountability surrounding state Medicaid programs. Understanding CMS’s history of recognizing problems and acting to find solutions, it stands to reason the agency will, in the future, establish compliance programs for state Medicaid plans that mirror those of Medicare. When…

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