HPMS Updates & CMS Guidance
Contract Year (CY) 2024 Part D Pricing Data Submission Guidance
Relevant to: All Part D Plans
Definition of Marketing
Relevant to: Medicare Advantage Organizations, Medicare Advantage-Prescription Drug Plans, Prescription Drug Plan Sponsors, and Section 1876 Cost Plans In order to ensure Medicare beneficiaries are
Final Medicare Part D DIR Reporting Guidance for 2022
Relevant to: All Medicare Advantage Organizations
Release of the Contract Year (CY) 2024 Bid Submission Functionality in HPMS
Relevant to: All Medicare Advantage Organizations
Instructions for Requesting Drug Manufacturer Access in the Health Plan Management System (HPMS)
Relevant to: All Medicare Advantage Organizations
Deadline for Submitting Risk Adjustment Data for Use in Risk Score Calculation Runs for Payment Years 2022, 2023, 2024 and 2025
Relevant to: All Medicare Advantage Organizations
Dual Eligible Special Needs Plan “Look-Alike” Transitions for Contract Year 2024
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)
NOTICE: April Drug Manufacturer Call on Implementation of IRA Medicare Provisions
Relevant to: All Organization Types and Stakeholders This memorandum provides Medicare Advantage (MA) organizations and section 1876 cost plan sponsors serving individuals dually eligible for
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
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
Incoming File From CMS: Beneficiary-level File to Support 2024 Part D Bids
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
Incoming Files from CMS: Beneficiary-level File to Support 2024 Part C Bids & ESRD Risk Scores
Relevant to: All Medicare Advantage Organizations and Section 1876 Cost Plans CMS has pushed out to all Medicare Advantage (MA) organizations and 1876 Cost Plans
UPDATES – 2023 Medicare Part D Patient Safety Reports
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
UPDATES – 2023 Medicare Part D Patient Safety Reports
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
2023 Call Center Monitoring Performance Metrics for Timeliness Study, Quarter 1
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
Contract Year 2024 Medication Therapy Management Program Information and Submission Instructions
Relevant to: Medicare-Medicaid Plans
Medicare-Medicaid Plan Submission of Plan Benefit Packages for Contract Year 2024
Relevant to: Medicare-Medicaid Plans
April 2023 Drug Manufacturer Module Enhancements
Relevant to: All Medicare Advantage Organizations
Release of the Non-Renewal/Service Area Reduction Module in the Health Plan Management System
Relevant to: All Medicare Advantage Organizations
New 2025 Prescription Drug Event (PDE) File Layouts (FINAL)
Relevant to: All Medicare Advantage Organizations
Supplemental Benefit Coverage of Over-the-Counter Naloxone
Relevant to: All Medicare Advantage Organizations
Updated Notice Part D Notice of Denial of Medicare Prescription Drug Coverage (CMS-10146)
Relevant to: All Medicare Advantage Organizations
Extension of the MA VBID
Relevant to: All Medicare Advantage Organizations
Preparing for the CY 24 Bid Submission Process in HPMS
Relevant to: All Current and Prospective Medicare Advantage, Prescription Drug Plan, Section 1876 Cost, PACE, and Demonstration Organizations
Part D Sponsors’ Access to the Medicare Plan Finder
Relevant to: All Prescription Drug Plans, Medicare Advantage-Prescription Drug Plans, and Section 1876 Cost Plans
Retail Pharmacy Network Access and Preferred Cost-Sharing Pharmacy Access Analysis Results for Q1 CY 2023
Relevant to: All Medicare Advantage Organizations
Update to Integrated Denial Notice for Medicare-Medicaid Plans
Relevant to: All Medicare Advantage Organizations
Long-Term Institutionalized Resident Report
Relevant to: All Medicare Advantage Organizations
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
Updated Notice of Denial of Medical Coverage (or Payment) Form CMS-10003
Relevant to: All Medicare Advantage Organizations
COB-OHI Record Updates
Relevant to: All Medicare Advantage Organizations