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July 2, 2015

Recent Stories of Interest

From Medicare Advantage News - The likelihood that Medicare Advantage plans’ risk-score documentation practices will have to change never has been higher. An assortment of federal government agencies, nonprofit organization researchers and private-sector whistleblowers all have dived deeply into MA risk adjustment in the past year, and the result is an unprecedented level of scrutiny for everything from consultant recommendations to findings of home health risk assessments (HRAs) to encounter data. Read more

Four years after the insurer exited the Medicare Advantage market because all… Read more

The 2016 Medicare Advantage and stand-alone Prescription Drug Plan (PDP) bids deadline… Read more

Insurers are greeting the first major proposed update of CMS Medicaid managed… Read more

From the Editor

Welcome to your Medicare Advantage News subscriber-only Web page

Be sure to visit often, for PDFs of issues, archives of articles, links to government documents and more!

Please e-mail me with your comments on the last issue of Medicare Advantage News, story ideas for future issues, or any other suggestions you have that can make the newsletter more useful for you.

July 1, 2015
California State Auditor's Report on Access Problems in Medi-Cal Managed Care

To view the California state auditor's June 16, 2015, report criticizing provider-network access for Medi-Cal managed care beneficiaries and state regulatory agencies' response to the criticisms, click here

July 1, 2015
CMS Presentation on Part D MTM Pilot Program

To view the June 16 presentation handouts of CMS's Rebecca Walden on the upcoming medication therapy management program for Medicare Part D plans, click here

June 18, 2015
Fallon Bails on Mass. Duals Demo

Fallon Health dropped out of Massachusetts' duals demo over financial concerns. http://tinyurl.com/otczzbe

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