Penstock

For years, issuers have managed their own justification forms alongside the Plan & Benefit Template submission process. But that’s changing. CMS is shifting the justification form into the MPMS portal, limiting access to just two users per organization. That means issuers need to be proactive—ensuring the right people have access and staying ahead of new workflow challenges. This shift will impact compliance, communication, and submission timelines. Is your team ready? Watch the latest episode of #RegulatoryJoe to learn how to prepare: https://hubs.li/Q03c3zVC0 #RegulatoryCompliance #HealthPlans #CMS #MPMS #PlanAndBenefitTemplate Joe Boyle

Ever wondered what ICD-10 codes exist for the truly unexpected? From rogue ducks to feisty cows, some medical claims are wilder than you’d think. But these aren’t made up—they’re real, billable codes. At Penstock, we help health plans stay on top of claims accuracy—whether they’re routine or out of the ordinary. Swipe through to see some of the animal-related codes our payment integrity experts have come across (and handled with ease). #PaymentIntegrity #MedicalBilling #ClaimsManagement #ICD10

Your team's next payment integrity idea could be a game-changer—or a dead end. The best concepts don’t just sound good in theory; they need to solve real problems, create measurable impact, and align with broader strategic goals. Without a structured evaluation process, teams risk investing time and resources in concepts that won’t deliver results. Nichole Russ, VP of Payment Integrity at Penstock, shares four critical questions every team should be asking before moving forward. Swipe through to see how you can identify concepts that will drive real impact! #PaymentIntegrity #ClaimsManagement #HealthcareFinance

Issuers have long submitted Justification Forms alongside their Plan and Benefit Template—but in 2026, that process is getting an overhaul. Starting next year, CMS will generate these forms post-submission within the MPMS portal, shifting the timing and control of the process. This means issuers need a new approach to ensure smooth plan approvals and compliance. In the latest episode of Regulatory Joe,?Joe Boyle?breaks down what this means for issuers, key steps to prepare and why strategies like proactive validation and version control will be more critical than ever. Tune in now on YouTube or wherever you listen to podcasts: https://lnkd.in/dgYfyX9j #HealthPlans #HealthPlanStrategy #MPMS #HealthInsurance #RegulatoryJoe

The difference between struggling with compliance and leveraging it? Strategy. Health plans that treat compliance as an afterthought are constantly reacting—rushing to meet deadlines, scrambling to fix errors, and risking costly penalties. But when compliance is integrated into operations, it improves efficiency, reduces audit risks, and creates a foundation for sustainable growth. From risk adjustment to licensing and regulatory filings, every requirement is an opportunity to strengthen processes and prevent downstream issues before they start. How is your organization making compliance work to its advantage? #RegulatoryCompliance #HealthPlans #HealthInsurance #ComplianceStrategy

Penstock is heading to Indianapolis for the National Association of Insurance Commissioners (NAIC) Spring National Meeting! For four days, regulators and industry leaders will be discussing the latest in compliance, filings and market trends—and we’re ready to talk real solutions. As regulatory expectations shift, efficiency in filing processes is more critical than ever. Penstock's ClearFile streamlines the filing process, helping teams stay ahead without the administrative burden. Will you be at NAIC? Schedule a time to connect with?Joe Boyle by messaging him here on LinkedIn. #NAIC #RegulatoryCompliance #HealthPlans #HealthInsurance

Steve Palma never set out to patch a broken system—he set out to fix it. From rebuilding a Special Investigations Unit and launching an innovative biological drug audit program in the '90s to leading Penstock, a company redefining payment integrity, his focus has always been on making sure payment accuracy isn’t an afterthought, but a given. As Penstock continues to grow, its mission remains clear: to help payers fix the system—not just profit from its dysfunction. Learn how Steve is?making it happen in the article below! ? #PaymentIntegrity #HealthPlans #Leadership #ClaimsManagement?

CMS is shifting more power to states in ACA marketplaces. Is your team ready? For issuers, that means navigating new policies, plan design requirements, cost-sharing caps and formulary rules as states transition off the federal platform. These changes could bring both opportunities and new regulatory complexities for issuers operating in multiple states. ?? Watch now:?https://lnkd.in/d79Jr_FN #HealthPlans #ACA #NBPP2026 #HealthInsurance #RegulatoryJoe

Expanding into the ACA market goes a lot smoother with a plan. Softheon’s Kevin Deutsch & Penstock ’s Joe Boyle break down the roadmap for a smooth market entry—covering compliance, operational readiness, and strategic positioning. Don't underestimate the time and support you'll need ?? ??

SHOCKING ACA pitfalls—our experts break them down. What teams keep getting wrong (and how to fix it). ?? Join Kevin Deutsch, our General Manager & SVP of Health Plan Cloud, and Joe Boyle, President of Regulatory Solutions at Penstock .