The introduction of Medicare Part D has created a host of administrative, operational, economic, and communication challenges for employer groups and union plan sponsors that still provide prescription drug benefits for their retirees. Under the Medicare Modernization Act, these organizations basically have two choices: either stay the course of being the primary payer/provider of retiree prescription drug benefits (and receive a government subsidy for doing so), or begin shifting retirees into a Medicare Part D plan. Each option has its various pros and cons – as well as unique sets of challenges.

Led by Jean LeMasurier, former Senior Advisor for the Employer Policy and Operations Group at CMS, Gorman Health Group’s experienced consultants can work with employers and union groups to sort out the complexities and help design a course of action that makes sense. We will work with organizations to determine the most cost-efficient options, develop a timeline and implementation strategy, and design an effective communication, training and outreach plan.

CMS Publishes Final 2009 MA Capitation Rates and Part D Payment Policies; CMS Will Conduct Plan Level Audits and Not Make Coding Intensity Adjustments for 2009, 04.10.08
2009 Advance Notice of Capitation Rates, 3.04.08
CMS Call Letter Establishes New Requirements and Reporting Metrics for Plans 1.24.08
Other SNP Sponsors Could Follow In QMed's Wake, Consultant Says; Medicare Advantage News, 11.15.07
The Medicare Outlook: Keys to Success in the New Senior Market, Munich Re America HealthCare Newsletter, 11.01.07
 
Protecting Beneficiaries: Improving & Monitoring Medicare Marketing Practices - AHIP, 05.07
Hard Sell Cited as Insurers Push Plans to Elderly, New York Times, 05.07.07
Advantage Plan's Risk- Wall Street Journal, 04.22.07
Power Shift in Congress Revives Health Debate - New York Times, 01.02.07
 

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