Medicare Advantage and Part D

From Medicare Advantage News - As part of an ongoing process to streamline its managed Medicaid program, the state of Illinois is in the midst of soliciting bids from insurers who will compete for a limited number of statewide contracts to serve a larger swath of Medicaid enrollees and meet certain quality objectives. Read more

From Medicare Advantage News - A new set of civil monetary penalties (CMPs) based on audits conducted by CMS last year indicate that Medicare Advantage and Part D plan sponsors are continuing to make some of the same mistakes in the drug-related areas of Formulary & Benefit Administration and Part D Coverage Determinations, Appeals, and Grievances (CDAG) as well as on the Part C side, where they are slow to process organization determination requests. Read more

Medicare Advantage & Part D Blog

By Lauren Flynn Kelly - February 3, 2017
Fulfilling a new statutory requirement, CMS on Feb. 1 released its annual Advance Notice and draft Call Letter for Medicare Advantage and Part D plans 60 days prior to the final notice — about two weeks earlier than usual. This theoretically gives plans more time to prepare bids due in June,...
By Lauren Flynn Kelly - January 12, 2017
Each year the editors of AIS Health interview dozens of industry experts to come up with predictions on what the next 12 months will look like for the insurers and other health care stakeholders that read our newsletters. But this year’s “Outlook” poll was daunting for sources and writers alike...
By Lauren Flynn Kelly - November 14, 2016
Following the Nov. 8 election of business mogul Donald J. Trump to the presidency, insurers, patients, policy experts, providers and taxpayers alike are scratching their heads as to what this means for health care in the U.S. Trump’s health care reform proposal centered largely on “repeal and...

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