Medicare Advantage and Part D

From Medicare Advantage News - A group of providers, patient-advocacy organizations and Medicare-Medicaid dual eligibles filed suit in California Superior Court in Sacramento this month in an effort to block the state’s CMS-backed duals initiative from proceeding. The judge in the case, Shelleyanne Chang, rejected the plaintiffs’ request for a temporary restraining order, but she did schedule a hearing on the lawsuit for Aug. 1. Read more

From Medicare Advantage News - A focus group of seniors enrolled in Medicare Advantage plans this month turned up considerable dissatisfaction with both the information available for choosing MA plans and the customer service once they were in the plans. Members of the group also seemed to regard the relationship between their providers and the MA plans as almost adversarial and sided with their doctors, although a minority did cite some good experiences with their… Read more

Medicare Advantage & Part D Blog

By James Gutman - August 28, 2014
It used to be pretty easy to be an operator of stand-alone Medicare Prescription Drug Plans (PDPs). An insurer didn’t need a partner, could offer as many product designs as it wanted and could vary the premiums for them as much or as little as it wished. The sponsor also could decide to skip the...
By James Gutman - August 14, 2014
If there is one thing that Congress is good at these days, it is posturing, which of course is a lot easier to do than is taking effective action. And this again was clear shortly before our legislature adjourned for the long summer break when the House Ways and Means Health Subcommittee held a...
By James Gutman - August 7, 2014
It has been a long time in coming, and it still isn’t here yet, but the start of Medicare Advantage (MA) Recovery Audit Contractor (RAC) audits moved a big step closer last month when CMS issued its Statement of Work (SOW) for the new audits. And the SOW leaves several observers wondering if the...

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