Why CMS audits are designed to test operations, not just documentation
For years, health plans treated CMS audits as documentation exercises. If policies looked current, files appeared complete, and evidence arrived
Healthcare Compliance
The CMS 2026 Program Audit Update: What I’m really hearing as a Chief Compliance Officer
When the 2026 Program Audit update landed, I didn’t read it as a checklist of changes. I’ve worked in healthcare
Build, Buy, or Own: How Payers Are Reframing Technology Decisions
The debate has evolved, from build vs. buy to own. For years, health plans have wrestled with the same technology
OBBBA: What Trump’s ‘One Big Beautiful Bill’ Act Means for Payers
Inovaare Perspective | This article breaks down what the OBBBA really means for payers and why payer-focused cloud platforms like Inovaare are uniquely positioned to help health plans move from reactive to resilient.
Key Updates in Medicare Parts C & D Appeals, Grievances, and Determinations Guidance
The Centers for Medicare & Medicaid Services (CMS) updated the Parts C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals
Medicare Appeals Manegement Best Practices
How can health plans improve their Medicare appeals management processes? For many health plans serving the Medicare population, they will
Forewarned is Forearmed: Prepare for 2021 CMS Audit Protocols Change
While the world remains unpredictable—especially in the age of COVID-19—fortunately, the Centers for Medicare and Medicaid (CMS) has been clear
Are you in control of your compliance processes?
Compliance maintenance and oversight for health plans can be a resource and time-consuming restraint. Challenges with manual processes, inefficient workflows
CMS Program Audit Universes as a Tool for Ongoing Compliance Monitoring
Creating the required universes for CMS Program Audit submission remains one of the most arduous and time-consuming tasks for MAPD
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