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August 22, 2017

Hot Topic

CMS has stepped up enforcement of Medicare Advantage rules forcing plan sponsors to keep provider directories updated and accurate — a task that is proving challenging for plans. Here’s a look at recent developments:

In Pursuit of Transparency, CMS Unveils Big Changes to Medicare Plan Finder
In order to ensure that Medicare beneficiaries have access to “meaningful benefit information” when selecting plans this fall, CMS is preparing revisions to the MPF that include showing data on more benefit categories...

AHIP Report Shows Plan Woes in Keeping Directories Up-to-Date
Results from a recent provider directory initiative conducted by AHIP provide new evidence of the difficulties plans face when attempting to update and verify provider directory information...

CMS Provider Directory Review Results In 21 Warning Letters; Fines Could Follow
The official results of the first phase of CMS’s directory accuracy pilot are in, and of the 54 MAOs whose online provider directories were reviewed, 21 received letters warning that if they fail to correct their deficiencies, they could be subject to enforcement actions...

Today's AIS Health Datapoint

240,904 ... lives are enrolled in UCare Choices, UCare's Medicaid managed care plan in Minnesota, as of July 2017. This is a 475.09% increase from the first quarter of 2017, following Medica's May exit from most of the state's Medicaid markets. Hennepin Health's Minnesota Medicaid enrollment increased by 139.46%, and HealthPartners Inc.'s by 60.90%.


AIS’s Medicare and Medicaid Market Data: Enrollment, Premium Rates, Benefit Designs and Strategies of Medicare and Medicaid Plans

Quote of the Day

“At some point [the Trump administration] can’t cancel the [cost sharing reduction] payment…because they’re already cutting the checks. The whole process starts now. The wheels are rolling.”

— Jason Karcher, an actuary in the Milwaukee office of Milliman, Inc., told Health Plan Week Aug. 1 about the lengthy process involved in making cost sharing reduction (CSR) payments to health plans.

Click here to read the HEALTH PLAN WEEK article in which this quote appeared — "If Plans Lose Federal CSR Pay, Bottom Lines Would Get Hard Hit"


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