We are pleased to issue this notice announcing the release of the DRAFT 2007 Medicare Advantage (MA), Medicare Advantage-Prescription Drug (MA-PD) and Stand Alone Prescription Drug Plan (PDP) Call Letters for public comment. We are sending theseletters out via HPMS and will post them on our website at http://www.cms.hhs.gov/HealthPlansGenInfo/02_WhatsNew.asp#TopOfPage and http://www.cms.hhs.gov/PrescriptionDrugCovContra/01_Overview.asp#TopOfPage
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The Centers for Medicare & Medicaid Services (CMS) announced today that it is expanding Medicare’s national coverage of bariatric surgery for all Medicare beneficiaries. For seniors, who have experienced high complication rates in some settings, Medicare will cover the procedure only in high-volume centers that achieve low mortality rates. DOWNLOAD COMPLETE PRESS RELEASE
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U.S. healthcare spending grew 7.4% in 2005 to surpass $2 trillion and is expected to grow 7.3% in 2006, the CMS said in an annual report. Thats down from a recent peak of 9.1% growth in 2002. The increase in spending on hospital services, 7.9%, outpaced overall healthcare spending growth for the second year...
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Here are the highlights from the CMS Advanced Notice of Methodological Changes to 2007 MA Rates and Part D Payments: GENERAL: The National Per Capita Growth percentage is used to baseline the rate tables for 2007. The rate is estimated at 6.9%. It is still not possible to predict the final impact on reimbursement...
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Next to the roll out of PART D, the implementation of Medicare’s HCC Risk Adjustment reimbursement model for Medicare Advantage plans is one of the most significant changes to the Medicare industry. In 2007 plans will receive 100% of their reimbursement based on the HCC Risk model that pays higher rates for beneficiaries who...
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Here are the highlights of the Deficit Reduction Act signed in to law on February 8, 2006: Fee for Services payments to physicians will NOT be reduced by 4.4%. Claims that have been already processed will be reprocessed. Retro payments will be paid through July 1, 2006. Increase in the base payments to ESRD...
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Today the Dept of Health and Human Services announced that Clawback bill will be lower than expected as a result of higher savings from the implementation of the Part D drug benefit. CA payment is estimated to be reduced by $113.2 million, HI $2.1 million, NV $2.2 million, and AZ $5.6 million. PRESS RELEASE...
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Dr. Moffit of the Heritage Foundation has done a great job outlining the changes proposed in President Bush’s 2007 budget. Here are some of the highlights Proposed a modest $36 billion reduction in the growth of the Medicare budget over 5 years. Medicare spending is projected to be $395 billing in 2007 and grow...
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Attached is a PDF file from CMS: “This table provides Part D coverage clarifications for specific products/drugs/drug categories in accordance with statutory and regulatory requirements for Part D drugs. This is not an exhaustive list but only addresses those products/drugs/drug categories that have been the subject of frequently asked questions. Specific products not identified...
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A coalition of drug manufacturers is working on a plan to help millions of low-income seniors to pay for drugs when they enter Medicare’s so called “Doughnut Hole.” The Doughnut Hole is the coverage gap when a beneficiaries is responsible for drug costs when their total is between $2,250 and $5,000 annually. The government...
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