Medicare Advantage and Part D

From Medicare Advantage News - Despite persistent and varied efforts by CMS to foster their spread, less than half of Medicare Part D enrollees eligible for medication therapy management programs receive them, and only 11% of all Part D enrollees were part of MTM programs in 2012, according to a new study of CMS data from that year by consulting firm Avalere Health LLC. Moreover, Avalere found that just 1% of Part D enrollees in 2012 received the comprehensive medication review (CMR) that all Part D plans must offer to MTM enrollees (see chart, p. 4). Read more

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… Read more

Medicare Advantage & Part D Blog

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...
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...

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