CMS Releases 2025 Plan Correction Module for Medicare Plans

Relevant to: PDP, Part D

Each week, we scan the latest CMS memos to find the most important ones that apply for PACE programs. Below is a summary of what you need to know.

Disclaimer: The content provided on this site is a summary for informational purposes only, and Grane PBM, Inc. assumes no liability for any errors or omissions in the site’s content. The information does not constitute legal or regulatory advice or replace the original CMS memo. Readers are advised to consult the CMS memo in its entirety and to verify information independently before making any decisions based on this information.

Click here to access the Contract Year 2025 Plan Correction Module.

Introduction

The Centers for Medicare & Medicaid Services has released the 2025 Plan Correction Module within the Health Plan Management System. This tool enables Medicare Advantage and Prescription Drug plans to submit corrections for the upcoming contract year, starting September 6, 2024, and ending on September 26, 2024. Approved contracts can utilize this module to ensure compliance and maintain up-to-date plan benefit packages.

Key Dates and Deadlines

  • Plan Correction Module Opens: September 6, 2024, at 12:00 a.m. EDT
  • Plan Correction Module Closes: September 26, 2024, at 11:59 p.m. EDT

PACE Compliance

The memo is relevant to PACE programs because it outlines new procedures that may impact their operations. Since PACE organizations can sometimes operate Medicare Advantage plans, it’s crucial for them to understand the details of the new Plan Correction Module.

PACE initiatives must pay attention to compliance actions mentioned in the memo. Non-compliant submissions will risk being suppressed in the Medicare Plan Finder until corrections are made. This implies that PACE plans must utilize the Bid Pricing Tool (BPT) to justify corrections during the plan correction period.

Here’s what PACE-related plans need to do:

  • Ensure that all corrections align with the Bid Pricing Tool (BPT).
  • Understand that only approved contracts appear in the Plan Correction module.
  • Be aware of the compliance actions and potential suppression from the Medicare Plan Finder for unresolved issues.
  • Regularly monitor the Bid Status History Report to stay informed on the status of their plans.

By staying informed and compliant with the outlined procedures, PACE organizations can ensure that they remain visible and competitive in Medicare Plan Finder listings.

Required Actions

The Centers for Medicare & Medicaid Services (CMS) has released information regarding the Contract Year 2025 Plan Correction Module, and there are several steps required for Medicare Advantage Organizations, Prescription Drug Plans, and Section 1876 Cost Plans to follow.

1. Access the Health Plan Management System (HPMS) to utilize the Plan Correction module for submitting corrections to CY 2025 Medicare Advantage and Prescription Drug plans. Ensure that your contract is approved by CMS and appears in the Plan Correction module.

2. Review the status of your contract using the Bid Status History Report found at HPMS Homepage > Plan Bids > Bid Reports > CY 2025 > Bid Status History Report. This will help you verify eligibility for plan corrections.

3. Submit corrections during the plan correction period from September 6, 2024, to September 26, 2024. Ensure that all requested changes to the PBP are supported by the Bid Pricing Tool (BPT). Access this feature via HPMS Homepage > Plan Bids > Plan Corrections > Contract Year 2025. Remember that non-compliance may result in suppression in the Medicare Plan Finder.

FAQs

  • “What is the Plan Correction Module in the HPMS?”
  • “What is the timeline for submitting plan corrections for CY 2025?”
  • “Where can I find the Bid Status History Report?”
  • “Are there any compliance actions related to submission of plan corrections?”
  • “Who can I contact for questions about the plan correction process?”

Click here to access the Contract Year 2025 Plan Correction Module.

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