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LATEST INDUSTRY UPDATES
June, 2025
QHP Access Surveys: Were Your Results Actionable—and Did the Timeframe Affect Compliance with CMS and State Requirements?
In the 2025 Final Rule, CMS released its expectations and reporting requirements to ensure timely access to care.
By the second Friday in June each year, issuers that offer QHPs—including stand-alone dental plans—in the federally-facilitated exchanges or SHOPs must report secret shopper survey results assessing compliance with appointment wait time standards.
Read on to understand if your plan is meeting access-to-care requirements
Avoid This RADV Coding Mistake Before It Costs You
CMS is launching the most extensive RADV audit expansion in Medicare Advantage history. Health plans need to move quickly—and smartly—to reduce risk and limit exposure.
One of the most common (and costly) mistakes? Contracting with the same vendors used for retrospective coding. Coders trained for retro reviews may bring the same biases to RADV—jeopardizing your audit results.
ATTAC takes a different approach. We’ve spent years focused specifically on RADV validation coding and HCC identification that aligns with CMS audit protocols.
We help health plans:
Enhance HCC coding accuracy to reduce RADV error rates
Limit exposure from extrapolated overpayments
Secure audit support capacity and pricing upfront to avoid delays
Conduct pre-audit compliance reviews and assess documentation sufficiency
Improve documentation and audit readiness
Identify additional HCCs to support accurate submissions
Our team knows what CMS expects—because we’ve helped dozens of plans deliver exactly that.
We’re trusted by plans nationwide and proven in every phase of RADV and HCC validation. Our seasoned industry experts will help your plan navigate the complexities of RADV audits.
Don’t wait for CMS to come knocking. Reach out to partner with ATTAC, prepare your plan, and ensure audit readiness.
ATTAC On The Road
Michigan Association of Health Plans
July 22-25 | Acme, MI
Medicaid Leadership Innovations Strategies
June 22 - 23 | Alexandria, VA
Join Jocelyn Bayliss, SVP, Provider Network Management, for the panel discussion: Strengthening and Expanding Access to Behavioral Health and SUD Services: Allocating Resources to Crisis Response, Addressing Workforce Shortages, and Supporting Innovative Care Delivery Models
Subbu Ramalingam, Managing Director, will moderate the panel discussion: Interoperability and Electronic Health Records: Ensuring Greater Data Sharing Between Providers and Payers
