Part C

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 »

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 »

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 »

CMS Takes Steps To Clean Up Enrollment

March 29, 2006
By jbaker

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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Posted in CMS, Enrollment, Part C, Part D | No Comments »

DEADLINE: PDPs, MA-PDs, Cost, and PACE 2007 Applications

March 20, 2006
By jbaker
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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Posted in CMS, General, Part A/B, Part C, Part D | No Comments »

Public Comment Period for Draft 2007 MA, MA-PD and PDP Call Letters

February 23, 2006
By jbaker
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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Posted in CMS, General, Part C, Part D | No Comments »

CMS UPDATE: Advance Notice of 2007 Technical Changes to MA Reimbursement

February 17, 2006
By jbaker
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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Posted in CMS, Part C, Part D, Risk Adjustment | No Comments »

Letter From CMS to Providers

January 31, 2006
By jbaker
Letter From CMS to Providers

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 »

NEW Report: Tracking Medicare Health And Rx Plans

January 17, 2006
By jbaker

January 6th, 2006 – Monthly Report for December 2005 The Kaiser Family Foundation releases a great monthly update on activites that impact Medicare Advantage and PartD businesses. Credits: Prepared by Stephanie Peterson and Marsha Gold, Mathematica Policy Research Inc. as part of work commissioned by the Kaiser Family Foundation Download MA Plan Tracking Report
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Posted in Enrollment, General, Part C, Part D | No Comments »

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