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- Regan Pennypacker on Latest Audit Enforcement Actions Issued by CMS
- Kathleen Chapman on 2019 Medicare Advantage Rate Announcement & Call Letter
- Michelle Juhanson on Latest Audit Enforcement Actions Issued by CMS
- Alan Mittermaier on MA and Part D Proposed Rule Increases Plan Flexibility, Reduces Regulatory Burden
- Sharon Willliams on A New Source of Capital for Star Ratings and Clinical Innovations
The Voice of Melissa Smith
At Gorman Health Group, we have the privilege of collaborating with organizations across the full spectrum comprising our members’ experience – from health plans and providers to vendors and pharmacy benefit managers (PBMs) – and though almost every person I talk to in every type of organization strives to create excellent member experiences, many struggle to successfully do so. The Centers for Medicare & Medicaid Services (CMS) recent pledge to put patients first in all of their programs has changed the calculus of “the member experience” in Medicare Advantage (MA). We’ve heard these words for years, but this time it’s real.
With the much anticipated Advance Notice now in hand, we have our first glimpse into the Centers for Medicare & Medicaid Services (CMS) proposed changes to the 2019 and 2020 Star Ratings. Though CMS hasn’t yet proposed any noteworthy changes (or removed any measures) as part of its “Meaningful Measures” or “Patients Over Paperwork” initiatives, there are plenty of proposals to be carefully considered. Here’s a quick summary of CMS’ proposals impacting the 2019 Star Ratings: Read more
With comments on the Medicare Advantage (MA) and Prescription Drug Benefit Program (Part D) Proposed Rule for 2019 due by January 16, 2018, we’ve received numerous requests for help distilling the Stars elements from the Centers for Medicare & Medicaid Services (CMS’) 713 pages of proposed regulations. Yep, we’ve read all 713 pages, and CMS is seeking feedback on numerous potential adjustments to the Star Ratings programs in the coming years. CMS has, and continues to, demonstrate its willingness to consider plan feedback on proposed changes, and plans should seize this opportunity to be “on the record” so CMS can make well-informed decisions as it adjusts the program in the coming years.