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
From Medicare Advantage News - In what may be a preview of issues other states also will face as they expand Medicaid managed care extensively and quickly, the California state auditor (CSA) on June 16 severely criticized what both managed Medicaid plans and state agencies have done to ensure adequate provider-network access for beneficiaries. But the major state agency involved said only some of the criticisms are warranted. Read more
Check out all of the benefits, sample issues & more!