Ensuring Accurate Drug Claims: Insights from CMS Audits and Best Practices
The Centers for Medicare & Medicaid Services (CMS) has added another category of drugs—immunosuppressants—to their national audits in collaboration with […]
Audit Readiness
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?
Starting January 2024, the Medicare Parts C and D Oversight and Enforcement Group of the Centers for Medicare & Medicaid
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