HPMS Updates & CMS Guidance
Submitting Other TrOOP Amount Information for 2023 Part D Payment Reconciliation of the Inflation Reduction Act Subsidy Amount (IRASA)
Relevant to: All Part D Sponsors
Prescription Drug Event Record Reporting Instructions for the Implementation of the Inflation Reduction Act for Contract Year 2025
Relevant to: All Part D Sponsors
Release of the Non-Renewal/Service Area Reduction Module in the Health Plan Management System
Relevant to: All Current Medicare Advantage Organizations, Prescription Drug Plan Sponsors,
Section 1833 and 1876 Cost Plans, PACE and Medicare-Medicaid Plans
Release of the Contract Year 2025 Service Area Verification Functionality
Relevant to: All Current and Prospective Medicare Advantage, Prescription Drug Plan, Section 1833
and 1876 Cost Plans, PACE, and Medicare-Medicaid Plan Organizations
Closing the Drug Data Processing System (DDPS) for Benefit Year 2017
Relevant to: All Medicare Advantage Organizations, Prescription Drug Plans, Cost Plans,
PACE Organizations, and Demonstrations
Information to Review Data Used for Medicare Part C and D Star Ratings and Display Measures
Relevant to: All Medicare Advantage Organizations, Prescription Drug Plans, and Section
1876 Cost Plans
Reinstatement of Low Income Subsidy (LIS) Periods Until April 2024 –INFORMATION
Relevant to: All Part D Plans
Registration Reminder: June 2024 Medicare Advantage Organizations (MAOs)and Prescription Drug Plans (PDPs) Fraud, Waste, and Abuse (FWA) Training
Relevant to: All Medicare Advantage Organizations (MAOs), Medicare Advantage Prescription Drug (MA-PD), and Prescription Drug Plan (PDPs)
Release of the Contract Year (CY) 2025 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
Dual Eligible Special Needs Plan “Look-Alike” Transitions for Contract Year 2025
Relevant to: Current Medicare Advantage Organizations with a Contract Year 2024 Dual
Eligible Special Needs Plan “Look-Alikes”
Medicare Part D Manufacturer Discount Program: 2025 Participant List; Identification of Specified Manufacturers and Specified Small Manufacturers
Relevant to: Pharmaceutical Manufacturers; All Part D Plan Sponsors
Medicare Advantage/Prescription Drug System (MARx) April2024 Payment – INFORMATION
Relevant to: All Medicare Advantage Organizations, Prescription Drug Plans, Cost Plans, PACE Organizations, and Demonstrations
Encounter Data Software Release Updates: March 2024 Release
Relevant to: All Medicare Advantage, Cost, PACE, and Demonstration Organizations Systems
Staff
Part D Sponsors’ Access to the Medicare Plan Finder (MPF) Communications Web Portal
Relevant to: All Prescription Drug Plans, Medicare Advantage-Prescription Drug Plans, and
Section 1876 Cost Plans
Support for Use of Encounter Data in Overpayment Reruns
Relevant to: All Medicare Advantage, Cost, PACE and Demonstration Organization Systems
Staff
Final Medicare Part D DIR Reporting Guidance for 2023
Relevant to: All Part D Plan Sponsors
2025 Prescription Drug Event (PDE) File Layout Updates for all Part D Plan Sponsors, and Additional 2025 Changes to PDE Reporting for PACE Organizations
Relevant to: All Part D Plan Sponsors, including Programs of All-inclusive Care for the Elderly
(PACE) Organizations
Addressing Impacts Related to the Cyberattack on Change Healthcare
Relevant to: All Medicare Advantage Organizations, Part D Sponsors, and Medicare-Medicaid Plans
Retail Pharmacy Network Access and Preferred Cost-Sharing Pharmacy Access Analysis Results for Q1 CY 2024
Relevant to: Medicare Prescription Drug Plans
NOTICE: Monthly Manufacturer Call Status, Current Open Comment Opportunities
Relevant to: All Drug Manufacturers and Other Interested Parties
Medicare Prescription Payment Plan: Final Part One Guidance on Select Topics, Implementation of Section 1860D-2 of the Social Security Act for 2025, and Response to Relevant Comments
Relevant to: Interested Parties
2024 Risk Score Reruns for Purposes of Payment Recovery
Relevant to: All Medicare Advantage Organizations, PACE Organizations, MedicareMedicaid Plans, Section 1833 Cost Contractors and Section 1876 Cost
Contractors, and Demonstrations
Completion of the Coverage Gap Discount Reconciliation for Benefit Year 2022
Relevant to: All Part D Sponsors
Medicare Advantage/Prescription Drug System (MARx) March 2024 Payment – INFORMATION
Relevant to: All Medicare Advantage Organizations, Prescription Drug Plans,
Cost Plans, PACE Organizations, and Demonstrations
Promising Practices: Opioid Educational Sessions
Relevant to: All Medicare Advantage Organizations (MAOs) and Prescription Drug Plan
Sponsors (PDPs)
Contract Year 2025 MA and Part D Bid Pricing Tool Beta Testing
Relevant to: Medicare Advantage & Prescription Drug Plan Sponsors and Certifying Actuaries
2023 Call Center Monitoring Performance Metrics for Timeliness Study, Quarter 4
Relevant to: All Medicare Advantage, Prescription Drug Plan, and Demonstration Organizations
Frequently Asked Questions related to Coverage Criteria and Utilization Management Requirements in CMS Final Rule (CMS-4201-F)
Relevant to: All Medicare Advantage Organizations and Medicare-Medicaid Plans
Contract Year (CY) 2024 Plan Benefit Package (PBP) Data Refresh in the PBP Sandbox
Relevant to: PBP
Release of 2024 MIPS Payment Adjustment Data File
Relevant to: All Medicare Advantage, Cost, PACE Organizations, and Demonstration Organizations Systems Staff