Wakely Consulting Group

Check out our latest Week in Washington: ?? - Senate and house discussions on reconciliation bill - Senate panel approved of Dr. Oz’s nomination for CMS Administrator - HHS announced that there would be mass layoffs - Tariffs on imported drugs, biotech, and device industry goods expected in April Read more in our latest release here ?? https://bit.ly/3Lf1ofr

What's new with our latest Wakely Wire: - Dr. Oz Vows to Scrutinize Medicare Advantage as CMS head - Congress Extends Medicare Telehealth Flexibilities for 6 Months - California Borrows $3.4 Billion for Medicaid Overrun as Congress Eyes Steep Cuts - Social Security Could Soon Take 100% of Your Benefit Check If You're Overpaid - Optum Rx Says it Will Eliminate 10% of Prior Authorizations Read more here and don't forget to sign up now for more timely news sent straight to your inbox: https://lnkd.in/gDMNT_Tb

Check out our latest Week in Washington: ?? - Memet Oz confirmation hearing overview - Social security recipients will not be allowed to verify their identities over the phone - The Federal Reserve this week announced steady interest rates - Cigna Group finalized its sales for $3.3 billion to Health Care Service Corp Read more in our latest release here ?? https://bit.ly/4ikGGcS

Our recent white paper, "Summary of Proposed Marketplace Integrity and Affordability Rule," our experts provide an overview of the proposed changes and their implications of the program integrity rule. Read the full white paper: https://bit.ly/4iLeRdD

What's new with our latest Wakely Wire: - CMS Takes Aim to Reduce Improper Enrollments and Promote More Affordable Health Insurance Marketplaces for Millions of Consumers - Consumers Can Buy Zepbound and Wegovy Direct from Drugmakers If They Pay Cash - Lawmakers Move to Allow Medicare Pay Cut, Drawing Rebuke from Physicians - Medicaid Expansion Cuts Could Hit Provider Revenue, Spike Uncompensated Care: Report - Unpaid Claims and Coverage Gaps: Changes to the Military's Health Care Program Are Causing Disruptions Read more here and don't forget to sign up now for more timely news sent straight to your inbox: https://lnkd.in/gfWwXUTQ

Join us at the National PACE? Association Spring Policy Forum in Washington DC where Health Management Associates PACE Consultants and Wakely Consulting Group’s Actuaries will be discussing key insights. Don't miss the chance to engage with our PACE and Actuarial Consultants at the event. See you there!

Check out our latest Week in Washington: ?? - CMS released a proposed program integrity rule that affects ACA Marketplaces - CMS announced that it would end certain CMMI demonstrations early - CMS announced that it was rescinding Medicaid and CHIP on health-related social needs - House Republicans passed a budget that would keep the government open until the end of the fiscal year (end of September) Read more in our latest release here ?? https://lnkd.in/gnM7nDn3

CMS recently proposed changes to the risk score model used for PACE, which will create funding vulnerabilities in the Medicare rate. If approved, this would likely mean PACE programs get significantly lower funding amounts from Medicare than under the current model. Experts from Wakely and Health Management Associates have put together an analysis to help PACE plans understand and prepare for this anticipated change. https://bit.ly/41Ls92B #PACE #CMS #Medicare

What's new with our latest Wakely Wire: - Trump vowed to end surprise medical bills. The office working on that just got slashed. - Who might lose eligibility for Affordable Care Act marketplace subsidies if enhanced tax credits are not extended? - Federal Medicaid cuts could shift $44.3 billion in costs to expansion states. - Trump Administration policies could create headwinds across healthcare. - CMS rescinds Medicaid's health-related social needs guidance. Read more here and don't forget to sign up now for more timely news sent straight to your inbox: https://bit.ly/4ixmG6g #AffordableCareAct #medicalbills #Medicaid #CMS #HRSN

Wakely supports a range of providers who take risk in Medicare Advantage (MA) and other government and commercial insurance programs. We offer an array of supports for our provider clients, from fully outsourcing data, actuarial, or financial functions to very specialized expertise for a niche problem. We recently developed a Provider Playbook that outlines steps that providers participating with MA plans can use to monitor their risk arrangements. Click here to receive your copy of this unique playbook and learn how we can equip your team with the tools it needs to monitor risk-based contracts. https://bit.ly/3DjE6Vj #MedicareAdvantage #riskadjustment