Posts Tagged ‘risk management’

3 Keys to a Successful Compliance Program

Complying with state and federal rules and regulations is a challenging endeavor. It requires health plans to manage a slew of different processes and resources.  Missteps pose risks that could result in compliance violations, fines and a drop on CMS’s Five Star Quality Ratings. Some of the most difficult areas to manage, from a compliance…

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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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