CMS

Obama Appoints New CMS Chief Without Senate Approval

July 8, 2010
By jbaker

Wednesday Barack Obama appointed Dr. Donald Berwick as the Administrator to the Centers of Medicare and Medicaid Services using a recess appointment.  Dr. Berwick is a Harvard professor and a patient care specialist.  He would be able to serve in his role though next year without Senate approval. Currently there are no hearings scheduled...
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Posted in CMS, News | No Comments »

CMS Updates MAPD and Cost Plan 2010 Reporting Tech Specifications

July 6, 2010
By jbaker

CMS has posted an update their 2010 MA Part C and Cost Plan Technical Reporting Specifications.  The update contains clarifications to commonly asked questions from plans. Part C reporting is a compliance requirement and plans that fail to submit data on time and in good fail will receive a compliance letter and notification.  The...
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Posted in CMS, Compliance, Part C | No Comments »

Medicare Advantage Plan Payments Adjusted By STARs Ratings

June 30, 2010
By jbaker

A key change included in the health reform legislation of 2010 was a change to the payment methodology for Medicare Advantage plans.  As of today, CMS has not released their policy or the methodology for applying the STARs rating to payment adjustments but the legislation does provide some insights in to the overall approach....
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Be Prepared for Spring 2011 MARx System Upgrades! Will You Be Ready?

June 29, 2010
By jbaker

CMS has planned a major overhaul of their MARx system impacting enrollment file layouts and changes to TRR processing in April 2011.   Here is a run down of the changes: IMPACTED SYSTEM / INTERFACE DESCRIPTION FROM TO Enroll Disenroll File Combining transaction codes 60, 61, 62 and 71 in to a single transaction code...
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Posted in CMS, Enrollment, Part C, Part D | 3 Comments »

2.2 Percent Medicare Physician Fee Schedule Update Through Nov 30, 2010

June 25, 2010
By jbaker

On June 25, 2010, President Obama signed into law the “Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010.”  This law establishes a 2.2 percent update to the Medicare Physician Fee Schedule (MPFS) payment rates retroactive from June 1 through November 30, 2010.  The Centers for Medicare & Medicaid...
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Posted in CMS, FFS, News | 1 Comment »

Medicare billings now reported on federal Web site

June 14, 2006
By jbaker

By KEVIN FREKING THE ASSOCIATED PRESS WASHINGTON – To help Americans become smarter health care shoppers, Medicare this month started publishing a range of what it pays for 30 common procedures and report how frequently hospitals perform them. The release of the information fits with the Bush administration’s strategy of moving more people into...
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Posted in CMS, FFS, General | No Comments »

Part D Weely Calls to Be Terminared

May 30, 2006
By jbaker

Since December of 2005 we have been holding weekly Part D Providers conference calls to address issues physicians and other health care providers were having with Part D. We have seen a gradual decline in the participation on those calls and this past week, we only had one question on the call. To that...
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Posted in CMS, Part D | No Comments »

2007 MA/MAPD Call Letter

April 5, 2006
By jbaker

CMS has released the 2007 MA/MAPD Call letter.  Download it here.
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Payment Increases to Medicare Advantage Plans Lower

April 4, 2006
By jbaker

CMS on Monday said that reimbursement rates for Medicare Advantage plans in 2007 will increase by only about 1.1% on average, rather than 4% as scheduled, because of a technical adjustment of how physicians code beneficiaries for billing, CQ HealthBeat reports. According to CQ HealthBeat, past small increases in reimbursement rates have led to...
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Posted in CMS, Part A/B, Part C, Part D | No Comments »

Health Plans Don’t Fear 2007 Medicare Advantage Rates, See Positive Long Term

March 29, 2006
By jbaker

CMS is expected to issue final 2007 Medicare Advantage (MA) payment rates April 3. But some established Medicare managed care organizations aren’t holding their breath: They anticipate satisfactory reimbursement for next year’s MA product lines…. Visit AISHealth to read the entire story.
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Posted in CMS, Part C, Part D | No Comments »

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