Instructions on Submitting Default Enrollment Renewal Applications in the Health Plan Management System (HPMS) for Plans with 5-year Approval End Dates Approaching
Relevant to: All Medicare Advantage Organizations
Relevant to: All Medicare Advantage Organizations
Relevant to: All Medicare Advantage Organizations
Relevant to: All Medicare Advantage Organizations (MAOs) and Prescription Drug Plan Sponsors (PDPs) The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Plan Program Integrity Medicare Drug Integrity Contractor (PPI MEDIC), conducted a National Audit of Medicare Part D Payments for Nuedexta prescribed without a documented medically accepted indication (MAI) under the …
Relevant to: All Medicare Advantage, Cost, PACE, and Demonstration Organizations Systems Staff Submission Performance Reports (SPRs) have been sent to Medicare Advantage Organizations (MAOs) since 2019 to help plans review instances where their encounter data submission patterns appear particularly low and for which technical assistance and feedback from CMS may be appropriate. See the full …
Relevant to: All Medicare Advantage Organizations, Part D Sponsors, and Medicare-Medicaid Plans As provided under 42 C.F.R. §422.516(g) and §423.514(j), Part C and Part D sponsors must participate in annual retrospective data validation (DV) of the Part C and D reporting requirements data. See the full guidance for more information.
Relevant to: All Drug Manufacturers The purpose of this memorandum is to notify drug manufacturers that the Centers for Medicare & Medicaid Services (CMS), Center for Medicare hosts monthly calls on implementation of the Medicare provisions of the Inflation Reduction Act of 2022 (Public Law 117-169). See the full guidance for more information.
Relevant to: All Prescription Drug Plans, Medicare Advantage-Prescription Drug Plans, Section 1876 Cost Plans, Medicare-Medicaid Plans, and PACE Organizations. The purpose of this memorandum is to notify Part D sponsor staff responsible for the receipt and processing of coordination of benefits files from the Centers for Medicare & Medicaid Services (CMS) of the upcoming annual …
Relevant to: Medicare Advantage Organizations Beginning in calendar year (CY) 2021, within the Value-Based Insurance Design (VBID) Model’s Hospice Benefit Component, the Centers for Medicare & Medicaid Services (CMS) is testing the impact on quality and program expenditures of incorporating the Medicare Part A hospice benefit into the Medicare Advantage (MA) program with the goal …