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October 23, 2014

Recent Stories of Interest

From Medicare Advantage News - The initial exultation many Medicare Advantage plans felt when CMS last month finally said it would consider evidence that Medicare-Medicaid dual-eligible status causes low star quality ratings (MAN 9/11/14, p. 1) has given way to a big question: How can they prove causality? And while numerous plans and their consultants and trade associations intend to respond to the CMS Request for Information (RFI) by the Nov. 3 deadline, several of them acknowledge to MAN that proving causality rather than correlation will be very challenging, if not impossible, within this time frame. Read more

So-called “high-touch” programs are a major key to success in managing care… Read more

The biggest news in the 2015 Medicare Advantage and stand-alone Prescription Drug… Read more

MVP Health Care said this month it is dropping for 2015 Medicare… 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.

October 23, 2014
Highmark's Oct. 2014 Suit Againt Pennsylvania Regarding New MA Product

To view Highmark Inc.'s October 2014 lawsuit against three Pennsylvania agencies regarding their effort to block its 2015 MA product that excludes UPMC providers, click here

October 23, 2014
Pennsylvania's Oct. 2014 Suit on New Highmark MA Plan

To view the state of Pennsylvania's lawsuit regarding Highmark Inc.'s 2015 MA product that excludes UPMC providers, click here

October 10, 2014
2015 Medicare Star Ratings Posted

2015 Medicare star ratings are now on Spreadsheets expected to be posted this morning on CMS site at

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