Learn more about CMS Updates that may impact your PACE Plan. FEATURED MEMO: 2018 Star Ratings Marketing Template
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Learn more about CMS Updates that may impact your PACE Plan.

2018 Star Ratings Marketing Template – Dated 10/6/2017

Summary: CMS released the 2018 Star Ratings Template which will be available in HPMS on October 11, 2017 along with the release of the 2018 Star Ratings on The Medicare Plan Finder. Plans are required to use the updated 2018 Star Ratings in all marketing materials that reference the 2018 benefit within 21 days of the public release of the information.

Action: Informational to PACE as PACE does not participate in the Star Ratings.

 

CY 2016 Part D Payment Reconciliation – Dated 10/10/2017

Summary: CMS completed the calculations for the 2016 Final Part D Payment Reconciliation.  The payment reconciliation reports will be available in the reconciliation mailboxes at CSSC on October 12, 2017.  Payment adjustments to remit and recover these calculated reconciliation amounts are planned for November 2017 payment.

Action: Applicable to PACE.  Refer to the memo for complete details.  If you cannot access these reports, please contact CSSC.

The Top 7 Lost PDE Revenue Opportunities

Update to the HPMS Memo “2018 Medicare Advantage Reporting Requirements for HEDIS, HOS, and CAHPS Quality Measures” – Dated 10/11/2017

Summary: CMS provided updates to two measures listed in the CMS 8/14/2017 Memo, “Reporting Requirements for 2018 HEDIS, HOS and CAHPS Measures” that are affected by the NCQA October Update.  

Action: Informational to PACE.  Refer to the email for complete details on the two measures.

 

Attestation of Prescription Drug Event Data (PDE) and Direct and Indirect Remuneration (DIR) Data related to the 2012 Reopening – Dated 10/13/2017

Summary: Due to the global reopening of the benefit year 2012 Part D payment reconciliation, CMS requires an electronically copy of the Attestation of Data Relating to CMS Payment to a Medicare Part D Sponsor to be signed by noon ET, October 30, 2017 for all Part D plans who were active in 2012.  The attestation is available on October 16, 2017 in HPMS.

Action: Applicable to PACE.  Refer to the memo for complete details and instructions on how to complete the attestation for plans who were active in 2012.

 

Release of Notice of Intent to Apply for Contract Year 2019 Medicare Advantage (MA), Medicare-Medicaid (MMP), and Prescription Drug Benefit (Part D) and Related CY 2019 Application Deadlines – Dated 10/13/2017

Summary: CMS announced the release of the Contract Year (CY) 2019 Notice of Intent to Apply (NOIA) web tool and key dates for the CY 2019 Medicare Advantage (Part C) and Prescription Drug Benefit (Part D) application cycle.  The memo details the CY 2019 application cycle key dates.

Action: Informational to PACE as PACE plans have their own application process.

 

Contract Year 2018 Monitoring of Medicare Medicaid Plan Provider and Pharmacy Directories – Dated 10/17/2017

Summary: CMS provided information on the upcoming monitoring of Contract Year (CY) 2018 Provider and Pharmacy Directories.  The Medicare-Medicaid Coordination Office, through a contractor, will review a sample of the Medicare-Medicaid Plans CY 2018 print and online Provider and Pharmacy Directories during November 15, 2017 and January 19, 2018.

Action: Informational to PACE.

 

Medicare Part C and Part D Reporting Requirements – Data Validation – 60 day Comment Period – Dated 10/18/2017

Summary: CMS is looking for comments on the Medicare Part C and Part D Data Validation of Reporting Requirements data for the 2018 and 2019 collection periods.  Comments must be received by December 13, 2017.

Action: Informational to PACE as PACE is waived of the Part C and Part D reporting requirements.

 

Important Date Reminders

Date

      Item

January 2018

Sensipar- ESRD Treatment must be included in the ESRD PPS & no longer payable under Part D benefit.

April 2018

Medicare Diabetes Prevention Program services to be covered for eligible Medicare beneficiaries.

April 2018

New Medicare Card (Formerly known as SSNRI) to Begin

January 2019

Enforcement Date for the Prescriber Enrollment Requirement

*Subject to change, forthcoming information to be release by CMS.

Please note that this information is provided to you in summary form for general informational purposes only and does not constitute legal or regulatory compliance advice.  It is your responsibility to consult with your Compliance Officer and/or legal counsel to determine applicability of any regulation or standards referenced herein to your organization and/or processes.

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