CMS Revises the 2019 A&G Guidance

CMS Revises the 2019 A&G Guidance By Jen Sousa, Vice President In February 2019, CMS released the long-awaited updates to Chapter 13 of the Medicare Managed Care Manual and Chapter 18 of the Medicare Prescription Drug Benefit Manual. These changes were released as...

Role of the Payer in Managing Opioid Use Disorder (OUD)

Role of the Payer in Managing Opioid Use Disorder (OUD) By Yvonne Tso, Vice President Polypharmacy is common among older adults, according to a New York Times article published on December 16, 2019. Individuals aged 65–69 years take an average of 15 prescriptions a...

Compliance Spotlight to Shine Brightly on FMOs

Compliance Spotlight to Shine Brightly on FMOs By Julie Mason, Principal After years of intense oversight of Medicare Advantage (MA) and Part D plans (plans) by CMS, those same plans have, in turn, intensified their oversight of contracted entities, including FMOs and...