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Tag Archives: CMS
As a follow up to my last article on the Notice of Intent to Apply, I give you an enhanced chart of 2019 application activities outlining things you should have been doing or should be in the middle of now. Thanks to the Centers for Medicare & Medicaid Services (CMS) for creating a base, published on Friday via memo – my colorful additions peppered throughout for your perusal. If past activities have not been done yet, it is time to get a move on, or you risk missing the deadline. Read more
The Centers for Medicare & Medicaid Services (CMS) Annual Call Letter calendar marks November 13, 2017, as the first due date for the Notice of Intent to Apply. It is expected the Center for Medicare will release a reminder memo this month outlining the details. In general, the agency requires a Notice of Intent to Apply to be submitted when an organization plans on submitting a request for any of the following: Read more
Program audits and oversight activities must be designed with many factors to balance: accuracy, consistency, efficiency, and in an effort to be least disruptive to a plan sponsor. Correspondingly, a plan should be tailoring its response to these audits with those same factors in mind. My colleague Deb Devereaux and I outline ten common risk areas we observe in plans large and small. Read more
CMS Releases Widely Anticipated Proposed ACA regulation, the New Administration’s First Attempt at Market Stabilization
On February 15, 2017, the Centers for Medicare & Medicaid Services (CMS) released its widely anticipated proposed rule introducing new market health insurance market reforms. CMS is proposing changes for stricter Special Enrollment Period (SEP) verification, exceptions to guaranteed availability, updated network adequacy requirements, and a shorter Open Enrollment Period.