With the issuance of a single memo, CMS has in effect removed the member lock in for MA and MAPD plans with the creation of a new SEP in 2012. The new SEP applies to all members who are enrolled in plans with a STAR rating below a 5 or are enrolled in original...
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MA Plan Member Lock In – GONE in 2012!
CMS Reiterates Standards for Selecting a Data Validation Contractor
MA, MAPD and PDP plans are required to report measures to CMS for Part C and D benefits. Additionally, plans are required to contract with an outside vendor to review and validate the data that was submitted to CMS. Attached is CMS’s standards that plans should use to select a validation vendor. Vendor should...
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CMS Releases Proposed Changes to MA and MAPD Programs for CY 2012
CMS on November 10, 2010 release the proposed changes to the MA and MAPD program for CY 2012. The proposed rule changes will is expected to be published in the federal register on November 22, 2010. A headline summary of changes is as follows: Implementing provisions of the Affordable Care Act; Clarifying various program...
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Upcoming Industry Conference: STARS in New Orleans
HEA is producing an industry conference on December 2nd and 3rd 2010 at the Roosevelt Hotel in New Orleans. Topics will include: CMS’ Proposed Rule to Incentivize Practitioners Quality Management and Quality Improvement Case Study: Early Adopter, Lovlace Health Plan New Trends in Medical Management: Integration Strategies And more! Contact www.healthcare-conferences.com for more information...
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UPDATE: April MARx System Changes
CMS today released a HPMS memo providing some minor additional details related to the major system update to CMS’ enrollment and plan payment processing systems in April 2011. The most significant new detail in the memo is that CMS is planning to ‘provide detailed information that Plans will require for implementation in early January...
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Medicare and You Handbook – 2011
There seems to be quite a bit of interest as to where you can find a copy of the 2011 Medicare and You Handbook. There are two ways you can get a copy 1) Call Medicare to request a copy: 1‑800‑MEDICARE (1‑800‑633‑4227) 2) Download a copy at the following link: http://www.medicare.gov/publications/pubs/pdf/10050.pdf Happy 2011 Annual Enrollment Period!
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