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Agent Broker Compensation Training– Dated 01/07/16

Summary: CMS is offering training on CMS’s Agent Broker Compensation policy and changes to the MARx Agent Broker Compensation report. The training will be on January 27, 2016 from 3:30pm to 5:00 EST

Action: Informational to PACE plans. PACE is not authorized to utilize agents and/or brokers.


Part D Point of Sale Pilot: Invitation to Attend Conference Call– Dated 01/07/16

Summary: CMS will hold a conference call on January 21, 2016 at 1-2:30pm EST to address concerns Part D enrollees have in difficulty accessing the coverage and appeals process after a rejected claim at point of sale. 

Action: Informational to PACE plans. No registration is required for the event.


Clarification of Benefit Flexibility and Coverage Guidance for Dual Eligible Special Need Plans and Process to Request to Offer Flexible Supplemental Benefits in Contract Year 2017– Dated 01/08/16

Summary: MAOs currently operating Dual Eligible Special Needs Plans (D-SNP) are being informed of request to offer supplemental benefits as part of the contract year 2017 plan benefit package. CMS provides guidance to MA and MAOs pertaining to:

  • Clarification of Benefit Flexibility Guidance
  • Eligibility Determination for Benefit Flexibility
  • Bid Submission and Flexible Supplemental Benefits

The deadline for MAOs to submit their notification to CMS of the intent to offer flexible supplemental benefits is 6:00 pm EST on January 22, 2016.

Action: Informational to PACE plans. For further details on submission of intent please refer to the memo in its entirety.


CY 2016 Core Reporting Requirements for Medicare-Medicaid Plans– Dated 01/08/2016

Summary: MMPs should follow the new release of CY 2016 Medicare-Medicaid Capitated Financial Alignment Model Reporting Requirements. The new requirements will commence on January 1, 2016. 

Action: Informational to PACE plans. 


Model of Care Training and Technical Assistance Teleconference Calls– Dated 01/11/16

Summary: The CY 2017 Model of Care dates and times have been set. These calls provide detailed information about the MOC for SNPs and Medicare-Medicaid Plans. MOC submissions are due by February 17, 2016. MOC Elements 1-2 call will be on Tuesday, January 12, 2016, 3:00-4:30pm EST. Please review memo for dial in information. 

Action: Informational to PACE plans. 


Health Plan Management System Customer Satisfaction Survey for External HPMS Users– Dated 01/11/16

Summary: CMS has released the annual HPMS customer satisfaction survey. All external HPMS users are strongly encouraged to participate in the survey, as all information received will be used to align HPMS improvement efforts with customer priorities. 

Action: Informational to PACE plans. The survey needs to be taken between Monday, January 11, 2016 through Wednesday, January 20, 2016 until 5:00 p.m. EST.


Medicare Parts C and D Oversight and Enforcement Group Leadership Announcement– Dated 01/11/16

Summary: This leadership announcement is from Gerard Mulcahy, Director, Medicare Parts C and D Oversight and Enforcement Group. This is to provide notification of leadership changes within MOEG in the Center for Medicare. 

Action: Informational to PACE plans. Refer to memo on the leadership changes.


Release of the CY 2017 Medicare Advantage and Prescription Drug Plan Applications– Dated 01/12/16

Summary: CMS released the 2017 Medicare Advantage, Prescription Drug Plan, Employer/Union-Only Group Waiver Plan applications, and the SNP proposals. All applications are due to CMS by 8:00 p.m. EST on February 17, 2016. All materials and supporting documentation must be submitted through CMS’s Health Plan Management System.  

Action: Informational to PACE plans. Review the memo for directions on where to find the postings for Part C and Part D applications as well as MA and PDP application questions. 


Submission of 2015 Beneficiary-Level Medication Therapy Management Program Data – Dated 01/13/15

Summary: As stated in the CY 2015 Part D Plan Reporting Requirements document, CMS requires that Part D sponsors with an approved MTM program submit beneficiary-level MTM program data. The OMB approved reporting requirements document, and supporting technical specifications, are posted on the CMS website. The reporting deadline for these is February 29, 2016. 

Action: Informational to PACE plans. PACE is waived of MTM requirements as they are duplicative of the PACE IDT.  


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.