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News Archives
C Refills of Part D Medications for residents in a declared Public Health Emergency Area: CMS expects Part D sponsors to guarantee immediate refills of Part D medications to any beneficiary located in an “emergency area,” defined as... [more]
Part C Provider Network Access for residents in a declared Public Health Emergency Area: For enrollees residing in an emergency area, CMS expects plans to waive prior authorization and out-of-network requirements. For example, a Medicare Advantage enrollee affected by the disaster may go... [more]
Quality and Performance Ratings for 15 Part D Prescription Drug Plans.This is a sampling of national and regional plans. There are two types of Medicare plans that provide prescription drug coverage: Medicare PDPs (Prescription Drug Plans) and Medical Health Plans. The MA-PDs offer both health care and prescription drugs while the PDPs offer only prescription drug coverage. To compare other PDPs or MA-PD plans in a particular state (or county) use the Plan Finder tool on www.medicare.gov. Read more details. 
Choosing a Medicare Drug Plan: Important information from Medicare & You 2008 (CMS publication):Each Medicare drug plan is different. When you choose a Medicare drug plan for the first time, or switch to a different Medicare drug plan, [more]
The 2008 Medicare prescription drug plan and health plan information is now online through the Medicare Prescription Drug Plan Finder at www.medicare.gov.
Need to be paid back for Medicare drug plan copayment and/or premium amounts? Read more details.
News 2008: Late Enrollment Penalty eliminated for LIS (low-income subsidy) eligible beneficiaries for 2007 The Centers for Medicare & Medicaid Services (CMS) Acting Administrator Kerry Weems announced the elimination of the 2008 late enrollment penalty for any beneficiary eligible for the low income subsidy of the Medicare prescription drug program. Medicare beneficiaries who qualify for the low-income subsidy for Medicare prescription drug coverage may enroll in a Medicare prescription drug plan with no penalty through December 31, 2008.
Overview of Medicare Drug Coverage Under Medicare Part A, Part B and Part D
Alert: Victims of Marketing Fraud can Disenroll from MA Plans. Individuals who think their enrollment in a Medicare Advantage (MA) plan was based on misleading or incorrect information provided by the Plan's employees, agents or brokers should call 1-800-MEDICARE. Customer service representatives at 1-800-MEDICARE and CMS regional office (RO) caseworkers will evaluate beneficiaries’ requests to disenroll and reenroll in a different plan during the Special Enrollment Period.
Important Clarifications on Prior Authorization and Utilization Management Requirements:CMS requires all Part D plans to inform patients and their physicians of "specific prior authorization criteria and other utilization management requirements. Read more details.
No Part D Late Enrollment Penalty for Low-Income Subsidy Eligible Beneficiaries.CMS announced elimination of the 2007 late enrollment penalty for any beneficiary eligible for the LIS [low income subsidy] for a Part D plan even if the beneficiary failed to sign up by the program’s initial deadline. Read more details.
CMS requires plans to accept premium payments made by supplemental payers on behalf of their Part D enrollees. Part D plans are required to work directly with SPAPs, or the other payers, to coordinate and accept premium payments in accordance with CMS guidelines It also points out that plans cannot require beneficiaries to go on direct bill for Part D premiums and must reimburse beneficiaries of any premium overpayments the plan receives.
2007 Costs for People Who Automatically Qualify or Apply and Qualify for Extra Help. CMS has released a new partner tip sheet PDF providing information...
Update on Premium Withholding. Medicare is mailing letters to people who selected premium withhold for 2006, but for which the premiums withheld were incorrect. You will receive a letter if you 1) had too much withheld and are due a refund; or 2) had too little or none at all withheld and owe no more than $200; or 3) had too little or none at all withheld and owe more than $200. To learn how this may affect you, read the CMS Tip Sheet. PDF
January 25, 2007
Special Election Period. For the 207,300 beneficiaries who were not sent their Annual Notice of Change in a timely fashion, CMS has extended the enrollment period to February 15. These beneficiaries can use this extra time to compare Plans’ options available in 2007, and allows affected beneficiaries one opportunity during this time to change plans if they so choose. An enrollment request made during this period will take effect on the first day of the month after the enrollment election is made. To view the CMS announcement, click here.
January 9, 2007
From CMS: Clarification of Special Enrollment Periods (SEP) for LIS Eligible Beneficiaries for 2007
Alert: If you are switching to a new Plan for 2007, do not disenroll from your current plan until you identify and enroll in the new plan. You will lose your prescription coverage and may incur a late enrollment penalty if you disenroll before you are signed up for the new one.
One-Time Special Enrollment Period for individuals who no longer qualify for LIS: Beginning January 1, 2007 through March 31, 2007 CMS will allow any individual who no longer qualifies for LIS to make one Part D enrollment election. Click to read details. PDF
Updated 10-12-2007
