What you should know about Part B drug payments to comply with IRA 2022
The Inflation Reduction Act of (IRA) 2022 has wide-ranging impact on payments for drugs used by Medicare beneficiaries, whether they
Regulatory Compliance
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
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) will be signing up
CY 2022 CMS Program Audit Protocols Changes
Updated October 2026: the protocol changes described here took effect in 2022 and remain the basis of the audit protocols
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
CMS 2022 Protocols for MMP SARAG & MMP CDAG Universe Submission
It is that time again! CMS Program Audits are imminent and the protocols have officially changed for 2022. This blog
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
Updated October 2026: this post describes the CMS program audit protocols as of 2015 and 2016. For current requirements, see
2015 CMS Audit Protocol: Your Takeaway
In early February, the CMS released its new audit protocol and process updates for 2015 for Medicare Advantage organizations and