CMS 2025 Update: Medicare Part C & D Reporting Guide for Health Plans
Every year, the Centers for Medicare & Medicaid Services (CMS) requires Medicare Advantage Organizations (MAOs) and Prescription Drug Plans (PDP)
Audit Readiness
Ensuring Accurate Drug Claims: Insights from CMS Audits and Best Practices
Updated October 2026: this post summarizes a CMS audit of immunosuppressant claims (Part B vs Part D) and a February
Capitation Rates Announcement for Medicare Advantage Plans for CY 2025
The Centers for Medicare & Medicaid Services (CMS) officially announced capitation rates for Medicare Advantage (MA) plans for CY 2025
Changes for Prescription Drug Encounter (PDE) Data in 2024
The Centers for Medicare & Medicaid Services (CMS) has been processing Part D drug claim data via the Drug Data
Navigating the 2025 Advance Notice: Implications for Medicare Advantage and Part D
On January 31, 2024, the Centers for Medicare & Medicaid Services (CMS) released a draft of the 2025 Advance Notice
CMS Program and Focus Audits: Are You Prepared?
Updated October 2026: this post describes the CMS program audit protocols as of 2024. For current requirements, see 2026 CMS
Streamline Your Parts C and D Reporting with Universe ScrubberÂ
Medicare Advantage Organizations (MAOs) and Prescription Drug Plan (PDP) sponsors have to submit Parts C and D reports to the