Agadia Blog
Company and Industry News
Enhancing MTM Programs: Impact of CMS’s 2025 Final Rule for Health Plans and PBMs
The recent final rule for the 2025 contract year issued by the Centers for Medicare & Medicaid Services (CMS) carries significant implications for Health Plans and Pharmacy Benefit Managers (PBMs) managing Medication Therapy Management (MTM) programs. This change...
Agadia Expands Suite of Healthcare Technology Solutions with the Launch of GrievancesHub
Parsippany NJ, April 2, 2024– Agadia, a leading provider of healthcare technology solutions, is pleased to announce the launch of GrievancesHub, a web-based Grievance Management solution designed to empower Health Plans and Pharmacy Benefit Managers (PBMs) in...
Improving Operational Efficiencies with Utilization Management Solutions
As our industry continues to evolve, efficiency, security, and adaptability are non-negotiables. Health plans, Pharmacy Benefit Managers (PBMs), and Third-Party Administrators (TPAs) need robust solutions that not only streamline operations but also ensure compliance,...
Unleash the Power of Prior Authorization Data with PAHub Insights
The need for effective Prior Authorization (PA) management for health plans, Pharmacy Benefit Managers (PBMs), and Third-Party Administrators (TPAs) continues to evolve. To propel your organization to new heights, it's not just about managing authorizations but...
Planning for the Future of Healthcare Legislation: Agadia’s Response to Colorado Revised Statutes
Planning for the Future of Healthcare Legislation: Agadia's Response to Colorado Revised Statutes When it comes to healthcare legislation, staying ahead is not just a necessity; it's our commitment at Agadia. As of February 20, 2024, the Colorado Revised Statutes...
Navigating Prior Authorization Reforms Across Multiple States: A State of Change
In response to escalating concerns voiced by providers and patients regarding delayed and denied care, an increasing number of states are taking decisive steps to impose limitations on prior authorization (PA) requirements. These legislative efforts, reaching beyond...
Navigating the CMS Interoperability & Prior Authorization Final Rule
The healthcare landscape is undergoing a transformative shift with the introduction of the Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization Final Rule (CMS-0057-F). This comprehensive regulation sets forth a series of...
Biden-Harris Administration Propels Transparency in Medicare Advantage: What Health Plans and PBMs Need to Know
The Biden-Harris Administration's recent announcement on promoting competition in healthcare includes a significant focus on increasing transparency in the Medicare Advantage (MA) insurance market. The U.S. Department of Health and Human Services (HHS) and the Centers...
Elevating Security Standards: The Significance of HITRUST Certification in Healthcare Vendors
Ensuring the security and confidentiality of patient data is paramount. Healthcare vendors play a crucial role in maintaining the integrity of sensitive information. One key aspect that highlights a commitment to robust security practices is achieving HITRUST...
ChatGPT Produces Unreliable Results in Recent Pharmacy Studies
Per a recent article posted by MedPage Today, researchers revealed that "ChatGPT provided incorrect or incomplete information when asked about drugs, and in some cases invented references to support its answers, two evaluative studies found. In the first, 39 questions...
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