On November 20, 2015, Center staff attended a one day symposium hosted by the federal Department of Health and Human Services (HHS) entitled “HHS Pharmaceutical Forum: Innovation, Access, Affordability & Better Health.” The … [Read more...] about Department of Health and Human Services Forum on Drug Pricing and Innovation
Medicare Part D / Prescription Drugs
Kaiser Family Foundation Releases Reports on MA and Part D in 2016
In a report entitled “Medicare Part D: A First Look at Plan Offerings in 2016” (October 2015), the Kaiser Family Foundation analyzed the Part D market in 2016 and found, among other things, that: In 2016, beneficiaries in each … [Read more...] about Kaiser Family Foundation Releases Reports on MA and Part D in 2016
Final 2016 CMS Call Letter for Medicare Parts C and D Released
Every year, the Centers for Medicare and Medicaid Services (CMS) issues payment, performance and other rules that apply to Medicare Advantage (MA) and Part D plans that choose to participate in the Medicare program in the following calendar year. … [Read more...] about Final 2016 CMS Call Letter for Medicare Parts C and D Released
Center for Medicare Advocacy Submits Comments to Draft 2016 Call Letter for Medicare Parts C and D
Every year, the Centers for Medicare and Medicaid Services (CMS) releases a draft of payment, performance and other rules that apply to Medicare Advantage (MA) and Part D plans that choose to participate in the Medicare program in the following … [Read more...] about Center for Medicare Advocacy Submits Comments to Draft 2016 Call Letter for Medicare Parts C and D
2016 Medicare Advantage (Part C) and Part D Final Rule Issued
On February 12, 2015, the Centers for Medicare and Medicaid Services (CMS) published final rules entitled “Medicare Program; Contract Year 2016 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit … [Read more...] about 2016 Medicare Advantage (Part C) and Part D Final Rule Issued
Update on MA and Part D Plans
A Brief Survey of Recent Reports, and a New Special Enrollment Period for 2015 Medicare's Annual Coordinated Election Period (ACEP) for Medicare Advantage and Part D plans began on October 15th and runs through December 7th. During the … [Read more...] about Update on MA and Part D Plans
2015 Medicare Cost Sharing
Hospital Deductible: $1,260.00 / Benefit period Hospital Coinsurance: Days 0-60: $0 Days 61-90: $315 / Day Days 91-150: $630/ Day Skilled Nursing Facility Coinsurance: Days 1-20: $0 Days 21-100: $157.50/ Day Part A … [Read more...] about 2015 Medicare Cost Sharing
Hospice and Access to Medications Update: CMS Replacement Guidance
Quick Summary When Medicare beneficiaries elect the hospice benefit, they waive Medicare coverage for all care and services related to the terminal illness that are not on the hospice plan of care and provided through the hospice provider. … [Read more...] about Hospice and Access to Medications Update: CMS Replacement Guidance
The Center Joins 26 Other Organizations in Calling for Suspension of Hospice and Part D Guidance
Research suggests that medications that should be covered by the Medicare Hospice Benefit are sometimes paid for by Medicare Part D plans. In March, to prevent this from happening, the Centers for Medicare & Medicaid Services (CMS) issued a … [Read more...] about The Center Joins 26 Other Organizations in Calling for Suspension of Hospice and Part D Guidance
Submitting Claims to Part D for Prescription Drugs Administered in the Hospital During an Observation Status Stay
The use of Medicare observation status in hospitals has increased dramatically over the past several years.[1] The most notable adverse consequence of Observation Status on beneficiaries is financial liability for any post-hospitalization care at a … [Read more...] about Submitting Claims to Part D for Prescription Drugs Administered in the Hospital During an Observation Status Stay