Last week CMS notified Medicare prescription drug plan sponsors of the process for reconciling plan enrollments to ensure that all beneficiaries who have elected to change plans are appropriately disenrolled from their initial plan by April 30, 2006. To ensure that all enrolled beneficiaries would have access to prescription drug coverage in the early...
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CMS
CMS Takes Steps To Clean Up Enrollment
DEADLINE: PDPs, MA-PDs, Cost, and PACE 2007 Applications
Today is the deadline for all PDPs, MA-PDs, Cost, and PACE 2007 applications. Details on the CMS website.
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Surprise CMS Move Will Cost Hospitals for Multiple Push Injections of Same Drug
AISHealth and the 3/6/06 Report on Medicare Compliance are reporting Hospitals are about to lose money for intravenous push injections because of a surprise move by CMS, experts say. CMS said recently that hospitals can’t charge Medicare for more than one IV push injection of the same drug during the same patient encounter (HCPCS...
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MMA 2003 Update
The Medicare Modernization Update (MMU) was updated on Wednesday, March 1, 2006. For your convenience, we offer the following topics and links that this office maintains. Please update your bookmarks and favorites accordingly. Subject area on the web site Link Medicare Modernization Update (MMU) http://www.cms.hhs.gov/MMAUpdate/ Quarterly Provider Update (QPU) http://www.cms.hhs.gov/QuarterlyProviderUpdates/ CMS Manuals http://www.cms.hhs.gov/Manuals/IOM/list.asp CMS...
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Public Comment Period for Draft 2007 MA, MA-PD and PDP Call Letters
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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U.S. healthcare spending rose 7.4% last year
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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CMS UPDATE: Advance Notice of 2007 Technical Changes to MA Reimbursement
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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Deficit Reduction Act Enacted!
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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Clawbacks Reduced Due to Higher Than Expected Drug Savings
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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CMS Issues guidance on Part B vs. D Coverage
On a January 24, 2006 conference call Craig Miner and Lawrence Kocot issued guidance on how plans should and should not be determining drug coverage under Parts B and D. “Part D plans should not be requiring a Part B rejection as their first step before they’ll start thinking about covering it under Part...
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