PACE, MAP, and Medicare Advantage
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PACE, MAP, and Medicare Advantage
CMS to Host Webinar on New Interoperability Rule The March 26th webinar will provide information to providers, patients, and plans about the new data sharing and prior authorization rule.
- March 5, 2024
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PACE, MAP, and Medicare Advantage
CMS Updates Data Submission System for Medicare Advantage and PACE Supplemental Benefits CMS updated instructions and systems to facilitate the submission of data on supplemental benefits in the Medicare Advantage Encounter Data System on Feb. 21st.
- February 27, 2024
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PACE, MAP, and Medicare Advantage
CMS Proposal Projects 3.7 Percent Payment Increase for Medicare Advantage The Advance Notice makes methodology changes and proposes CY 2025 payment levels for Medicare Advantage plans.
- February 15, 2024
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PACE, MAP, and Medicare Advantage
DOH, Deloitte Review Update to PACE Rates The update incorporates the impact of minimum wage increases and other State policy changes into April 2023 rates.
- January 30, 2024
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PACE, MAP, and Medicare Advantage
CMS Issues Interoperability and Prior Authorization Final Rule and Medicare Advantage RFI The Interoperability and Prior Authorization Rule is intended to improve health information sharing among payers, providers, and patients, and improve prior authorization turnaround times for Medicare Advantage, Medicaid fee-for-service, and Medicaid managed care. The Request for Information seeks input into the collection and publication of Medicare Advantage data.
- January 29, 2024
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PACE, MAP, and Medicare Advantage
Guidance for PACE and Part D Sponsors on COVID-19 Prescription Antivirals The guidance is intended to ensure that claims for oral antivirals are processed appropriately to serve the goals of ensuring beneficiary access to these medications at no cost sharing for as long as possible and utilizing supply that has already been procured by the U.S. government.
- January 16, 2024
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PACE, MAP, and Medicare Advantage
DOH Finalizes Supplemental PACE Rates Revised April 2023 Medicaid rates reflect minimum wage increases, as well as hospital, nursing home, and behavioral health rate updates.
- January 9, 2024
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PACE, MAP, and Medicare Advantage
Medicare Advantage Regulations Impose Limits on Utilization Management Key provisions of the regulations take effect on Jan. 1, 2024 and require Medicare Advantage coverage decisions to be no more restrictive than fee-for-service Medicare, limit the uses of prior authorization, and require physician-ordered sites of service to be honored.
- December 18, 2023
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PACE, MAP, and Medicare Advantage
Proposed Medicare Advantage and PACE Regulations Offer Additional Beneficiary Protections On Nov. 6, 2023, CMS posted a proposed rule that would revise the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, PACE, and certain health information technology standards. The proposed regulations are intended to strengthen beneficiary protections and ensure that Medicare Advantage plans meet the needs of beneficiaries.
- November 13, 2023
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PACE, MAP, and Medicare Advantage
CMS Issues Various Memos for Medicare Advantage and PACE Plans Plans should preview their 2024 "Medicare and You" Handbook data and verify their HPMS crosswalk data for accuracy and completeness.
- August 7, 2023
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