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CY 2025 Part D Formulary Submission Information
Relevant to: All Prescription Drug Plans, Medicare Advantage-Prescription Drug Plans, Section 1876 Cost Plans, Medicare-Medicaid Plans, and PACE Organizations
Read MoreRelease 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...
Read MoreRelease 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...
Read MoreRelease 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...
Read MoreMedicare Advantage/Prescription Drug System (MARx) April2024 Payment – INFORMATION
Relevant to: All Medicare Advantage Organizations, Prescription Drug Plans, Cost Plans, PACE Organizations, and Demonstrations
Read MoreEncounter Data Software Release Updates: March 2024 Release
Relevant to: All Medicare Advantage, Cost, PACE, and Demonstration Organizations Systems Staff
Read MoreSupport for Use of Encounter Data in Overpayment Reruns
Relevant to: All Medicare Advantage, Cost, PACE and Demonstration Organization Systems Staff
Read More2025 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
Read More2024 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...
Read MoreMedicare Advantage/Prescription Drug System (MARx) March 2024 Payment – INFORMATION
Relevant to: All Medicare Advantage Organizations, Prescription Drug Plans, Cost Plans, PACE Organizations, and Demonstrations
Read MorePromising Practices: Opioid Educational Sessions
Relevant to: All Medicare Advantage Organizations (MAOs) and Prescription Drug Plan Sponsors (PDPs)
Read MoreRelease of 2024 MIPS Payment Adjustment Data File
Relevant to: All Medicare Advantage, Cost, PACE Organizations, and Demonstration Organizations Systems Staff
Read MoreContract Year (CY) 2025 Final 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
Read MoreCompletion of the Reopening of the 2018 Final Part D Payment Reconciliation
Relevant to: Part D Plan Sponsors, PACE Organizations
Read More2024 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, and...
Read MorePACE Organization Risk Adjustment Submissions to the Encounter Data System
Relevant to: PACE Organizations
Read MorePACE Participation in the Manufacturer Discount Program beginning January 1, 2025
Relevant to: PACE Organizations
Read MoreRelease of the CY 2025 SMAC Submission Instructions and Updates to Medicare Managed Care Manual Chapter 16-B
Relevant to: Medicare Advantage Organizations with a Dual Eligible Special Needs Plan
Read MoreRegistration Open: March 2024 Medicare Part C Fraud, Waste, and Abuse(FWA) Webinar
Relevant to: All Medicare Advantage Organization (MAOs) and Medicare Advantage Prescription Drug Plans (MA-PDs)
Read MoreContract Year 2024 Part C and Part D Reporting Requirements and Technical Specifications
Relevant to: Part C, Part D
Read More2024 PACE Application Quarterly and Waiver Request Submission Dates
Relevant to: PACE Organizations
Read More2024 PACE Application Quarterly and Waiver Request Submission Dates
Relevant to: PACE Organizations
Read MoreContract Year (CY) 2025 Plan Benefit Package (PBP) Industry Testing
Relevant to: Current Prospective Medicare Advantage, Prescription Drug Plan, Section 1876 Cost, PACE, and Demonstration Organizations
Read MoreIntroduction of Prescription Oral Antivirals for COVID-19 to the CommercialMarket
Relevant to: All Prescription Drug Plans, Medicare Advantage-Prescription Drug Plans, Section 1876 Cost Plans, Medicare-Medicaid Plans, and PACE Organizations
Read MoreAnnouncement of Global Reopening of the Part D Payment Reconciliation for Calendar Year 2022
Relevant to: All Part D Plans, PACE Organizations
Read More2024 Health Equity Index Confidential Contract-level Reports
Relevant to: MAOs, PDPs, Cost
Read MoreCY 2024 Formulary Information
Relevant to: PDPs, MA-PDPs, Cost, MMPs, PACE
Read MoreContract Year 2024 Part C and Part D Baseline Out-of-Pocket Cost Models
Relevant to: Cost, MAOs, MMPs, PDPs
Read MoreRelease of Additional Information Regarding Total Pass-Through Amounts Data for Optional Use by Medicare Advantage Organizations
Relevant to: MAOs, MPDP
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