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2020 Estimated Improper Payment Rates for Centers for Medicare & Medicaid Services (CMS) Programs
Fact Sheet
Medicare Advantage and Part D Drug Pricing Final Rule (CMS-4180-F)
The Centers for Medicare & Medicaid Services (CMS) issued a final rule on May 16, 2019 that modernizes and improves the Medicare Advantage and Part D programs. These changes will ensure that patients have greater transparency into the cost of prescription drugs in Part D and will also enable Medicare Advantage plans to negotiate better prices for physician-administered medicines in Part C.
Fact Sheet Contract Year 2020 Medicare Advantage and Part D Flexibility Final Rule (CMS-4185-F)
On April 5, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates the Medicare Advantage (MA or Part C) and Medicare Prescription Drug Benefit (Part D) programs by promoting innovative plan designs, improved quality, and choices for patients.
Fact Sheet Claim Rejection and Denials for Providers on the Preclusion List to begin on April 1, 2019
Fact Sheet
2020 Medicare Advantage and Part D Advance Notice Part II and Draft Call Letter
On January 30, 2019, the Centers for Medicare & Medicaid Services (CMS) released Part II of the 2020 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part D Payment Policies (the Advance Notice), and Draft Call Letter.
Fact Sheet 2021 Medicare Advantage Advance Notice Part I – Risk Adjustment
Today, the Centers for Medicare & Medicaid Services (CMS) released Part I of the 2021 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part C and Part D Payment Policies (the Advance Notice), which contains key information about proposed updates to the Part C CMS-Hierarchical Condition Categories (HCC) risk adjustment model and the use of encounter data.
Fact Sheet