Medicare Advantage and Part D

From Medicare Advantage News - While some health plans and states participating in the huge CMS-backed demonstration for Medicare-Medicaid dual eligibles have struggled with its passive-enrollment emphasis, New Jersey’s own voluntary duals initiative begun in 2012 has avoided many of those difficulties. And a key reason for this, state officials say, is that New Jersey’s program is built around Medicare Advantage Special Needs Plans (SNPs) for duals. Read more

From Medicare Advantage News - This month’s $1 million fine levied by CMS against Aetna Inc. for erroneously listing nearly 6,000 retail pharmacies as in network for its Part D plans when they weren’t (MAN 1/22/15, p. 4) is the agency’s biggest financial penalty so far this year for violations related to drug benefits under Medicare. But it is far from the only one, as CMS in the first 100 days of the year has… Read more

Medicare Advantage & Part D Blog

By James Gutman - May 27, 2015
If there is one time of year when Medicare Advantage (MA) and Part D executives are sure to be burning the midnight oil, it is now: a few days before the deadline for submission to CMS of their bids for the following year. But while the pre-bid period this time around still is hectic, the...
By James Gutman - May 13, 2015
The annual CMS spring Medicare Advantage (MA) and Part D conference has evolved in recent years from a largely in-person event with top-of-mind topics for MA plan strategists and good opportunities to speak directly with top agency officials to something less than that. It now is a largely webinar-...
By James Gutman - April 28, 2015
If it’s true that “fool me once, shame on you; fool me twice, shame on me,” then Medicare Part D plans might be feeling a lot of shame right about now. This is because even though CMS has made it super-clear that one of its highest priorities is ensuring pharmaceutical access to Part D...

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