logo
Simplify Healthcare's Benefits1™.Medicare Drives Over 30% of Nationwide PBP Submissions to CMS, Marking Over 7 Years as a Trusted Industry Leader

Simplify Healthcare's Benefits1™.Medicare Drives Over 30% of Nationwide PBP Submissions to CMS, Marking Over 7 Years as a Trusted Industry Leader

Yahooa day ago

AURORA, Ill., June 06, 2025--(BUSINESS WIRE)--Simplify Healthcare, a recognized leader in enterprise software solutions for Payers, proudly announces that its flagship platform, Benefits1™.Medicare, played a key role once again in streamlining over 30% of Medicare Advantage (MA) Plan Benefit Package (PBP) submissions to the Centers for Medicare & Medicaid Services (CMS) this year. This milestone highlights the platform's transformative impact on benefit plan management and its integral role in supporting Payers across the nation.
Benefits1™.Medicare continues to be the industry leader, enabling large-scale CMS bid submissions successfully for over 7 years, while also importing data seamlessly from the CMS-PBP software. Designed to handle the complexities of bid submission and accessible immediately (benefit updates can be started at any time independent of HPMS releases), the platform continues to set the standard for speed, accuracy, and compliance in PBP submissions with its seamless integration, robust reporting, global data updates, secure user roles, workflow automation and audit tracking capabilities.
"Our customers relied on Benefits1™.Medicare to streamline over 30% of nationwide PBP submissions—proof of the trust we've earned and the efficiency our platform delivers year after year." — Ramesh Padri, VP of Product Delivery at Simplify Healthcare.
"Managing the full Medicare Advantage lifecycle—from bids to digital delivery—makes Benefits1™.Medicare truly stand out in helping Payers drive value and improve member experiences." — Tasneem Chital, VP of Government Markets at Simplify Healthcare.
Industry Leadership Through Customer Focus
As healthcare organizations face increasing operational and regulatory challenges, Benefits1™.Medicare offers an effective solution that simplifies workflows while driving greater organizational efficiency.
"This milestone reflects our long-standing commitment of partnering with health plans to successfully manage bid submissions. We bring the full stack partnership experience — people, thought leaders, product, and technology— towards delivering a superior bid submission experience for our customers." — Nirnay Patel, EVP & GM of Benefits1™ at Simplify Healthcare.
About Simplify Healthcare
Simplify Healthcare powers connected benefits and provider journeys for Payers through a scalable, enterprise-grade, secure, compliant, and configurable cloud-based software platform — Simplify Health Cloud™. We offer highly scalable, technology-centered document and translation management services to Payers through Simplify Docs™. We also empower industries with AI-native SaaS solutions designed to build and deploy digital solutions faster, better, and with embedded AI through SimplifyX™.
View source version on businesswire.com: https://www.businesswire.com/news/home/20250606918480/en/
Contacts
Simplify HealthcarePhone: (844) 720-6678Email: info@simplifyhealthcare.com

Orange background

Try Our AI Features

Explore what Daily8 AI can do for you:

Comments

No comments yet...

Related Articles

Why Oscar Health, Inc. (OSCR) Soared On Thursday
Why Oscar Health, Inc. (OSCR) Soared On Thursday

Yahoo

time6 hours ago

  • Yahoo

Why Oscar Health, Inc. (OSCR) Soared On Thursday

We recently published a list of . In this article, we are going to take a look at where Oscar Health, Inc. (NYSE:OSCR) stands against other best-performing stocks on Thursday. Oscar Health snapped a five-day losing streak on Thursday, jumping 10.6 percent to close at $15.65 apiece as investors resorted to bargain-hunting while waiting for more concrete developments on the Trump administration's Medicare Advantage review. Earlier this year, lawmakers passed a $5-trillion tax-and-spending package that shaves as much as $900 billion in Medicaid, which servers over 70 million low-income households. A close up of a patient and a healthcare professional engaging in conversation, showing the company's commitment to patient care. Now, Senate Republicans to broaden savings by looking for supposed inefficiencies in the Medicare program for senior citizens. In the first quarter of the year, Oscar Health, Inc. (NYSE:OSCR) registered a 55-percent increase in attributable net income of $275 million versus the $177 million registered in the same period last year. Revenues rose by 42 percent to $3.046 billion from $2.142 billion year-on-year. Overall, OSCR ranks 5th on our list of best-performing stocks on Thursday. While we acknowledge the potential of OSCR as an investment, our conviction lies in the belief that some AI stocks hold greater promise for delivering higher returns and have limited downside risk. If you are looking for an extremely cheap AI stock that is also a major beneficiary of Trump tariffs and onshoring, see our free report on the best short-term AI stock. READ NEXT: 20 Best AI Stocks To Buy Now and 30 Best Stocks to Buy Now According to Billionaires. Disclosure: None. This article is originally published at Insider Monkey. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data

