HPMS Updates & CMS Guidance
Encounter Data Software Release Updates: November 2023 Release
Relevant to: MA, PACE, Cost
Application of Pharmacy Price Concessions to the Negotiated Price at the Point of Sale Beginning January 1, 2024
Relevant to: All Part D Sponsors
Health Plan Management System (HPMS) Program Integrity (PI) Portal for Fraud, Waste, and Abuse (FWA) Reporting Module Enhancements
Relevant to: MA, PDPs, PACE
Contract Year 2024 Monitoring of Posted Comprehensive Formularies
Relevant to: MAOs, PDPs, Cost
Attestation of Prescription Drug Event (PDE) Data and Direct and Indirect Remuneration (DIR) Data related to the 2018 Reopening
Relevant to: All Part D Plan Sponsors, PACE
Contract Year (CY) 2024 Online Enrollment Center (OEC) Special Enrollment Period (SEP) Code Updates
Relevant to: Cost, MA, PDPs, RFB, SNP
New 2025 Prescription Drug Event (PDE) FINAL File Layouts – FIELD UPDATES
Relevant to: All Part D Plan Sponsors
New 2025 Prescription Drug Event (PDE) FINAL File Layouts – FIELD UPDATES
Relevant to: All Part D Plan Sponsors
Calendar Year (CY) 2024 Resource and Cost-Sharing Limits for Low-Income Subsidy (LIS)
Relevant to: All Part D Plan Sponsors
2024 Medicare CAHPS® Survey
Relevant to: MA, Cost, PDPs, MMPs
Updated Medicare-Medicaid Capitated Financial Alignment Model Core Quality Withhold Technical Notes for Demonstration Years 2 through 12
Relevant to: MMP
Release of Notice of Intent to Apply for Contract Year 2025 Medicare Advantage (MA), Prescription Drug Benefit (Part D) and Related CY 2025 Application Deadlines
Relevant to: PDPs, MAOs
Contract Year (CY) 2024 Readiness Checklist for Medicare Advantage Organizations, Prescription Drug Plan Sponsors, 1876 Cost Plans, and Medicare-Medicaid Plans
Relevant to: MMP
2024 Reassignment of Low-Income Subsidy Beneficiaries in Prescription Drug Plans
Relevant to: PDPs
2024 Reassignment of Low-Income Subsidy Beneficiaries in Non-Renewing Medicare Advantage Plans and Medicare Advantage Plans Reducing their Service Areas
Relevant to: MAOs
2023 Medicare Advantage Organization and Prescription Drug Plan Fraud, Waste, and Abuse Training Postponed Until 2024
Relevant to: MAOs, PDPs
Corrections to the Year of Service (YOS) 2021 Polypharmacy: Use of Multiple Central-Nervous System – Active Medications in Older
Relevant to: PDPs, PACE, Cost, MA-PD
Medicare Advantage/Prescription Drug System (MARx) October 2023 Payment – INFORMATION
Relevant to: PDPs, MAOs, PACE, Cost
Non-Renewal and Service Area Reduction Guidance and EnrolleeNotification Models
Relevant to: MAOs, PDPs, Cost, MMPs
Corrected Contract Year 2024 Translated Model Materials Requirements and Language Data Analysis
Relevant to: MA, PDPs
Results of the 2023 Part C and D Reporting Requirements Data Validation
Relevant to: MMPs, PDPs, MAOs
Retail Pharmacy Network Access and Preferred Cost-Sharing Pharmacy Access Analysis Results for Q3 CY 2023
Relevant to: MPDP
Contract Year 2024 Annual Notice of Change and Evidence of Coverage Submission Requirements and Yearly Assessment
Relevant to: MAOs, MMPs, PDPs, MA-PDOs, Cost
September 2023 Updates to the Drug Data Processing System (DDPS)
Relevant to: All Part D Plan Sponsors
Long-Term Institutionalized Resident Report
Relevant to: PDPs, MA-PDPs, Cost, MMPs, PACE
Medicare-Medicaid Plan Past Performance Reviews
Relevant to: MMPs
Alert: MedCare Clinic & Pharmacy, LLC
Relevant to: MAOs, PDPs
Second Plan Preview of 2024 Part C and D Star Ratings Data
Relevant to: Cost, MAOs, PDPs