Medicare Advantage and Part D

From Medicare Advantage News - The biggest news in the 2015 Medicare Advantage and stand-alone Prescription Drug Plan (PDP) “landscape files” that CMS released Sept. 18 is what didn’t happen. Despite the substantial cuts in MA plan payments coming for the vast majority of sponsors next year, there aren’t many plan exits, and premium increases generally are fairly low. Even benefit reductions, which look to be the main channel for MA plan efforts to offset some payment reductions for 2015, appeared to be mainly small in the files that show the products to be offered in each service area, along with their premiums. Read more

From Medicare Advantage News - Opponents this month filed a second lawsuit aimed at blocking and reversing implementation of California’s CMS-backed demonstration program for Medicare-Medicaid dual eligibles. And this one could have a better chance than the first suit, which was filed in July and seeks an injunction that was denied by a state judge (MAN 7/24/14, p. 5), because it focuses on actual harm allegedly suffered by specific duals beneficiaries as a result of… Read more

Medicare Advantage & Part D Blog

By James Gutman - October 22, 2014
The health insurance industry’s equivalent of the feud between the Hatfields and the McCoys sprung up again this month, and the new battleground is Medicare Advantage (MA) products for 2015. Specifically, Highmark, Inc. on Oct. 1 unveiled a new MA product, Community Blue Medicare HMO, with both...
By James Gutman - October 10, 2014
Waiting for the new Medicare Advantage (MA) and stand-alone Prescription Drug Plan (PDP) star ratings is a little like what people in my old New York City neighborhood used to call — in their politically incorrect way — “Chinese water torture.” CMS first lets plans see their own ratings for the...
By James Gutman - September 26, 2014
There are many takeaways from CMS’s release of the 2015 Medicare Advantage “landscape files” on Sept. 18, but perhaps the biggest one is that not many MA plan sponsors are ready to walk away from the products yet. Even staring into the face of a year that will show the biggest plan payment cuts yet...

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