Medicare Advantage and Part D

From Medicare Advantage News - A flurry of additional mass terminations of physicians from Medicare Advantage networks this year has triggered new legislation in Congress that would reduce the flexibility of MA plans to make such cuts in the future. The Medicare Advantage Participant Bill of Rights Act of 2014 (H.R. 4998) was introduced June 26 by U.S. Rep. Rosa DeLauro (D-Conn.), with a companion measure introduced at the same time in the Senate. Read more

From Medicare Advantage News - Another sizable and previously fast-growing Florida Medicare Advantage plan is about to disappear as a result of financial problems. On June 9, Leon County Circuit Court Judge Charles Francis ordered Physicians United Plan, Inc. (PUP) into receivership under the Florida Department of Financial Services (DFS), which will liquidate it effective July 1. Orlando-based PUP began operations in January 2006 and has about 40,000 MA prescription drug HMO members, mainly in Central… Read more

Medicare Advantage & Part D Blog

By James Gutman - July 24, 2014
If you can’t beat 'em, sue ’em — or discourage their beneficiaries from participating. That at least may be the attitude of some provider groups toward the Medicare-Medicaid dual eligibles demonstration programs starting up in multiple states, as shown by a lawsuit filed in California in mid-July...
By James Gutman - July 15, 2014
The Medicare Advantage (MA) industry knows what its critics think about it, and that’s a good thing for planning strategy changes. But does the industry know that its customers — presumably its biggest fans — also have some major criticisms, especially regarding customer service? And does it also...
By James Gutman - July 8, 2014
The drumbeat to do something about mass terminations of providers from Medicare Advantage (MA) networks is getting louder. Even though CMS put new limits on such terminations in the final 2015 MA payment notice and Call Letter in April, Democrats in both the House and Senate late last month...

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