In the Midst of AEP…Don’t Lose Sight of the Upcoming Application Season Compliance Solutions

In mid-October, CMS will release the online Calendar Year 2021 Notice of Intent to Apply (NOIA).  The NOIA must be submitted to CMS by November 12, 2019 if organizations plan to submit an application for the 2021 plan year, either for a new contract or contract expansion, including the following:

It’s that time again…time to begin marketing for the upcoming plan year and prepare for sales and enrollment activities during the Annual Election Period (AEP).  With all that entails, it can be easy to forget about other upcoming important dates on the Centers for Medicare and Medicaid Services (CMS) calendar.

  • New Medicare Advantage (MA) or Prescription Drug Benefit (Part D) contract
  • Offering a new product type
  • Expanding the service area
  • Adding prescription drug benefits (Part D) to an existing contract

How can organizations be best prepared?  It’s not too late to conduct a feasibility study to assist in the ‘go/no-go’ decision.  A network analysis should also be completed to determine any potential adequacy issues or gaps.  Remember that filing the NOIA with CMS only informs them of the Organization’s intent to apply, it does not require that a formal application be submitted.

Gorman Health Group can assist in all phases of the application process including the feasibility study, network analysis, and application completion/submission.  We have a long history of successful submissions and support.  Contact us today to discuss how we can best support your Organization.

GHG cannot only assist with your application filing but can also project manage the entire process?  Contact us today for more information.

Tina Bailey
Tina Bailey

Tina Bailey is Vice President of Compliance Solutions at Gorman Health Group (GHG). In this role, she assists health plans in preparing for and undergoing Centers for Medicare & Medicaid Services (CMS) audits, directs onsite and remote focused audits, assesses new and existing plan readiness, produces Part C and Part D delegation oversight programs, leads large-scale member/marketing material review, assists with CMS/state applications, and creates and conducts focused trainings.

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