Archive for: Medicare Advantage

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Payment Innovation: Other

CMS Proposes Changes for MA and Part D Plans: Coverage Changes for Protected Class Drugs, Step Therapy Requirements and Greater Price Transparency for Medicare Beneficiaries

On November 26, 2018, CMS released a proposed rule that would allow for changes in 2020 to coverage of protected class drugs, establish new requirements for when MA plans may apply step therapy as a utilization management tool for Part B drugs and implement electronic tools to increase drug price transparency for Medicare beneficiaries.

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Payment Innovation: Other

CMS Releases Proposed Rule on Medicare Advantage, Medicare Part D, PAC and Medicaid

CMS releases proposed rule implementing certain provisions of the Bipartisan Budget Act of 2018.  Under this proposed rule, MA plans would be able to offer telehealth benefits beyond what is currently allowable under the traditional Medicare telehealth benefit.

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Payment Innovation: Other

LAN Releases Updated Report on APM Adoption

Health Care Payment Learning and Action Network released a new report on alternative payment model adoption.

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Payment Innovation: Other

CMS Releases 2019 Medicare Advantage and Part D Prescription Drug Quality Program Star Ratings

CMS has released Part C and Part D Star Ratings; providing information about the quality of plan choices.

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Payment Innovation: MIPS

CMS Launches MAQI Demonstration Website

The Centers for Medicare and Medicaid Services (CMS) posted a webpage dedicated to the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration.

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Payment Innovation: Quality Payment Program

CMS Advances Medicare Advantage Alternative Payment Model Demonstration

The Centers for Medicare and Medicaid Services (CMS) announced that it is pursuing a demonstration project, the Medicare Advantage Qualifying Payment Arrangement (MAQI) demonstration, which would allow clinicians involved in risk contracts in Medicare Advantage (MA) to be exempt from the Merit-Based Incentive Payment System (MIPS).

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