CMS Announces Updates to Medicare Parts C & D Appeals Guidance Effective January 1, 2025. These changes, related to enrollee grievances, organization/coverage determinations, and appeals guidance, will take effect on January 1, 2025 and affect plans nationwide. The updates aim to enhance clarity, streamline processes, and expand enrollee rights.

Important Updates for CMS Calendar Year 2025 Evidence of Coverage Models. CMS updated URLs due to an error in links of the previous models. Plans should verify URLs in their current CY 2025 EOCs, correct them with URLs found in the reposted CY 2025 EOC models, and follow CMS CY 2025 EOC instructions.

Webinar Replay | Essential Risk Adjustment Insights for 2025-2026: How Plans and Providers Can Stay Ahead of Regulatory Changes and Compliance Challenges. This webinar equips health plans and providers with critical knowledge to stay ahead of regulatory changes and compliance challenges in 2025. The session provides actionable insights into optimizing risk adjustment programs, navigating new HCC coding requirements, and preparing for heightened OIG audit scrutiny.

Justin Murakami, JD, CHC, Joins ATTAC Consulting as Sr. Consultant for Compliance Solutions. Justin is a highly accomplished healthcare compliance expert. He specializes in California’s complex regulatory landscape, and has deep experience in Medicaid, Medicare, commercial health plans, and provider organizations.