Never miss a memo!
Contract Year (CY) 2024 Part D Pricing Data Submission Guidance
Relevant to: All Part D Plans
Read MoreDefinition of Marketing
Relevant to: Medicare Advantage Organizations, Medicare Advantage-Prescription Drug Plans, Prescription Drug Plan Sponsors, and Section 1876 Cost Plans In order...
Read MoreFinal Medicare Part D DIR Reporting Guidance for 2022
Relevant to: All Medicare Advantage Organizations
Read MoreRelease of the Contract Year (CY) 2024 Bid Submission Functionality in HPMS
Relevant to: All Medicare Advantage Organizations
Read MoreNOTICE: 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...
Read MoreRelease 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...
Read MoreIncoming 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...
Read MoreIncoming 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)...
Read MoreUPDATES – 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...
Read MoreUPDATES – 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...
Read MoreRelease of the Non-Renewal/Service Area Reduction Module in the Health Plan Management System
Relevant to: All Medicare Advantage Organizations
Read MoreNew 2025 Prescription Drug Event (PDE) File Layouts (FINAL)
Relevant to: All Medicare Advantage Organizations
Read MoreSupplemental Benefit Coverage of Over-the-Counter Naloxone
Relevant to: All Medicare Advantage Organizations
Read MorePreparing 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
Read MorePart D Sponsors’ Access to the Medicare Plan Finder
Relevant to: All Prescription Drug Plans, Medicare Advantage-Prescription Drug Plans, and Section 1876 Cost Plans
Read MoreLong-Term Institutionalized Resident Report
Relevant to: All Medicare Advantage Organizations
Read MoreInstructions 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
Read MoreCompletion of National Audit: Analysis of Prescription Drug Event Records for Nuedexta for Beneficiaries without a Medically Accepted Indication
Relevant to: All Medicare Advantage Organizations (MAOs) and Prescription Drug Plan Sponsors (PDPs) The Centers for Medicare & Medicaid Services...
Read More2023 Data Validation of Medicare Part C and Part D Reporting Requirements Data
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),...
Read MoreAnnual Coordination of Benefits-Other Health Insurance (COB-OHI) Full Replacement File for 2023
Relevant to: All Prescription Drug Plans, Medicare Advantage-Prescription Drug Plans, Section 1876 Cost Plans, Medicare-Medicaid Plans, and PACE Organizations. The...
Read MoreCalendar Year 2024 Preliminary Hospice Capitation Payment Rate Actuarial Methodology for the Hospice Benefit Component of the Medicare Advantage Value-Based Insurance Design Model
Relevant to: Medicare Advantage Organizations Beginning in calendar year (CY) 2021, within the Value-Based Insurance Design (VBID) Model’s Hospice Benefit...
Read MoreCompletion of the Coverage Gap Discount Reconciliation for Benefit Year 2021
Relevant to: All Part D Sponsors The Centers for Medicare & Medicaid Services (CMS) completed the calculations for the 2021...
Read MoreRelease of 2023 MIPS Payment Adjustment Data File
Relevant to: All Medicare Advantage Organizations, Prescription Drug Plans, Cost Plans, PACE This memorandum provides Medicare Advantage (MA) organizations and...
Read More2023 Medicare Part D Low-Income Subsidy (LIS) Income and Resource Standards
Relevant to: All Prescription Drug Plan Sponsors, Medicare Advantage Organizations, Cost Plans, Programs for All-Inclusive Care for the Elderly This...
Read MoreCompletion of the Reopening of the 2017 Final Part D Payment Reconciliation
Relevant to: All Organizations This memorandum provides Medicare Advantage (MA) organizations and section 1876 cost plan sponsors serving individuals dually...
Read MorePublic Health Emergency Resource Update
Relevant to: All Organizations This memorandum provides Medicare Advantage (MA) organizations and section 1876 cost plan sponsors serving individuals dually...
Read MoreDraft Contract Year (CY) 2024 Part D Bidding Instructions
Relevant to: All Prescription Drug Plans, Medicare Advantage-Prescription Drug Plans, Section 1876 Cost Plans, Medicare-Medicaid Plans, and PACE plans The...
Read MoreMedical Loss Ratio Data Form and Attestation Submission Reminder for Contract Year 2021
Relevant to: Medicare Advantage Organizations, Cost Plans, and Prescription Drug Plan Sponsors Each Medicare Advantage (MA) Organization, Cost Plan, and Part...
Read More