CMS Application Development
Once an organization decides to offer a new Medicare product or expand its service area, it must start the CMS application development and filing process.
This process itself is not as daunting as it once was, as the application now contains a large number of attestations. however, this simply transfers the bulk of the work to the implementation phase. This makes it even more important to have a smooth transition from feasibility, to application and provider contracting, and then to implementation. For a new entrant to Medicare, by the time the February filing comes around, you have no time to delay if your product is to be ready for marketing in October. For new plans, the application is often the dose of reality needed to underline the scope of the work before them. And for existing plans, the prospect of adding new applications to existing staff responsibilites presents a substantial challenge.
Since 1996, Gorman Health Group has developed and submitted countless applications on behalf of Medicare plan sponsors. In conjunction with the application process, we’ve also helped plans:
- prepare for the obligatory CMS pre-approval site visit
- address post-submission implementation issues
- develop provider networks
- acquire state licensure
- And much more!
Sample Documentation Required by the CMS Application Process:
- Health service delivery tables
- Provider contracts and agreements
- Access standards
- Administrative contracts
- Models of Care (Special Needs Plans)
- Quality Measures (Special Needs Plans)
- Pre-enrollment verification documentation (Chronic Care SNPs)
