Medicaid managed care provider payments restructuring
PCOOB Weekly — June 18, 2026 PCOOB Weekly | June 18, 2026 | Regulatory Analysis Medicaid managed care provider payments […]
The MCO Is Not in the Room. It Still Has to Pay the Bill.
The 2025 federal budget reconciliation law’s Medicaid work requirements hand states the policy design while managed care organizations absorb the financial exposure.
Ten Days to Comment: What the CMS-0062-P Drug PA Interoperability Rule Requires
PCOOB Weekly — June 5, 2026 10 PCOOB Weekly · June 5, 2026 · Prior Authorization / Interoperability / IT
The Guardrails Came Down. The Enforcement Didn’t.
PCOOB Weekly — May 29, 2026 PCOOB Weekly · May 29, 2026 · MA Marketing / FDR Oversight / OIG
The 80% Number Isn’t a Customer Service Problem. It’s a Compliance Finding.
PCOOB Weekly — May 22, 2026 80% PCOOB Weekly · May 22, 2026 · Appeals & Grievances The 80% Number
CMS Redesigns Program Audits. Your Audit Readiness Program is Still Built for Scoring
PCOOB Weekly — May 15, 2026 PCOOB Weekly — Issue 5 — May 15, 2026 The Audit Changed. Your Audit
CY2027 MA Stars Final Rule Cuts 11 Measures, Adds New Risk
The CY2027 MA Stars final rule is a financial windfall for insurers but a compliance infrastructure reckoning for quality and governance teams.
When the Audit Finds the Pattern
PCOOB Weekly — May 1, 2026 PCOOB Weekly — Issue 4 — May 1, 2026 When the Audit Finds the
Three Federal Clocks, Fifty State Rules
PCOOB Weekly — April 25, 2026 | Three Federal Clocks, Fifty State Rules PCOOB Weekly — April 25, 2026 |
The Audit That Doesn’t Stop
PCOOB Weekly · April 18, 2026 · Vol. 1, No. 1 The Audit That Doesn’t Stop CMS has scaled its