Affordable Care Act

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 Health Exchange plans covered under ACA (Accountable Care Act) witnessed 36% enrollment growth between 2021 and 2023. This is the … Read More


Proactive Healthcare Compliance and the Importance of Continuous Monitoring

Proactive healthcare compliance refers to an approach where an organization seeks to identify and address compliance risks before they become a problem. This approach can have several benefits, including:  Mitigating legal and financial risks: By identifying and addressing compliance risks … Read More


Streamline Your Parts C and D Reporting with Universe Scrubber 

Medicare Advantage Organizations (MAOs) and Prescription Drug Plan (PDP) sponsors have to submit Parts C and D reports to the Centers for Medicare & Medicaid Services (CMS) annually. The reporting data are quarterly. These reports are to show:  Costs of … Read More


Is your Medicare Advantage Organization Ready for Compliance with Regulatory Changes in 2023?

Annual Election Period (AEP) is about two weeks away when Medicare Advantage Prescription Drug Plans (MAPD)[1] will be signing up new enrollees by the thousands. According to the Centers for Medicare & Medicaid Services (CMS), enrollment in MAPD keeps rising. In … Read More


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 do it all? The short answer is Yes! Healthcare organizations increasingly need compliance support, given the amount of federal and … Read More

Healthcare Risk Management

Risk Management Essential for Healthcare Organizations 

Medicare Advantage Organizations (MAOs) are private health plans that contract with the Centers for Medicare & Medicaid Services (CMS) to provide a menu of health care services similar to those offered under Original Medicare. They pay for the services with monthly … Read More