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Health Insurance Exchange Quality Ratings System

Did you notice that during the current 2020 Open Enrollment Period (OEP), federal and state-based exchanges are publicly displaying their Five-Star Quality System (QRS) rating information on exchange health plans? The goal of the QRS is to increase transparency and competition by providing comparative information for consumers as they shop and select plans. The Centers…

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Is Your Team Ready for the Public Charge?

Fear and confusion have caused immigrants to disenroll from government programs or forgo benefits for which they are eligible. According to a December 2018 nationwide survey, about one in seven adults in immigrant families did not participate in a government program for fear of risking future green card status.1   What is causing this? “Public…

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CMS Best Practices Toolbox Snapshot

This is an overview on how to expand your Risk Adjustment renovation toolbox, so you can better construct and implement your data submission program. The following are the tools and strategies needed to implement the 12 CMS Best Practices and help ensure program success. Tool #1 – Magic Bullet – Analyze transactional reports to track,…

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Section 1115 Waivers Update – First Quarter 2019

1115 Waiver Activity: 2019 Q1 Overarching Developments There were some key developments in the first quarter of 2019 that have potential long-term impacts to the 1115 waivers: Federal judge blocks community engagement requirements in Kentucky and Arkansas A federal judge’s Mar. 27, ’19 ruling immediately suspended community engagement requirements for Medicaid recipients in Kentucky and…

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