Posts Tagged ‘CMS’
CodySoft® Adds Part C and Part D Reporting Feature
CodySoft® has added a new feature to its Investigations Module®, making it easier for health plans to pull their Part C and Part D reports on plan oversight of agents. Even though the Centers for Medicare & Medicaid Services (CMS) no longer requires this report in the annual Part C and D reports, health plans…
Read MoreIndustry Alert: Iowa Senator Calls for Greater Scrutiny of MA Plans
Kaiser Health News recently published an article about Senator Chuck Grassley (R-Iowa) asking federal health officials to tighten scrutiny of private Medicare Advantage (MA) health plans. His request comes amid ongoing concern that insurers over-bill the government by billions of dollars every year. In mid-April, Grassley wrote a letter to Centers for Medicare and Medicaid Services…
Read More4 Ways to Prepare for Increased CMS Oversight in the wake of Secret Shopper Success
Good news for Medicare agents and brokers: The Centers for Medicare and Medicaid Services (CMS) recently reported that of the 1,320 marketing events secretly shopped during the 2014 contract year Annual Enrollment Period (AEP), 85.5% were fully compliant. This is a huge improvement from previous years, when CMS found more than half of secretly shopped…
Read MoreAre you prepared for a CMS audit?
If The Centers for Medicare and Medicaid Services (CMS) walked through your door today and asked to audit your health plan, would you be prepared? Unfortunately, for many Medicare Advantage and prescription drug plans, the answer is “no.” Yet, with CMS continuing to crack down on compliance violations, this hypothetical audit could very well become…
Read MoreAre you Prepared for an Audit of your HPMS Memos?
If the Centers for Medicare and Medicaid Services (CMS) reviewed your procedures around Health Plan Management System (HPMS) memos tomorrow – would you be happy with the outcome? Unfortunately for many health plans, the answer is, “No.” With anywhere from 10 to 20 HPMS memos distributed each week, there’s a heavy burden on compliance departments…
Read MoreAre You Prepared to Comply with the Summary of Benefits Guidance Released by CMS?
On April 15, the Centers for Medicare and Medicaid Services (CMS) released the Summary of Benefit (SB) Guidance for Contract Year 2017. Based on these requirements, health plans can now more easily utilize a template to create SB versions. This is great news for health plans, because they will no longer be required to use…
Read MoreHow CodySoft® Will Address CMS’ Updates to Summary of Benefits and Coverage Template
On February 25, 2016, The Centers for Medicare and Medicaid Services (CMS) released a proposed revision to the way health plans create their Summary of Benefits (SB) documents. Within the notice, it stated that HPMS will no longer generate the SB, and that plans would develop their own SB based upon their bid data within…
Read MoreFor MA Plans: Increased Payments will mean Increased Compliance
By now, it is safe to assume that health plans across the nation have thoroughly read and examined CMS’ Final Medicare Advantage (MA) Rate Announcement and Call Letter for 2016. I think we all heard a collective sigh of relief with the announcement that reimbursements would increase, rather than decrease, in the coming year.
Read MoreMA and Part D Plans: Jumpstart Your CY2016 ANOC and EOC Documents Creation
In late January, CMS released the “CY 2016 PBP/SB Software List of Changes and Known Issues,” which includes a summary of the changes to the Plan Benefit Package (PBP) software that Medicare Advantage and Part D plans will use to upload their 2016 AEP materials bid submissions to CMS later this year.
Read MoreCMS Announces Quality Rating System for Qualified Health Plans
Beginning in 2016, all Qualified Health Plan (QHP) issuers operating in healthcare exchanges will be required to submit strict quality data on a number of measures under the Center for Medicare and Medicaid’s (CMS’) Quality Ratings System (QRS).
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