MHK news and milestones

Artificial intelligence (AI) is creating new opportunities to improve healthcare operations by supporting clinical decision-making and reducing administrative complexity. But as…

The Bottom Line CMS has finalized the CY 2027 Medicare Part C and Part D Program Audit Protocols and supporting data collection instruments (CMS-10717). The final materials are n…

CMS-0062-P may be a proposed rule, but its direction is clear: Drug prior authorization is becoming an increasingly important part of the broader shift toward electronic, standar…

The Centers for Medicare & Medicaid Services (CMS) released proposed Contract Year (CY) 2027 Part C and Part D reporting and technical requirements in 2026, including a proposed…

The Centers for Medicare & Medicaid Services (CMS) will release updates to the Health Plan Management System (HPMS) Complaints Tracking Module (CTM) on October 30, 2026. The chan…

Healthcare prior authorization is undergoing a significant transformation. With CMS-0057-F (introduced in January 2024), the Centers for Medicare & Medicaid Services (CMS) establ…

As health plans prepare for the next phase of CMS-0057-F, much of the attention has understandably focused on APIs, interoperability, and the January 1, 2027, compliance deadline…

The Bottom Line Up Front CMS's CY 2027 guidance changes enrollment, disenrollment, election periods, eligibility, passive enrollment, notices, and website access requirements acr…

January 1, 2027, is more than an API deadline. For health plans, it is an operational deadline. The next major milestone under the CMS Interoperability and Prior Authorization Fi…

The Bottom Line The second preview of the 2027 Medicare Star Ratings is giving health plans more than a preliminary look at their scores. It also reveals a more demanding perform…