Medicare Advantage and Part D

From Medicare Advantage News - A group of speakers voiced strong support for the Medicare Advantage program at a July 24 House Ways and Means Health Subcommittee hearing that seemed more designed to let organizations air recommendations for protecting the program than to work for any specific legislation this year. Indeed, the panel’s chairman, Rep. Kevin Brady (R-Texas), who put together the hearing, asserted in his announcement of it that MA products “are being threatened by cuts in the Affordable Care Act and onerous regulations,” but did not mention any bill to deal with this. Read more

From Medicare Advantage News - CMS on July 16 took another step in the move toward the start of a long-delayed Recovery Audit Contractor (RAC) program for Medicare Advantage plans, as required under the 2010 Affordable Care Act. But the issuance by the agency’s Center for Program Integrity of a Statement of Work (SOW) for the MA RAC initiative still leaves attorneys with questions about how effective the program might be and what problems it… Read more

Medicare Advantage & Part D Blog

By James Gutman - September 12, 2014
One word offered by Robb Cohen, senior vice president, public policy at Gorman Health Group, LLC, upon hearing that CMS on Sept. 8 is seeking research that shows beneficiaries’ Medicare-Medicaid dual-eligible status causes lower star-rating scores for their health plans, says it all. “Finally,”...
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...

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