The Transformative Power of GenAI in Healthcare Compliance and Operations
As a former U.S. healthcare operation management professional, I understand the complexities and dynamic nature of the healthcare compliance landscape. […]
Will Reporting Medical Loss Ratio (MLR) Constrain Payments to Medicare Advantage Plans?
Medicare Advantage plans (MAO) have been increasingly popular, with Medicare-eligible beneficiaries enrolling 51% of the eligible population in 2023, taking
Regulatory Changes for PDE Reporting in CY 2024 and Beyond
On October 13, 2023, the Centers for Medicare & Medicaid Services (CMS) published the Readiness List for CY 2024. This
2024 Medicare Advantage and Part D Star Ratings: Key Observations and Takeaways
2024 Star Ratings, which CMS released on October 13, 2023, has forced the industry to reflect upon and restrategize the
The Inovaare – MongoDB Partnership: Unlocking Excellence in Healthcare Compliance
Add New Post In a world of evolving healthcare regulations, compliance isn’t just a mandate – it’s a cornerstone of
How Price Transparency in Healthcare Affects Providers, Payers and Patients
Price transparency is a term that has recently become a leading factor among healthcare payers and providers. It’s a tool
Enhancing Vendor Management Oversight: The Role of Technology Solutions in Health Plans
In the ever-evolving landscape of healthcare, health plans are realizing the importance of leveraging technology solutions to improve their Vendor
What you should know about Part B drug payments to comply with IRA 2022
The Inflation Reduction Act of (IRA) 2022 has wide-ranging impact on payments for drugs used by Medicare beneficiaries, whether they
2023 CMS Audit Protocols: What You Need to Know
The Centers for Medicare & Medicaid Services (CMS) has released new audit protocol changes for Medicare and Medicaid plans. These
ACA Health Plans — Key considerations for staying relevant
A perspective on recent industry shifts influencing ACA plan operations in states, which are yet to adopt ACA Medicaid expansion