by Hayden Parsons | Mar 30, 2026 | Compliance
Download the Full PDF Here Listen to the Audio Version Here Time to Watch for 2025 RxDC Data Requests! Each year by June 1, the Centers for Medicare and Medicaid Services (CMS) requires group medical plans to report certain prescription drug and healthcare spending...
by Hayden Parsons | Mar 16, 2026 | Uncategorized
There is a growing trend among self-funded medical plans: an increased focus on claims audits. These audits are essential for ensuring accuracy, compliance, and operational efficiency. Let’s start with a quick refresher on the four main types: Medical Claims Audit –...
by Hayden Parsons | Mar 5, 2026 | Compliance
Download the PDF version here! Listen to the audio version here! Want just the highlights? Click here! Federal PBM Reforms Are Here Federal changes are coming for group health plans with respect to their contracts with Pharmacy Benefit Managers (PBMs). Following are...
by Hayden Parsons | Mar 5, 2026 | Uncategorized
A growing trend among self-funded medical plans is the increased focus on claims audits. Unlike dependent audits, claims audits are more comprehensive and time-consuming. Employers are increasingly recognizing their fiduciary duty to act in their employees’ best...
by Hayden Parsons | Feb 4, 2026 | Compliance
Download the PDF Version Here! Click here to listen to the audio version! 2026 Federal Poverty Level Updated, Increasing FPL Affordability Safe Harbor The federal government updated the 2026 Federal Poverty Level (FPL), increasing the mainland U.S. amount to $15,960...
