From Medicare Advantage News - CMS is likely to take a more active stance on regulatory issues affecting Medicare Advantage and Part D plans in 2014, and some old and new hotspots are likely to get the most attention, observers tell MAN. At the top of the list, they suggest, are regulatory initiatives related to MA plans’ use of health risk assessments (HRAs) for diagnosis purposes and patient access to prescription drugs. Read more
From Medicare Advantage News - Some of the new star-rating measures CMS said last month it is considering adopting for 2015 could prove difficult for Medicare Advantage plans to do well on. Consultants’ predictions, in interviews with MAN, of such difficulties is based on timeline requirements and plans’ results on such measures while they have been on the CMS “display page” and thus not used in the actual ratings. Read more
From Medicare Advantage News - Organizations representing or working with health plans that have or may get Medicare-Medicaid dual-eligible members are launching a major effort aimed at remedying the relatively low quality payments those plans receive based on their CMS star ratings. The organizations contend that the nature of the duals population and its health status puts those plans at an unfair competitive disadvantage in getting much-needed bonuses from CMS that are based on star… Read more
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