Analysis & White Papers
Expert analysis and commentary for business executives, investment analysts, policy makers, and members of the national media.
Summary of Final Notice of Payment Policies and Final Call Letter for CY 2011
Access GHG's April 8 summary of key provisions here.
Gorman Health Group Summary of the CMS 2010 Call Letter
On March 30, 2009 CMS issued the Final Call Letter for 2010. The Final Call Letter summarizes legislative and operational changes to Medicare Advantage, Part D, and cost plan programs that will apply in 2010. Plan Sponsors will face considerable challenges in meeting new and more stringent requirements that are intended to increase program transparency, reduce discriminatory pricing, facilitate informed beneficiary choice of plans and increase plan accountability.
Gorman Health Group 2010 Second Draft Call Letter Summary 2.25.09
CMS is re-issuing the 2010 draft Call Letter for public comment. We originally released a draft Call Letter for public comment on January 8, 2009 and withdrew it on January 22, 2009 pending further review. This new version of the draft Call Letter includes revisions, which are noted in italicized font in the attached document.
Gorman Health Group Summary of the Final and Proposed Regulations Impacting Medicare Advantage, Part D and RDS Programs, 01.16.09
On January 12, 2009, CMS issued final regulation CMS-4131-FC, “Medicare Program; Medicare Advantage and Prescription Drug Benefit Programs: Negotiated Pricing and Remaining Revisions”. This regulation finalizes a number of provisions from the May 16, 2008 proposed regulation impacting the Medicare Advantage, Prescription Drug and the Retiree Drug Subsidy programs. Regulations to implement related provisions from the Medicare Improvements for Patients and Providers Act (MIPPA) are also included.
Gorman Health Group Summary of MIPPA Regulations Released 9/15/08
On September 15, 2008, CMS issued two regulations to implement the provisions in the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).
Medicare Chronic Condition Special Needs Plans
The number of Medicare Chronic Condition Special Needs Plans (SNPs) is expected to proliferate in the coming years. In fact, the future of Medicare managed care delivery will be driven largely by how well SNPs succeed in improving the health outcomes of Medicare beneficiaries while also managing the total costs of providing care and services to this population. This white paper provides background regarding Medicare Chronic Condition SNPs and the factors health plans should consider when setting up and running these types of plans.
