Medicare Advantage and Part D

From Medicare Advantage News - For the second time in as many years, Florida is about to liquidate a Medicare Advantage plan sponsor that became insolvent. The state’s Department of Financial Services (DFS) on Dec. 10 obtained a Circuit Court order authorizing the liquidation of Florida Healthcare Plus, Inc. (FHPI), which has about 10,000 MA members, effective Jan. 1, 2015. Read more

From Medicare Advantage News - There were few surprises and only one brand-new measure — but some important potential changes — outlined in CMS’s Nov. 21 memo on proposed “enhancements” to its Medicare plan star quality ratings for 2016 and beyond. This year’s 22-page edition of what has become an annual document makes clear, for instance, that CMS intends finally to end use of predetermined four-star “thresholds” effective with the 2016 ratings. Read more

Medicare Advantage & Part D Blog

By James Gutman - January 22, 2015
There are many trade associations that tread very carefully out of fear of antagonizing people or organizations they may need later. The 23,000-member National Community Pharmacists Association is not one of them. When NCPA finds something it doesn’t like — which it often does in managed care — the...
By James Gutman - January 8, 2015
It doesn’t take a genius to know why Florida has attracted so many Medicare Advantage (MA) plan sponsors. The state, of course, is crawling — so to speak — with seniors, and its high prevailing Medicare fee-for-service payment rates have meant in the past high pay for MA plans. But Florida also...
By James Gutman - December 30, 2014
It was a year when things happened quickly — such as two Florida Medicare Advantage (MA) plans being ordered into liquidation — and things happened slowly, such as enrollment into the new CMS-backed demonstrations for Medicare-Medicaid dual eligibles. 2014 also was a year in which MA plans lived...

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