6 Ways To Rethink Retirement in an Ongoing DOGE Economy
6 Ways To Rethink Retirement in an Ongoing DOGE Economy

Yahoo

time8 hours ago

  • Yahoo

6 Ways To Rethink Retirement in an Ongoing DOGE Economy

Elon Musk may have left his Department of Government Efficiency (DOGE) behind, but the DOGE office and the intentions to cut government spending remain. It will likely have a lingering effect on many aspects of Americans' lives, particularly regarding the agencies where staffing or budgets were slashed or may be in the future. Find Out: Read Next: One of the areas DOGE did a lot of cutting was the Social Security Administration. For anyone retiring in this DOGE environment, in which security nets like Social Security and Medicare may not be so secure, it may be time to rethink some aspects of retirement. Christopher Stroup, a CFP and owner of Silicon Beach Financial, explained some ways to prepare for this new policy landscape. Retirees relying on timely Social Security or Medicare have faced longer processing times and inconsistent access to benefits. 'The cuts didn't just trim fat, they disrupted core services, forcing many to navigate a fragmented system at a life stage when stability matters most,' Stroup said. This volatility adds a new layer of risk to traditional retirement planning that requires more strategy. Be Aware: Simply put, if government support continues to shrink, which is likely, retirees may need to assume greater out-of-pocket costs for healthcare and essentials, Stroup warned. 'Financial plans must now stress-test for reduced safety nets, inflation uncertainty and delayed services,' he said. The assumption that Medicare and Social Security will 'just work' is no longer a safe bet. Stroup suggested soon-to-be-retirees now think of retirement less as a finish line and more as a transition that demands flexibility. 'You'll want to build contingency funds, diversify your income sources, and plan for potential lags in public benefits,' he said. Just as important, don't delay filing paperwork since bureaucratic backlogs can derail even well-funded retirements if you're not proactive. It's also a time to focus on liquidity, not just longevity, Stroup said. This means maintaining a strong emergency fund for benefit delays or policy changes. It's a great time to reevaluate withdrawal rates and healthcare coverage with the help of a financial advisor, and to consider supplemental insurance or annuities to hedge against 'service erosion.' 'Above all, revisit your financial plan annually as this environment demands regular recalibration,' Stroup said. To get down to the essentials and focus your energy, Stroup recommended prioritizing the following three things: Healthcare planning: Confirm coverage and estimate out-of-pocket costs. Guaranteed income: Layer Social Security with annuities or conservative income streams. Tax strategy: Optimize withdrawals to minimize tax drag. A well-sequenced drawdown strategy can preserve capital longer, especially if public benefits falter. Lastly, Stroup feels that 'policy disruption is the new normal.' This means you can't count on yesterday's assumptions. 'Whether it's delayed Social Security checks, Medicare limits or staff shortages, retirees need personal resiliency baked into their plan,' he said. Work with a fiduciary who understands the tech-policy overlap and can help you adapt as systems shift beneath your feet. More From GOBankingRates 3 Luxury SUVs That Will Have Massive Price Drops in Summer 2025 These 10 Used Cars Will Last Longer Than an Average New Vehicle 10 Genius Things Warren Buffett Says To Do With Your Money This article originally appeared on 6 Ways To Rethink Retirement in an Ongoing DOGE Economy

DOGE just got a green light to access your Social Security data. Here's what that means
DOGE just got a green light to access your Social Security data. Here's what that means

Yahoo

time20 hours ago

  • Yahoo

DOGE just got a green light to access your Social Security data. Here's what that means

