Rebellis Group

Don't miss this valuable resource from #CMS. Now is the time to assess your compliance program and prepare for evolving CMS audit priorities. We're here to help 👉🏼partners@rebellisgroup.com

Health plans continue to face growing pressure to improve #MedicalLossRatio (MLR). As part of the Alerion Advisors family of companies, Rebellis Group is helping organizations take a more integrated, action-based approach to improving #MLR performance. Together with Alerion Advisors, Advent Advisory Group LLC, and Toney Healthcare, we've developed an executive perspective and MLR Assessment to help health plans uncover opportunities and prioritize meaningful action. If you're a health plan leader looking to take a fresh approach to improving MLR, we'd love to connect. Read the article ➡️ https://lnkd.in/ei3XYmk4

The proposed 2027 #CMS Medicare Program #Audit Protocols are more than an audit update—they signal where CMS is headed. A few themes stand out: 🔹Greater reliance on operational data and data quality 🔹Increased focus on D-SNP oversight and care coordination 🔹More standardized root cause analysis and corrective action expectations 🔹Streamlined audit processes—but not reduced scrutiny The takeaway? Audit readiness is becoming a continuous operational discipline, not just a compliance exercise. If you haven't had a chance to review the proposed changes, Jordan F. and our team summarized the key updates and what they could mean for #MA organizations. We are ready to help. Read the full article here ▶️ https://lnkd.in/eECdf_wD

For #MedicareAdvantage organizations that qualified for CY2027 bid resubmissions, now is the time to revisit member-facing materials. But even if your bids didn't change, material review is already underway—and accuracy, consistency, and compliance remain critical as AEP approaches. At Rebellis Group, we're helping organizations review and validate materials to help ensure they're member-ready and aligned with finalized bid information.

As #compliance requirements continue to evolve, health plans need practical strategies to strengthen oversight while supporting innovation. Our latest blog explores key considerations for integrating #AI into existing compliance programs and governance frameworks. If you're evaluating your compliance strategy for the year ahead, it's worth a read 👉 https://lnkd.in/e3s9Nk3z

#CMS Continues Outreach on the #Medicare #GLP-1 Bridge Program CMS recently hosted a listening session focused on the Medicare GLP-1 Bridge Program, highlighting key program requirements, directing beneficiaries to 1-800-MEDICARE for support and addressing frequently asked questions. As awareness and implementation continue to evolve, it's important for stakeholders, providers and beneficiaries to stay informed about eligibility requirements, enrollment processes and available resources. Our latest article breaks down what you need to know and why these updates matter: https://lnkd.in/ethfVhky

#CMS has reopened the 2027 #MedicareAdvantage bid cycle for eligible plans receiving higher recalculated Quality Bonus Payment (QBP) ratings. "The question isn't just whether your rating changed—it's what that change could mean for rebate revenue, bid strategy, benefit design and overall financial performance," said Roshan Desai, VP, Product & Financial Strategy at Rebellis Group. MA plans have days, not weeks, to act. 🔹 Notify CMS of intent to resubmit: June 22 🔹 Resubmit bids: June 29 🔹 Actuarial certification due: July 1 For organizations impacted by the recalculation, now is the time to quickly assess the financial value of a higher rating and determine whether bid resubmission creates meaningful opportunity. Our team is here and ready to help with impact assessments, revenue modeling, bid strategy evaluation and executive decision support. Check out our latest article for key considerations and strategic questions every #MA organization should be asking: https://lnkd.in/ekdHwXa5

The biggest challenge with Medicare's new #GLP1 Bridge Demonstration isn't the drug coverage. It's the operational impact on health plans. Member calls. Pharmacy questions. Appeals. Compliance oversight. Is your team prepared? Roxanne Newland, BPharm, RPh, MHSA, our SVP of Pharmacy breaks down the recent #CMS webinar and what's next 👉 https://lnkd.in/eQ8AHzQY

What will separate successful #MedicareAdvantage plans over the next 3-5 years? It's not just technology. It's the ability to align #AI, distribution strategy, #compliance and operations to drive sustainable growth. Great discussions this week at the Health Plan Alliance and Alliance of Community Health Plans (ACHP) Medicare Advantage 2026 Summit.

Rebellis Group is excited to be speaking at the Health Plan Alliance and Alliance of Community Health Plans (ACHP) Medicare Advantage Summit this week in Chicago. Join John A. Selby, as he discusses the evolving landscape and agent/broker relationships. We are also excited to have Jason Montrie, CEO of Alerion Advisors, onsite connecting with health plan leaders from across the country. If you'll be attending, let us know in the comments or send us a message 👇