The ongoing requirements and regulations imposed by the Centers for Medicare and Medicaid Services can create an administrative headache for health plans who already have a laundry list of things to accomplish every day. All marketing materials – including a health plan’s website – must comply with CMS guidelines that are often confusing, extensive and time-consuming. Here … Read more
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Studies for years have shown that more than half of Americans make financial resolutions in the New Year. (Not surprisingly, the other half vow to lose weight.) New Year’s Resolutions often include business goals. Building efficiency, saving money and increasing value should be at the top of every company’s list for 2019 – including health … Read more
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The Centers for Medicare and Medicaid Services has reversed its rule prohibiting formulary design that would expand prescription drug choices for Part D health plans and their members. CMS in August announced that starting in 2020 it will allow Medicare Part D plan sponsors to implement indication-based formulary design. That means plans can cover specific … Read more
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Medicare is making a big change to its enrollment period that could benefit new and existing members – but create more work for already-swamped health plans. Starting next year, Medicare Advantage enrollees will have from Jan. 1 to March 31 to choose the health plan that is right for them, according to the Centers for … Read more
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The Centers for Medicare and Medicaid Services released its 2019 Star Ratings last month – which already has some health plans thinking about 2020. If it seems far off, it’s really not. That’s because it takes time to ensure your health plan is doing everything it can to ensure a four or five star rating. It’s … Read more
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Is your health plan’s Medicare Provider and Pharmacy Directory up-to-date? If not, keep reading. The federal Centers for Medicare and Medicaid Services requires health plans to provide their members with a Provider and Pharmacy Directory, both print and online. That way, when men and women enroll in Medicare they have immediate access to lists of … Read more
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Medicare’s Plan Finder remains the best consumer tool to search for a Medicare Part D and Medicare Advantage Plan. The government wants to keep it that way. Plan Finder lists all of the health plans available in a person’s zip code and includes crucial information about premiums and out-of-pocket costs, particularly for prescription drugs. Pricing … Read more
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Pharmacy benefits are crucial to any healthcare plan. However, the administration and management of a health plan’s prescription drug component can be a difficult and overwhelming task. Health plans are always looking to do more — but sometimes the resources just aren’t there. That’s when it’s critical to have the right team in place.
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