Blog | Integritas

Congress seeks to improve MA prior auth process

by Yvonne Tso, PharmD, MBA The House of Representatives is proposing legislation (H.R. 3173) to streamline prior authorization...

Lots of New ODAG/CDAG Guidance and Clarity

by Yvonne Tso, PharmD, MBA On August 3, 2022, the Centers for Medicare & Medicaid Services (CMS) released an updated version of the Parts...

CMS Wants to Know: Are You Overcharging Members for Drugs?

By Yvonne Tso, PharmD, MBA All Medicare Advantage and Prescription Drug Plans (collectively, Sponsors) submit prescription drug event...

All the new in the CMS ’22 ODAG Protocol

by Yvonne Tso, Senior Vice President of Pharmacy, Pharm.D., MBA The Centers for Medicare & Medicaid Services (CMS) launched a new cycle...

Using CMS Data for Identifying Potential FWA

by Yvonne Tso, Pharm. D., MBA On April 15, 2022, the Centers for Medicare & Medicaid Services (CMS) released potential fraud, waste and...

Impact of CMS Changes to Negotiated Price Definition in the Final Rule

By Yvonne Tso, Pharm. D., MBA On May 9, 2022, the Centers for Medicare & Medicaid Services (CMS) issued final rules for Policy and...

Changes in the CMS Readiness Checklist for 2022

by Yvonne Tso, PharmD, MBA Annually, the Centers for Medicare & Medicaid Services (CMS) distributes a Readiness Checklist to Medicare...

Leveraging Medicare audits to improve processes and the bottom line

by Yvonne Tso, Pharm D., MBA The Centers for Medicare & Medicaid Services (CMS) announced that engagement letters for routine audits...

The CMS 2020 Audit and Enforcement Report is Out—What the Results Might Mean for 2021

The much-anticipated 2020 CMS Program Audit and Enforcement Report was released on Friday, May 14. CMS readily admits in the report that...