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Medicare Advantage/Prescription Drug System (MARx) July 2024 Payment – INFORMATION

July 5, 2024

Relevant to: MAOs, PDPs, Cost Plans, PACE Organizations, Demonstrations

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Contract Year 2025 Agent and Broker Compensation Rates, Referral/Finder’s Fees, and Training and Testing Requirements

June 28, 2024

Relevant to: MAOs, PDP Sponsors, Section 1876 Cost Plans, MMPs

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Rerun of Payment Year (PY) 2017

June 28, 2024

Relevant to: MAOs, PACE Organizations, MMPs, Cost Contractors, Demonstrations

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Alert: Santyl

June 26, 2024

Relevant to: MAOs, PDPs

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Request for Review – Draft Medicare Advantage and Part D Enrollment and Disenrollment Guidance

June 26, 2024

Relevant to: MAOs, PDPs, Cost Plans, MMPs, PACE Organizations

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Contract Year (CY) 2024 Monitoring Parts C & D Reporting Web Portal Access

June 24, 2024

Relevant to: MAOs, PDPs, MMPs

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CY 2025 Plan Connectivity Data Submission and Verification

June 10, 2024

Relevant to: All Current and Prospective Medicare Advantage (MA), Prescription Drug Plan (PDP), Cost, Programs for All-Inclusive Care for the...

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Public Posting of Medicare Part D Retail Pharmacy Network Access Results Q2 2024

June 3, 2024

Relevant to: Medicare Part D Plan Sponsors, Excluding PACE and Employer-Only Plans

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Medicare Part C and Part D Past Performance Results for Lookback Period March 1, 2023 through February 29, 2024

June 3, 2024

Relevant to:  All Medicare Advantage Organizations, Prescription Drug Plan Sponsors, Cost Plans, Employer-Direct and Employer-Only Contracts, and Medicare-Medicaid Plans 

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Release of the Contract Year (CY) 2025 Bid Submission Functionality in HPMS

May 3, 2024

Relevant to: All Current and Prospective Medicare Advantage, Prescription Drug Plan, Section 1876 Cost, PACE, and Medicare-Medicaid Plan Organizations, Bid...

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CY 2025 Part D Formulary Submission Information

April 16, 2024

Relevant to: All Prescription Drug Plans, Medicare Advantage-Prescription Drug Plans, Section 1876 Cost Plans, Medicare-Medicaid Plans, and PACE Organizations

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Release of the Non-Renewal/Service Area Reduction Module in the Health Plan Management System

April 15, 2024

Relevant to: All Current Medicare Advantage Organizations, Prescription Drug Plan Sponsors, Section 1833 and 1876 Cost Plans, PACE and Medicare-Medicaid...

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Release of the Contract Year 2025 Service Area Verification Functionality

April 12, 2024

Relevant to: All Current and Prospective Medicare Advantage, Prescription Drug Plan, Section 1833 and 1876 Cost Plans, PACE, and Medicare-Medicaid...

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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

April 5, 2024

Relevant to: All Current and Prospective Medicare Advantage (MA), Prescription Drug Plan (PDP), Section 1876 Cost, PACE, and Medicare-Medicaid Plan...

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Medicare Advantage/Prescription Drug System (MARx) April2024 Payment – INFORMATION

March 28, 2024

Relevant to: All Medicare Advantage Organizations, Prescription Drug Plans, Cost Plans, PACE Organizations, and Demonstrations

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Encounter Data Software Release Updates: March 2024 Release

March 20, 2024

Relevant to: All Medicare Advantage, Cost, PACE, and Demonstration Organizations Systems Staff

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Support for Use of Encounter Data in Overpayment Reruns

March 15, 2024

Relevant to: All Medicare Advantage, Cost, PACE and Demonstration Organization Systems Staff

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2025 Prescription Drug Event (PDE) File Layout Updates for all Part D Plan Sponsors, and Additional 2025 Changes to PDE Reporting for PACE Organizations

March 8, 2024

Relevant to: All Part D Plan Sponsors, including Programs of All-inclusive Care for the Elderly (PACE) Organizations

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2024 Risk Score Reruns for Purposes of Payment Recovery

February 29, 2024

Relevant to: All Medicare Advantage Organizations, PACE Organizations, MedicareMedicaid Plans, Section 1833 Cost Contractors and Section 1876 Cost Contractors, and...

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Medicare Advantage/Prescription Drug System (MARx) March 2024 Payment – INFORMATION

February 28, 2024

Relevant to: All Medicare Advantage Organizations, Prescription Drug Plans, Cost Plans, PACE Organizations, and Demonstrations

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Promising Practices: Opioid Educational Sessions

February 9, 2024

Relevant to: All Medicare Advantage Organizations (MAOs) and Prescription Drug Plan Sponsors (PDPs)

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Release of 2024 MIPS Payment Adjustment Data File

February 2, 2024

Relevant to: All Medicare Advantage, Cost, PACE Organizations, and Demonstration Organizations Systems Staff

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Contract Year (CY) 2025 Final Part D Bidding Instructions

February 1, 2024

Relevant to: All Prescription Drug Plans, Medicare Advantage-Prescription Drug Plans, Section 1876 Cost Plans, Medicare-Medicaid Plans, and PACE Plans

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Completion of the Reopening of the 2018 Final Part D Payment Reconciliation

January 29, 2024

Relevant to: Part D Plan Sponsors, PACE Organizations

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2024 Medicare Part D Low-Income Subsidy (LIS) Income and Resource Standards

January 29, 2024

Relevant to: All Prescription Drug Plan Sponsors, Medicare Advantage Organizations, Cost Plans, Programs for All-Inclusive Care for the Elderly, and...

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PACE Organization Risk Adjustment Submissions to the Encounter Data System

January 29, 2024

Relevant to: PACE Organizations

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PACE Participation in the Manufacturer Discount Program beginning January 1, 2025

January 26, 2024

Relevant to: PACE Organizations

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Release of the CY 2025 SMAC Submission Instructions and Updates to Medicare Managed Care Manual Chapter 16-B

January 25, 2024

Relevant to: Medicare Advantage Organizations with a Dual Eligible Special Needs Plan

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Registration Open: March 2024 Medicare Part C Fraud, Waste, and Abuse(FWA) Webinar

January 22, 2024

Relevant to: All Medicare Advantage Organization (MAOs) and Medicare Advantage Prescription Drug Plans (MA-PDs)

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Contract Year 2024 Part C and Part D Reporting Requirements and Technical Specifications

January 11, 2024

Relevant to: Part C, Part D

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