From Medicare Advantage News - Both CMS and Aetna Inc. learned valuable lessons as a result of what the company now acknowledges were its confusing efforts to institute multiple pharmacy networks in Medicare Part D plans this year, the two organizations said at a conference last month. Speaking at the agency’s fall Medicare Advantage and Part D conference in Baltimore Sept. 10, Aetna executives outlined what they did to rectify the well-publicized problems, which led to CMS assessing a $1 million fine against Aetna (MAN 4/23/15, p. 4). Read more
From Medicare Advantage News - The switch by NCQA from a ranking to a rating methodology in its health plan evaluations did not seem to have a major impact on which plans were identified as the top Medicare performers in its annual list. The new stars-like ratings that the accreditation group released Sept. 17 include among the nine plans that won its top rating of 5.0 (see table, below) eight that were in the top… Read more
From Medicare Advantage News - In its first-ever deal to own behavioral-health organizations, Molina Healthcare, Inc. said on Sept. 3 it agreed to acquire two BH units of The Providence Service Corp. (PSC) for about $200 million. And President and CEO J. Mario Molina, M.D., tells MAN that the company has been eyeing BH for years looking “for a suitable entry,” partly as a means for better managing care of Medicare-Medicaid dual eligibles. Read more
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