Opportunities in Special Enrollment Periods

Are Your Clients Eligible for SEP? When certain events happen, your Medicare-eligible clients may qualify to change their plan outside of the Annual Election Period. These are Special Enrollment Periods (SEPs). The Centers for Medicare & Medicaid Services (CMS) determines what events and criteria qualify for an SEP. Each one ... Read More

Centers for Medicare & Medicaid Services (CMS) Proposes New Rules to Improve the Interoperability of Health Information

New Innovations in technology promote patient access and could make health data exchange reality for millions! On Monday, February 11, 2019, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator (ONC) released proposed rules to support seamless and secure access, exchange, and use of ... Read More

CMS Proposes Medicare Advantage and Part D Payment and Policy Updates to Maximize Competition and Coverage

Medicare Advantage and Part D Payment and Policy Updates Today, the Centers for Medicare & Medicaid Services (CMS) released proposed changes that will take significant steps in continuing the agency’s efforts to maximize competition among Medicare Advantage and Part D plans. These proposals will increase plan choices and benefits and ... Read More

Congress Wades Into Emotional Debate Over High-Cost Prescription Drugs

Congress Wades Into Emotional Debate Over High-Cost Prescription Drugs Senators railed against pharmaceutical executives Tuesday for declining to testify before Congress about out-of-control drug prices, as lawmakers on both sides of the U.S. Capitol kicked off investigations sure to rattle one of the nation’s most powerful industries. Sen. Chuck Grassley ... Read More

Open Payments Data Refresh

CMS Updates Open Payments Data Today, January 18, 2019, the Centers for Medicare & Medicaid Services (CMS) updated the Open Payments dataset to reflect changes to the data that took place since the last publication in June 2018. The updated dataset is now available for viewing at CMS updates the Open ... Read More

CMS Announces New Model to Lower Drug Prices in Medicare Part D and Transformative Updates to Existing Model for Medicare Advantage

Providing Seniors with More Benefits While Strengthening Competition Among Plans. Today, CMS’s Center for Medicare and Medicaid Innovation (“Innovation Center”), which tests innovative payment and service delivery models to lower costs and improve the quality of care, announced a new payment model and transformative updates to an existing model. The ... Read More

The Electronics Industry Sees Money in Your Health

The Electronics Industry Sees Money In Your Health LAS VEGAS — If the scores of personal health care devices at the Consumer Electronics Show last week are any indication, it’s clear that the Apple Watch has kicked off a rush by high-tech companies to capitalize on people’s worries about their ... Read More

New Medicare Card Mailing Complete, 58% of Claims Submitted with MBIs

Center for Medicare & Medicaid Services (CMS) CMS finished mailing new Medicare cards to people with Medicare across all mailing waves, including Wave 7 states and territories and also to people with Medicare Parts A&B who live in Canada and Mexico. Medicare patients are using their new cards in doctor’s ... Read More

2019 Overview of Medicare Advantage Open Enrollment Period (OEP)

CMS will restore the Medicare Advantage (MA) Open Enrollment Period (OEP) starting in 2019 and will take place from January 1 through March 31 each year.  Individuals enrolled in MA, including eligible individuals, to make a one-time election to switch to another MA plan or to return to Original Medicare (with ... Read More

How the Government Shutdown Affects Health Programs

With the new congress scheduled to start on January 3, members of Congress have not come up with a solution to President Trump’s calls for funding to build a wall along the U.S.-Mexico border   There seems to be no end in sight for the current partial government shutdown, the third ... Read More