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July 2, 2015

Recent Stories of Interest

From Medicare Advantage News - In an unsurprising decision but one that raised new doubts about the viability of the huge CMS-backed demonstration program for Medicare-Medicaid dual eligibles, Fallon Total Care said in mid-June that it would exit the Massachusetts duals demo for financial reasons on Sept. 30. This would leave only two plans in a state that initially selected six insurers to participate in the nation’s first CMS-funded duals demo but in which three of those chosen dropped out before the program began in late 2013 (MAN 7/25/13, p. 1). Read more

A highly rated Medicare Advantage plan operator in Michigan has used an… Read more

The likelihood that Medicare Advantage plans’ risk-score documentation practices will have to… Read more

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