Articles and Blogs

On November 26, 2024, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule that revises the Medicare Advantage (“MA”) Program, Medicare Prescription Drug Benefit Program (“Part D”), Medicare Cost Plan Program and Programs of All-Inclusive Care for the Elderly for the Contract Year 2026 (“Proposed Rule”). The Proposed Rule clarifies the... READ MORE

In a move likely to ignite strident industry opposition, on January 30, 2023, the Centers for Medicare & Medicaid Services (“CMS”) announced finalization of its rule on Medicare Risk Adjustment Data Validation (“RADV”) audit methodology and resulting collection of overpayments from Medicare Advantage Organizations (“MAOs”). Experts estimate that the final rule will result in... READ MORE