HCSC Acquires Cigna’s Medicare Businesses and CareAllies
Health Care Service Corporation (HCSC) has entered into a definitive agreement to purchase Cigna’s Medicare Advantage, Medicare Supplemental Benefits, Medicare […]
Healthcare Payer
Understanding the 2025 Medicare Part D Re-design: What You Need to Know
The Prescription Drug Program, commonly known as Medicare Part D, is undergoing significant transformations in 2025 due to the Inflation
2024 CMS Program Audit Updates: Summary and Insights
Summary of the HPMS Memo Generated by USHER (Inovaare’s AI-powered Compliance Assistant) The Centers for Medicare and Medicaid Services (CMS)
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
What you should know about Part B drug payments to comply with IRA 2022
The Inflation Reduction Act of 2022 has wide-ranging impact on payments for drugs used by Medicare beneficiaries, whether they are
Healthcare Compliance Partner, A&G Vendor or Both?
When health plans want compliance support, and technical solutions that drive healthcare compliance, can they turn to one company to
Theme and Focus for Medicare Regulations for Calendar Year (CY) 2023
On February 2, 2022, the Centers for Medicare & Medicaid Services (CMS) released the CY 2023 Advance Notice of Methodological
Optimizing Appeal Decisions
Medical Directors need relevant Information. Health plans must identify the key pieces of information Medical Directors will need in order
Americans with Disabilities Act (ADA) Changes
I attended a call recently with CMS and the ADA, CMS is looking to adhere to the Americans with Disabilities
2015/2016 CMS Program Audit Protocols and Process Updates
CMS program audit evaluate the performance of the Medicare Advantage/Prescription drug plans (MAPDs) and prescription drug plans (PDPs) that provide