The April 1 CMS announcement included finalized payment updates within the 2025 Medicare Advantage and Part D Rates. Highlights include goals for MA and Part D programs, including advancing equity, driving person-centered care, and promoting affordability. Read more for the expected impact of these changes and things your organization should be considering because of them.
Megan Christiana has been appointed Healthcare Solutions Consultant for Garnet River. Christiana is responsible for business development, client experience, and product and program development. She is based in Garnet River’s headquarters office at 60 Railroad Place in Saratoga Springs, N.Y.
In the upcoming weeks, I’ll guide us through a journey exploring the diverse perspectives of caregivers. But before we embark on this exploration together, I want to share why caregiving resonates so deeply with me.
One of our products, CareHerd, reduces the stress and increases the effectiveness of family care by combining the best caregiving tools into one application. Today, as a way to thank and celebrate caregivers on Caregiver Appreciation Day, we share thoughtful ways you can show your appreciation to those who selflessly give and make a difference.
Annually, open enrollment activities are a true performance test of your company’s systems and processes. Challenges faced during open enrollment can lead to significant compliance risks for your organization as it enters the CMS 2024 Program Audit time of year.
On November 30th, 2023, CMS released the updated Plan Communications User Guide (PCUG) 17.4v for Medicare Advantage and Prescription Drug Plans. Changes are minimal, but the release is always a good time for you to revisit what you're doing. Here's what you need to know and what you should be thinking about.
On August 30, the Centers for Medicare & Medicaid Services (CMS) sent a letter to all 50 states, requiring a review of their eligibility systems. The impetus for this letter: CMS determined some states’ Medicaid and CHIP eligibility systems are incorrectly configured to automatically renew people at the family level and not the individual level. Read here how this requirement and recommendations affect health plan partners.
On August 15, 2023, CMS released the updated guidance for Part C and Part D enrollment and eligibility. Included with the policy and technical changes was a new MA model enrollment request form. Read about the notable updates here, as well as access links to enrollment/disenrollment instructions and forms.
Annually, open enrollment activities are a true performance test of your company’s systems and processes. Challenges faced during open enrollment can lead to significant compliance risks for your organization as it enters the CMS 2023 Program Audit time of year.
From 2022 to 2023, star ratings for Medicare Advantage Plans (MAPs) have dropped—from 68 percent of MAPs having 4 stars or higher to only 51 percent having 4 stars or higher. That means slightly less than half the plans available to Medicare eligible members have achieved a good rating. For those MAPs with lower CMS star ratings than they would like, or those with CMS star ratings they would like to maintain or boost, here are four tips for setting your organization apart and helping increase your CMS star rating.
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