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Medicare Advantage/Prescription Drug System (MARx) July 2024 Payment – INFORMATION
Relevant to: MAOs, PDPs, Cost Plans, PACE Organizations, Demonstrations
Read MoreContract Year 2025 Agent and Broker Compensation Rates, Referral/Finder’s Fees, and Training and Testing Requirements
Relevant to: MAOs, PDP Sponsors, Section 1876 Cost Plans, MMPs
Read MoreRerun of Payment Year (PY) 2017
Relevant to: MAOs, PACE Organizations, MMPs, Cost Contractors, Demonstrations
Read MoreRequest for Review – Draft Medicare Advantage and Part D Enrollment and Disenrollment Guidance
Relevant to: MAOs, PDPs, Cost Plans, MMPs, PACE Organizations
Read MoreContract Year (CY) 2024 Monitoring Parts C & D Reporting Web Portal Access
Relevant to: MAOs, PDPs, MMPs
Read MoreCY 2025 Plan Connectivity Data Submission and Verification
Relevant to: All Current and Prospective Medicare Advantage (MA), Prescription Drug Plan (PDP), Cost, Programs for All-Inclusive Care for the...
Read MorePublic Posting of Medicare Part D Retail Pharmacy Network Access Results Q2 2024
Relevant to: Medicare Part D Plan Sponsors, Excluding PACE and Employer-Only Plans
Read MoreMedicare Part C and Part D Past Performance Results for Lookback Period March 1, 2023 through February 29, 2024
Relevant to: All Medicare Advantage Organizations, Prescription Drug Plan Sponsors, Cost Plans, Employer-Direct and Employer-Only Contracts, and Medicare-Medicaid Plans
Read MoreRelease of the Contract Year (CY) 2025 Bid Submission Functionality in HPMS
Relevant to: All Current and Prospective Medicare Advantage, Prescription Drug Plan, Section 1876 Cost, PACE, and Medicare-Medicaid Plan Organizations, Bid...
Read MoreCY 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
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