Medicare Advantage and Part D

From Medicare Advantage News - CMS’s annual report summarizing activities for the prior audit year — released several months earlier than usual — contained some “encouraging” results, such as improved performance in the Part D program areas of Formulary and Benefit Administration (FA) and Coverage Determinations, Appeals, and Grievances (CDAG), observed a CMS official who spoke during a May 11 session of the Medicare Advantage and Prescription Drug Plan Audit and Enforcement Conference. Read more

From Medicare Advantage News - Medicaid enrollment has increased significantly over the past year and is the fastest growing health insurance sector, according to preliminary results from the annual research cycle for AIS’s Directory of Health Plans: 2017. With an average increase of 7.5% among the first 20 states to respond to AIS’s annual survey, researchers are discerning some prominent trends that could bode well for insurers in this sector. A larger proportion of Medicaid eligibles… Read more

Medicare Advantage & Part D Blog

By Lauren Flynn Kelly - June 29, 2017
In writing the latest issue of Medicare Advantage News, which was made more difficult by late-breaking developments in the Senate’s effort to repeal and replace the Affordable Care Act, I was struck by how sensitive the issue of delivering health care is. At the end of the day, it’s about meeting...
By Lauren Flynn Kelly - May 25, 2017
In the 2018 final payment notice and Call Letter issued last month, CMS threw in an unusual request for information (RFI) soliciting ideas on ways it can bring more transparency, flexibility, program simplification and innovation to the Medicare Advantage and Part D programs. The agency has...
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,...

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