Inovaare Blog

Insights for Health Plan Leaders

Practical perspectives on Medicare Advantage compliance, CMS audit readiness, and AI-assisted automation for payer operations.

Regulatory Compliance

Inovaare- Delegation oversight dashboard for TPAs
Delegation Oversight, Regulatory Compliance

TPA Compliance Risks for Health Plans: Is Your Third-Party Administrator/Vendor Putting You at Risk?

In the complex healthcare landscape, delegating critical functions to third-party administrators (TPAs) can streamline operations but also introduce significant compliance risks. With CMS intensifying oversight, health plans must recognize that accountability for every delegated action lies squarely with them. From data integrity gaps to missed SLAs, the hidden risks can lead to audit findings and financial penalties. Discover how a continuous, digital-first Delegation Oversight approach can transform your TPA management, ensuring compliance and protecting your members. Don’t let your vendors define your risk profile, take control and gain confidence in your oversight strategies.

Inovaare-CMS Audit Updates 2025 What Medicare Advantage Plans Need to Know
Audit Readiness, Regulatory Compliance

CMS Audit Updates 2025: What Medicare Advantage Plans Need to Know

CMS has introduced key RADV audit updates that raise the bar for health plan accountability. This blog breaks down what payers need to know, including changes to sampling, extrapolation, and error rate calculations, and how to stay audit-ready. Learn how automation, data quality, and GenAI can help reduce risk and improve compliance with the new CMS RADV audit requirements.

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