April 2023 Memos

Dual Eligible Special Needs Plan “Look-Alike” Transitions for Contract Year 2024

April 2023 Memos / By

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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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

April 2023 Memos / By

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 …

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 Read More »

Incoming File From CMS: Beneficiary-level File to Support 2024 Part D Bids

April 2023 Memos / By

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 …

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UPDATES – 2023 Medicare Part D Patient Safety Reports

April 2023 Memos / By

Relevant to: All Prescription Drug Plans, Medicare Advantage-Prescription Drug Plans, Section 1876 Cost Plans, Medicare-Medicaid Plans, and PACE Organizations This memorandum provides updated information to Part D sponsors regarding contract year (CY) 2023 Drug Management Programs (DMPs). See the full guidance for more information.

UPDATES – 2023 Medicare Part D Patient Safety Reports

April 2023 Memos / By

Relevant to: All Prescription Drug Plans, Medicare Advantage-Prescription Drug Plans, Section 1876 Cost Plans, and PACE plans The purpose of this memorandum is to announce the availability of the 2023 Patient Safety Reports on the Patient Safety Analysis Web Portal on April 28, 2023, updates to measure calculations, changes to measure specifications, new measures, and …

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2023 Call Center Monitoring Performance Metrics for Timeliness Study, Quarter 1

April 2023 Memos / By

Relevant to: All Medicare Advantage, Prescription Drug Plan, and Demonstration Organizations CMS monitored the timeliness of Part C and Part D current enrollee beneficiary customer service call centers’ response performance Monday through Friday, 8 a.m. to 8 p.m., in the service area for the plans from January 2 – January 27, 2023. CMS also monitored …

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