CY 2023 Formulary Information
Relevant to: All Prescription Drug Plans, Medicare Advantage-Prescription Drug Plans, Section 1876 Cost Plans, Medicare-Medicaid Plans, and PACE Organizations
GPBM Memos
Hospital Outpatient Prospective Payment System Update on Payment Rates for Drugs Acquired through the 340B Program – INFORMATIONAL for MAOs
Relevant to: All Medicare Advantage Organizations, Prescription Drug Plans, Cost Plans, PACE Organizations, and Demonstrations
VBID Prescription Drug Event (PDE) Reporting Guidance for Contract Year (CY) 2023
Relevant to: Current/Prospective Medicare Advantage Organization (MAO) Participants of the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model
Updates and Timeline for the Contract Year (CY) 2024 Plan Benefit Package
Relevant to: All Current and Prospective Medicare Advantage Organizations, Prescription Drug Plan Sponsors, Section 1876 Cost Plans, PACE Organizations, Medicare- Medicaid Plans, and Bid Consultants
Medicare Advantage/Prescription Drug System (MARx) November 2022 Payment – INFORMATION
Relevant to: All Medicare Advantage Organizations, Prescription Drug Plans, Cost Plans, PACE Organizations, and Demonstrations
2023 Medicare CAHPS® Survey
Relevant to: Medicare Advantage, 1876 Cost Contracts, Medicare-Medicaid Plans, and Prescription Drug Plan Quality Contacts and Medicare Compliance Officers
Part C&D User Group Calls – Inflation Reduction Act of 2022 (IRA) Implementation
Relevant to: All Medicare Advantage Organizations and Part D Sponsors
Health Plan Management System (HPMS) Program Integrity (PI) Portal for Fraud, Waste, and Abuse (FWA) Reporting Module Training
Relevant to: All Current and Prospective Medicare Advantage, Prescription Drug Plan, PACE, and Demonstration Organizations
Contract Year 2023 Monitoring of Posted Comprehensive Formularies
Relevant to: Medicare Advantage Organizations, Prescription Drug Plans, and Section 1876 Cost Plans
Termination of Pre-2019 Beneficiary-Specific Part D Opioid Point of Sale Claim Edits
Relevant to: All Part D Plan Sponsors