Dear Health Care Professional:The new Medicare Part D prescription drug program is the single biggest change to Medicare since the program began 40 years ago and one which has been long overdue. But adding a benefit as significant as the new Medicare prescription drug program, which affects millions of individuals, involves some start-up challenges....
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Posted in CMS, General, Part C, Part D | No Comments »
Background on Payments for Medicare Advantage Plans Medicare advantage plans are private managed care plans that offer typically offer benefits beyond traditional fee for service Medicare. Plan bids outline the benefit packages offered to an area and the beneficiary contributions, if any. By law, CMS is required to publish the Medicare Advantage payment rates...
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Posted in General, Part A/B, Risk Adjustment | No Comments »
Following is a brief overview of the stakeholder conference call lead by Jeff Flick today: States On Track To Federal Part D Reimbursement – The Federal Government is moving to quickly provide a process to reimburse states who have stepped up to be the payer of last resort for duel Medicare beneficiaries who have...
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Posted in CMS, Enrollment, Part D | No Comments »
Medicare sign-up extension urged Chicago Sun-Times, United States - 8 hours ago WASHINGTON — Noting that Medicare’s new drug benefit is off to a rocky start in some states, a few Republican lawmakers are joining scores of Democrats in … Update 3: Delay in Drug Benefit Deadline Sought Forbes Fix Medicare prescription drug law Lowell Sun, MA -...
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In this article The Wall Street Journal outlines the aggressive land grab going on right now in the Medicare marketplace as plans use Part D enrollment to capture new applicants and then attempt to migrate them to a full Medicare Advantage program. Also, the article discusses AARP’s influence on the senior population and the success some...
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Posted in Enrollment, News, Part D | No Comments »
On Tuesday, January 24, the Centers for Medicare and Medicaid Services hosted a call to discuss coverage of Medicare Part B drugs as it relates to Medicare Part D. Drugs excluded from coverage under Part D were also discussed. CMS provided an overview of the Medicare Parts B/D Issues (http://www.cms.hhs.gov/Pharmacy/) and followed by answering...
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Posted in CMS, Part A/B, Part D | No Comments »
Look for news, updates and front row coverage of the 2006 Medicare Advantage Congress in Phoenix, AZ. If you get a chance find me and say hello. I will post updates from the breakouts and the event floor later today.
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Can 2007 Institutionalized SNPs Survive? 2006 Is the Year of the Medi-Medi SNP in the hopes of plans capturing as mant auto-assigned Part D enrollees at a low acquisition cost and then sign them up in to their duel-eligiable SNP. 2007 is the year of the institutionalized and chronic condition SNP…however will changes in...
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Posted in News, SNP | No Comments »
bipartisan group of at least five senators plans to sponsor legislation that would reimburse states that are covering the costs of drugs for Medicare beneficiaries who have had difficulty obtaining medications under the new Medicare drug benefit, AP/Long Island Newsday reports. The legislation — co-sponsored by Sens. Norm Coleman (R-Minn.), Dianne Feinstein (D-Calif.), Frank...
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Posted in Part D | No Comments »
The Centers for Medicare & Medicaid Services (CMS) announces the establishment of the Medicare Beneficiary Ombudsman’s Open Door Forum (ODF). Daniel J. Schreiner, the Medicare Beneficiary Ombudsman, coordinates with CMS to oversee beneficiary concerns including appeals, complaints, grievances and requests for assistance. The Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA), Section...
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Posted in CMS, General, Part D | No Comments »