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April 9, 2015

Recent Stories of Interest

From Medicare Advantage News - A rising medical cost trend will wind up helping Medicare Advantage plans’ payment rates for 2016, as CMS in its final 2016 payment notice issued April 6 turned what it had calculated as a 0.95% net pay cut in the advance notice Feb. 20 into a 1.25% increase. But consultants queried by MAN say this good news for plans also probably accounted for CMS’s decision to keep its proposal to fully phase in the agency’s new risk-adjustment system, which figures without the other offsets to cut MA plans’ pay an average of 1.7%, since it felt the insurers benefited enough from the cost-trend revision to be able to absorb that hit. Read more

In an unusual alliance, hashed out over an 18-month period and marrying… Read more

As Congress neared a vote this week on a bill that finally… Read more

Facing the likelihood that both unexpected and inherent difficulties in integrating care… 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.

April 15, 2015
SGR Repeal Easily Clears Senate

The doc-fix bill repealing the sustainable growth rate passed the Senate April 14 with little problem. http://tinyurl.com/najjz4h

April 9, 2015
AHIP Report on Medicaid Pharmacy Carve-ins Saving More Than Carve-outs

To view the April 1 report by The Menges Group for the America's Health Insurance Plans trade group on Medicaid managed care pharmacy carve-ins saving more than carve-outs, click here

April 9, 2015
CMS's Final 2016 MA Payment Notice and Call Letter

To view CMS's final Medicare Advantage payment notice and MA and Part D Call Letter, released Apr. 6, 2015, click here

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