Insights on governance, cross-functional alignment, staff development, change management, and building high-performing operational and compliance teams.
The Centers for Medicare & Medicaid Services (CMS) has finalized the 2026 PACE Audit Protocol, PACE Audits | CMS, marking one of the most significant changes to PACE auditing in…
Medicare Advantage organizations facing program audits in 2026 will encounter an unusual batch of changes. These changes, revealed in a November CMS memo, are intended to streamline the process and…
Annual CPE audits are required by CMS, but their value goes beyond compliance. These audits assess the effectiveness of your compliance program, identify gaps, and prevent fraud, waste, and abuse.…
Star Ratings are more than numbers—they determine your plan’s financial health, market position, and member loyalty. Every interaction matters, from member experience to clinical outcomes and pharmacy adherence. High ratings…
The CMS Readiness Checklist is more than a compliance requirement—it’s your blueprint for success in 2026. This tool ensures your organization is prepared to meet updated regulations, deliver accurate benefits,…