The Affordable Care Act (ACA) is beginning to rein in Medicare Advantage (MA) overpayments by bringing MA payment more in line with what traditional Medicare spends on a given beneficiary.  The insurance industry is not only fighting this payment reform, but has launched a campaign against a 2.3% reduction in payment projected for 2014.[1]   This … Read more →

The Medicare Advantage Disenrollment Period (MADP) lasts from January 1st through February 14th of each year.  During the MADP, a beneficiary can switch from an MA plan to traditional Medicare. The new MADP also provides an opportunity to enroll in a Part D drug plan for those who have not already done so. When disenrolling … Read more →

As discussed in last week’s Alert, the current Medicare Annual Enrollment Period lasts until December 7th.[1]  During this time period, Medicare beneficiaries can choose a Medicare Advantage (Part C) or Part D plan for 2013.  This Alert discusses Part C and D plan quality ratings for 2013, and special enrollment periods related to these ratings.  … Read more →

On April 23, 2012, the Government Accountability Office (GAO) released a report that concludes, among other things, that a Medicare demonstration program providing bonus payments to Medicare Advantage (MA) plans mainly benefits plans whose performance is no more than average.  While the program is supposed to reward quality, in practice it largely rewards plans receiving … Read more →

  Part 1: Today (12/7/2011) is the Last Day of the Medicare Annual Enrollment Period, With a Limited Extension Today, December 7, 2011, is the last day of the Medicare Annual Coordinated Election Period (ACEP), also known as the Annual Election Period (AEP), the period during which people can make changes to their Medicare Advantage … Read more →

The nearly nine million Medicare beneficiaries who are also eligible for some form of Medicaid, the so-called dual eligibles, are the subject of federal, state and local policy discussions because many of them are among the highest users of health care services in the country and thus are very costly to both Medicare and Medicaid.  … Read more →

Once again the Medicare Advantage and Part D Annual Coordinated Election Period (ACEP) is upon us; it's time to contemplate Medicare prescription drug and Medicare Advantage choices for another calendar year.  The big news is that the ACEP, while one week longer than in the past, starts and ends much earlier this year.  The ACEP … Read more →

Fall is the time for Medicare beneficiaries to explore their options regarding Part D prescription drug and Part C Medicare Advantage plans.  In years past, the annual enrollment period began in mid-November and lasted to the end of the year, with any changes or choices made effective January 1st.  Starting this year, that time period … Read more →

An estimated 50,000[1] Medicare beneficiaries who are currently enrolled in Medicare Advantage "Special Needs Plans" (SNPs) but who do not meet the definition of a special needs individual for purposes of their plan will be disenrolled from those plans effective December 31, 2011. Before the end of September 2011, each such beneficiary will receive a … Read more →

On April 15, 2011, the Centers for Medicare & Medicaid Services (CMS) issued final regulations to provide policy and technical changes to the Medicare Parts C (Medicare Advantage) and D programs.[1]  The regulations address concerns raised by Medicare beneficiary advocates, and implement provisions of the Affordable Care Act.  They also codify into regulation some existing … Read more →