Editor's Note: This article, which originally ran on February 19, has been updated to reflect a Supreme Court decision handed down on June 6. When people think of Social Security, they typically think of monthly benefits — for the roughly 69 million retirees, disabled workers, dependents and survivors who receive them today. But efforts by the Department of Government Efficiency this year to access the Social Security Administration's data systems should conjure up thoughts of data on hundreds of millions of people. Why? Because the SSA's multiple data systems contain an extensive trove of personal information on most people living in the United States today — as well as those who have died. While a lower federal court had blocked DOGE's efforts to access such data — which it argued it needs in order to curtail waste, fraud and abuse — the Supreme Court lifted that order on Friday, allowing DOGE to access the data for now. The three liberal justices — Sonia Sotomayor, Elena Kagan and Ketanji Brown Jackson — dissented. In her opinion, Jackson wrote, 'The government wants to give DOGE unfettered access to this personal, non-anonymized information right now — before the courts have time to assess whether DOGE's access is lawful,' she added. The personal data the Social Security Adminstration has on most Americans runs 'from cradle to grave,' said Kathleen Romig, who used to work at the SSA, first as a retirement policy analyst and more recently as a senior adviser in the Office of the Commissioner. DOGE was created unilaterally by President Donald Trump with the goal of 'modernizing Federal technology and software to maximize governmental efficiency and productivity,' according to his executive order. To date, the group has caused chaos and intimidation at a number of federal agencies where it has sought to take control and shut down various types of spending. It is also the subject of various lawsuits questioning its legal right to access wholesale the personal data of Americans on highly restricted government IT systems and to fire groups of federal workers in the manner it has. Here's just a partial list of the data the SSA systems likely have about you: your name, Social Security number, date and place of birth, gender, addresses, marital and parental status, your parents' names, lifetime earnings, bank account information, immigration and work authorization status, health conditions if you apply for disability benefits, and use of Medicare after a certain age, which the SSA may periodically check to ascertain whether you're still alive. Other types of personal information also may be obtained or matched through the SSA's data-sharing agreements with the IRS and the Department of Health and Human Services. Information on your assets and living arrangements also may be gathered if you apply for Supplemental Security Income (SSI), which is meant to help those with very limited income. As with the IRS data systems to which DOGE has also sought access, the SSA systems are old, complex, interconnected and run on programming language developed decades ago. If you make a change in one system, it could trip up another if you don't know what you're doing, said Romig, who now is director of Social Security and disability policy at the liberal Center on Budget and Policy Priorities. And, just as at the IRS, there are concerns that if DOGE team members get access to the SSA systems and seek to make changes directly or through an SSA employee, they could cause technical errors or base their decisions on incorrect understandings of the data. For example, multibillionaire CEO Elon Musk, a driving force at DOGE, had incorrectly claimed that SSA is making payments to millions of dead people. His claim appeared to be based on the so-called Numident list, which is a limited collection of personal data, Romig said. The list includes names, Social Security numbers, and a person's birth and death dates. But the Numident list does not reflect the death dates for 18.9 million people who were born in 1920 or earlier. That's a known problem, which the Social Security inspector general in a 2023 report already recommended the agency correct. That same report, however, also noted that 'almost none of the 18.9 million number holders currently receive SSA payments.' And making any decisions based on mistaken interpretations could create real-world problems for individuals. For example, Romig said, there are different types of Social Security numbers assigned — eg, for US citizens, for noncitizens with work authorization and for people on student visas who do not have work authorization. But a person's status can change over time. For example, someone on a student visa may eventually get work authorization. But it's up to the individual to update the SSA on their status. If they don't do so immediately or maybe not even for years, the lists on SSA systems may not be fully up to date. So it's easy to see how a new entity like DOGE, unfamiliar with the complexity of Social Security's processes, might make a quick decision affecting a particular group of people on a list that itself may not be current. Charles Blahous, a senior research strategist at the Mercatus Center at George Mason University, has been a leading proponent of addressing Social Security's long-term funding shortfall. And he is all for rooting out waste, fraud and abuse. But, Blahous noted, 'best estimates of improper payments in Social Security are less than 1% of the program's outlays. I've been concerned that this particular conversation is fueling profound misimpressions about Social Security and the policy challenges surrounding it.' SSA's data systems are housed in locked rooms, and permission to view — never mind alter — information on them has always been highly restricted, Romig said, noting that she was fingerprinted and had to pass a background check before being allowed to view data for her research while at the agency — and it could only be data that had no personally identifiable information. Given the variety of personal data available, there are also a number of federal privacy and other laws limiting the use and dissemination of such information. Such laws are intended to prevent not only improper use or leaks of the data by individuals, but abuse of power by government, according to the Center on Democracy and Technology. DOGE's arrival at the SSA resulted in a number of seasoned employees leaving the agency, including Michelle King, a long-time career service executive who briefly served as acting commissioner from January 20 until February 16. She resigned after DOGE staffers attempted to access sensitive government records. In her place, SSA employee Lee Dudek was named acting director. Dudek put out a statement on SSA's 'Commitment to Agency Transparency and Protecting Benefits and Information' when he came on. In it, he noted that DOGE personnel: a) 'cannot make changes to agency systems, benefit payments, or other information'; b) 'only have read access' to data; c) 'do not have access to data related to a court ordered temporary restraining order, current or future'; and d) 'must follow the law and if they violate the law they will be referred to the Department of Justice for possible prosecution.' CNN's Alayna Treene and John Fritze contributed to this report.

DOWNLOAD THE APP

Get Started Now: Download the App

Ready to dive into the world of global news and events? Download our app today from your preferred app store and start exploring.
app-storeplay-store