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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Part D
Be Prepared for Spring 2011 MARx System Upgrades! Will You Be Ready?
Medicare | House Democratic Caucus Asks CMS To Help Low-Income Medicare Beneficiaries Enroll in Prescription Drug Benefit
Nearly 150 members of the House Democratic Caucus have sent a letter to CMS Administrator Mark McClellan urging him to take additional steps to enroll low-income beneficiaries in the Medicare prescription drug benefit, CQ HealthBeat reports. The letter asks CMS to take several steps, including working with the Social Security Administration to identify low-income...
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Part D Weely Calls to Be Terminared
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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Payment Increases to Medicare Advantage Plans Lower
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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Health Plans Don’t Fear 2007 Medicare Advantage Rates, See Positive Long Term
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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CMS Takes Steps To Clean Up Enrollment
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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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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Market Responce: Get the Word Out Tours
Private providers are hoping to clear up the confusion over the new Medicare Prescription Drug Plan with road trips to enroll new members and by offering information to consumers about competing plans. Representatives for Humana, one such provider, will answer questions for the public from its “Let’s Talk” tour bus, which will be at...
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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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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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