Medicare Advantage and Part D

From Medicare Advantage News - CMS this month cited six Medicare Advantage sponsors for failing to furnish correct and/or timely benefit and cost information for their MA plans for the 2015 contract year (CY). The agency notified the plans involved that it will impose civil money penalties (CMPs) that range from a low of $34,445 for Health Alliance Medical Plans to a high of $349,075 for Health Net of Arizona. Read more

From Medicare Advantage News - It is not hard to see in the revised Medicare Marketing Guidelines that CMS released July 2 what issues are at the top of the agency’s mind in terms of needing marketing-related regulatory changes. A good chunk of the revisions relate to (1) the accuracy and dissemination of directories of network providers and pharmacies, (2) the need for clear disclaimers in language about member benefits and costs and (3) the… Read more

Medicare Advantage & Part D Blog

By James Gutman - August 20, 2015
Maryland, where I reside, is a strange state in many ways, and especially when it comes to both Medicare Advantage (MA) and hospitals. In Medicare, managed care penetration has been dismal, with the most popular product not even really an MA one but instead a five-star-rated Kaiser Permanente cost...
By James Gutman - August 4, 2015
Just when some may have thought the years of big decline in the annual Part D benchmarks that determine how much plans are paid had to be nearing an end, the drop is accelerating. CMS on July 29 said the national average monthly bid amount for Part D in 2016 is $64.66, down from $70.18 for 2015, $...
By James Gutman - July 21, 2015
Provider directories, not long ago an annual hard-copy document customarily banished shortly after receipt to either the “circular file” or the nethermost reaches of beneficiaries’ storage areas, are now one of the hottest areas for regulations in Medicare Advantage (MA). If there had been any...

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