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Risk Adjustment Compliance Recap: Best Practices for Avoiding Legal Action
Last week, Health Fidelity hosted a risk adjustment legal compliance webinar, “Risk Adjustment Compliance: Best Practices for Avoiding Legal Action.” I had the privilege of being joined by Health Fidelity VP of business development John Blevins as well as lawyers and healthcare legal experts Stephen Bittinger and John Lawrence of K&L Gates. The event itself […]
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Value-Based Care and Health Equity Post 2021
After more than a decade of debate, litigation, and experimentation, the adoption of value-based care and alternative payment models endures, and 2021 is presenting us with a picture of what more can be done with value-based care and health equity. First, beyond the headlines and political posturing, policymakers and market players have persevered through ongoing […]
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Concurrent EDPS and RAPS support from Lumanent
Health Fidelity is pleased to share that the Lumanent platform is fully prepared to offer concurrent EDPS and RAPS support, congruent with the CMS-HCC risk adjustment model transition.
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MA Deadline Extensions for 21-22: CMS Policy Update and Strategy Guidance
Earlier this year, we discussed the final call letter from CMS detailing the Medicare Advantage (MA) deadline extensions for PY 2020 (i.e. 2019 dates of service) to account for COVID-19 related disruptions. We suspected, but had no confirmation at the time, that this would continue going forward. While CMS hasn’t made any public announcements, we […]
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CMS Policy Update: RAPS and EDPS, Model Updates, and PY 2022 Risk Calculations
Last month, CMS released their final announcement for calendar year (CY) 2022. This is a follow up to the advanced notice we covered September, particularly around the RAPS and EDPS transition. Before we begin, I think it’s important to mention that while not every facet of every update from CMS impacts every organization the same […]
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CMS Submission Deadline Extension Clarification
On 9/18/20, CMS announced a submission deadline extension option for 2019 dates of service (DoS) for Medicare Advantage organizations, PACE organizations, Medicare-Medicaid plans, and other cost contractors from 2/1/21 to 8/2/21. The announcement created some confusion, namely that the 2/1/21 deadline still existed alongside the 8/2/21 final deadline. There wasn’t clear direction on why nor […]
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Risk Adjustment and Telehealth Policy under COVID-19
Health Fidelity offers conclusions on the flurry of CDC and CMS telehealth policy updates around coding and risk adjustment practices under COVID-19
