RISE

Happy Thanksgiving to our RISE friends and family!

CMS recently announced a proposal to require Medicare Part D and Medicaid programs to cover medications used to treat obesity. Weight loss drugs have only previously been covered under Part D if the drug is also used to treat another condition medically accepted, such as diabetes. If finalized, the proposed rule would provide more Americans access to transformative medications and improve the health and quality of life for millions of people who have obesity, CMS said. #Medicare #Medicaid

RISE is pleased to announce our second keynote for The AI in Health Care Summit, January 12-14 in Phoenix. Diana Kelley, CISO for Protect AI, will present Guarding the Digital Pulse: AI and Cybersecurity in Modern Health Care. “In this talk I’m going to do some baselining, a 101 of what’s the difference between AI machine learning and Generative AI. A lot of people get really hung up on that, so it's critical to educate people so they know about this new technology, what the risks are, how the risks have changed or shifted with the new technology and what processes we need,” she says. Read More: https://lnkd.in/gj4npPGr #RISEAI25 #GenAI #machinelearning #cybersecurity

A federal judge in Texas on Friday ruled that the Centers for Medicare & Medicaid Services made a mistake when it calculated the insurer’s Medicare Advantage quality scores for 2025. The agency must recalculate the score and immediately publish the updated rating on the Medicare Plan Finder.

As the #MedicareAdvantage market resets from the impact of V28 and new cut points have come out for Stars, health plans are withdrawing from markets, cutting benefits, and increasing premiums in response. But there are other less drastic options to maintain revenue. This new environment requires plans to have a more integrated management structure and eliminate silos to grow and maintain revenue. Join expert from Vatica Health on January 23 to hear how payers can restructure, identify additional data sources for clinical validation, and work with key departments to succeed in this dynamic environment.

The March of Dimes 2024 Report Card has been released, and the United States has scored a D+ for the third year in a row. The annual report cards, which have been released since 2008, aim to educate and advocate for better outcomes for mothers and babies across the nation by highlighting the factors driving maternal and infant mortality and morbidity.

Take advantage of 3 events, all under one roof! This January, we are headed to Phoenix for two returning events & one brand new master class. Bring your team to mix and match sessions across all 3 events with an all access pass. ?? The 9th Annual CMS Bid Boot Camp ?? The AI in Health Care Summit ?? The RISE Audit Readiness Master Class Learn More: https://lnkd.in/gprZm8CM #CMSBid2025 #RISEAI25 #RISEAuditMC25 #Medicare #MedicareAdvantage #valuebasedcare #RADV

RISE reviews the latest regulatory headlines: ? Study: 4M people will lose health insurance if premium tax credit enhancements expire ? Commonwealth Fund: Nearly 1 in 4 US adults are underinsured ? DOJ: Texas lab owner charged with role in $79M fraud scheme Read More: https://lnkd.in/gabRkAzB

“Tobacco use imposes a heavy toll on families across generations. Now is the time to accelerate our efforts to create a world in which zero lives are harmed by or lost to tobacco,” said Dr. Murthy in a statement. “This report offers a vision for a tobacco-free future, focused on those who bear the greatest burden, and serves as a call to action for all people to play a role in realizing that vision.”

President-elect Donald Trump on Tuesday?announced?he would nominate Mehmet Oz, 64, the television personality known as “Dr. Oz,” to serve as administrator of the Centers for Medicare & Medicaid Services. The announcement comes on the heels of his?plans?to have Robert F. Kennedy Jr. serve as the secretary of the Department of Health and Human Services. Both announcements were posted to Trump’s Truth Social platform.