Contract Year (CY) 2024 Part D Pricing Data Submission Guidance
Relevant to: All Part D Plans
GPBM Memos
Definition of Marketing
Relevant to: Medicare Advantage Organizations, Medicare Advantage-Prescription Drug Plans, Prescription Drug Plan Sponsors, and Section 1876 Cost Plans In order to ensure Medicare beneficiaries are making enrollment decisions based on up-to-date and accurate information, the Centers for Medicare & Medicaid Services (CMS) is issuing this memo to clarify the definition of marketing for Medicare Advantage-Prescription …
Final Medicare Part D DIR Reporting Guidance for 2022
Relevant to: All Medicare Advantage Organizations
Release of the Contract Year (CY) 2024 Bid Submission Functionality in HPMS
Relevant to: All Medicare Advantage Organizations
Instructions for Requesting Drug Manufacturer Access in the Health Plan Management System (HPMS)
Relevant to: All Medicare Advantage Organizations
Deadline for Submitting Risk Adjustment Data for Use in Risk Score Calculation Runs for Payment Years 2022, 2023, 2024 and 2025
Relevant to: All Medicare Advantage Organizations
Dual Eligible Special Needs Plan “Look-Alike” Transitions for Contract Year 2024
Relevant to: Current Medicare Advantage Organizations with a Contract Year 2023 Dual Eligible Special Needs Plan (D-SNP) “Look-Alike” Plan This memorandum provides Medicare Advantage (MA) organizations and section 1876 cost plan sponsors serving individuals dually eligible for Medicare and Medicaid with additional guidance on the obligation to refund any payments of excess cost sharing. See …
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NOTICE: April Drug Manufacturer Call on Implementation of IRA Medicare Provisions
Relevant to: All Organization Types and Stakeholders This memorandum provides Medicare Advantage (MA) organizations and section 1876 cost plan sponsors serving individuals dually eligible for Medicare and Medicaid with additional guidance on the obligation to refund any payments of excess cost sharing. See the full guidance for more information.
Release of the Contract Year (CY) 2024 Plan Benefit Package and Bid Pricing Tool Software and Related Technical Bidding Guidance for Employer/Union-Only Group Waiver Plans
Relevant to: All Current and Prospective Medicare Advantage (MA), Prescription Drug Plan (PDP), Section 1876 Cost, PACE, and Medicare-Medicaid Plan (MMP) Organizations and Bid and Actuarial Certification Consultants CMS has pushed out to all Medicare Advantage-Prescription Drug Plans (MA-PDs), 1876 Cost Plans, PACE organizations, and standalone prescription drug plans (PDPs) a beneficiary-level file that your …
Incoming File From CMS: Beneficiary-level File to Support 2024 Part D Bids
Relevant to: All MA-PD plans, 1876 Cost Plans, PACE organizations, and PDPs CMS has pushed out to all Medicare Advantage-Prescription Drug Plans (MA-PDs), 1876 Cost Plans, PACE organizations, and standalone prescription drug plans (PDPs) a beneficiary-level file that your actuaries will be using to develop 2024 Part D bids. See the full guidance for more …
Incoming File From CMS: Beneficiary-level File to Support 2024 Part D Bids Read More »