CMS and the FDA are coordinating with each other to ensure the market is aware of the changes to the regulatory status of marketed prescription drug products. The Non-Matched NDC List represents drug products that have not been properly registered and listed with the FDA. The non-match FDA list is NOT to be used...
Read more »
CMS has posted an updated Calendar Year 2011 Model Diagnoses crosswalk on the Risk Adjustment webpage. The crosswalk incorporates Fiscal Year 2011 ICD-9 code updates that are effective October 1, 2010. The crosswalk file link is named “2011 Model Diagnoses” and can be found on the CMS Website here: http://www.cms.gov/MedicareAdvtgSpecRateStats/06_Risk_adjustment.asp
Read more »
CMS provided new guidance on HMPS today on changes to their edit logic for PDE transactions submitted to CMS system, DDPS. Summary of Changes: PLAN BID TABLE – New table that contains abbreviated plan bid information including the plan’s ICL, and application for supplemental benefit coverage MANUFACTURER AGREEMENT TABLE - This will be the...
Read more »
Today CMS provided guidance on the preview Part C Plan rating data that has been made available to plans. —————————-FROM HPMS—————————– To: Part C Compliance Officers From: Cynthia G. Tudor, Ph.D., Director, Medicare Drug Benefit and C & D Data Group Date: September 24, 2010 We have updated the Part C data included in...
Read more »
Today CMS sent a HPMS memo clarifying the use of DRAFT Plan Ratings Data that became available on 9/15/2010. MA, MAPD and PDP plans should NOT use these rating scores in any marketing materials or communications. There is the reality that potential findings from CMS or other Plan Sponsors may change final calculations and...
Read more »
The Affordable Care Act of 2010 (ACA) will allow the HSS Secretary to adjust the payments to certain Dual Eligible Special Needs Plans (SNP) based on the frailty of their population. This adjustment will not take place in payment year 2011 because of the lack of data for Dual SNP plans. Medicare Advantage Organizations...
Read more »
