Mary Moll Alexandre on Medicare Part D

CMS Proposes to Prohibit Overrides in Medicare Advantage

On November 6, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule regarding Contract Year (CY) 2025 Policy and Technical Changes to the Medicare Advantage (MA) and Medicare Prescription Drug...more

11/10/2023 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Managed Care Contracts , Medicare , Medicare Advantage , Medicare Advantage Organizations (MAOs) , Medicare Part D , Proposed Rules

CMS Updates COVID-19 Guidance for MA Organizations and Part D Sponsors, Addresses the Status of Telehealth Visits for Risk...

Since early March 2020, the Centers for Medicare and Medicaid Services (CMS) has released a steady stream of guidance to Medicare Advantage Organizations (MAOs) and Part D sponsors in connection with the Coronavirus...more

5/5/2020 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Health Plan Sponsors , Medicare Advantage Organizations (MAOs) , Medicare Part D , New Guidance , Telehealth

CMS Seeks to Provide Flexibility and Facilitate Innovation in Medicare Advantage and Part D

The Centers for Medicare and Medicaid Services (CMS) recently released several significant Medicare Advantage (MA) and Part D guidance documents outlining new Center for Medicare and Medicaid Innovation (CMMI) programs and...more

2/8/2019 / Advance Notice , Bipartisan Budget Act , Call Letter , Centers for Medicare & Medicaid Services (CMS) , CMMI , GAO , Medicare Advantage , Medicare Part D , Opioid , Prescription Drugs , Risk Adjustment Formula , Social Security Act

Administration Offers Up New Proposals to Cut Drug Costs

On November 26, CMS released a notice of proposed rulemaking, “Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses,” which includes provisions that aim to reduce overall drug...more

12/3/2018 / Centers for Medicare & Medicaid Services (CMS) , Drug Pricing , Life Sciences , Medicaid , Medicare Advantage , Medicare Part B , Medicare Part D , Pharmaceutical Industry

Flurry of Medicare Advantage and Part D Changes Includes Significant Policy Shifts

Last week, CMS released new regulations and guidance for Medicare Advantage Organizations (MAOs) and Part D Sponsors. These documents—along with the Bipartisan Budget Act of 2018 that was passed in January—reflect significant...more

4/13/2018 / Centers for Medicare & Medicaid Services (CMS) , Medicare , Medicare Advantage Organizations (MAOs) , Medicare Part D

CMS Encourages Innovation in MA, Asks Part D Plans to Combat Opioid Overuse, and Fine-Tunes Payments

The Centers for Medicare & Medicaid Services (CMS) has released its annual payment and policy guidance for Medicare Advantage and Part D plans. CMS is continuing to find ways to inject more flexibility into these programs,...more

2/7/2018 / Centers for Medicare & Medicaid Services (CMS) , Medicare Advantage , Medicare Part D

Medicare Advantage Draft Call Letter Addresses Encounter Data, Star Ratings

On February 1, 2017, the Centers for Medicare & Medicaid Services (CMS) released proposed updates to the Medicare Advantage (MA) and Part D programs through the CY 2018 Advance Notice and Draft Call Letter. Despite largely...more

2/8/2017 / Centers for Medicare & Medicaid Services (CMS) , Enforcement , Medicaid , Medicare , Medicare Advantage , Medicare Advantage Organizations (MAOs) , Medicare Part D

CMS Releases Plan for Expanded Monitoring of Medicare Advantage and Part D Appeals and Grievances

In Depth - The Centers for Medicare & Medicaid Services (CMS) recently announced that it will monitor—beginning in January 2017—Part C and D appeals timeliness on an industry-wide basis. Under this initiative, all...more

12/6/2016 / Centers for Medicare & Medicaid Services (CMS) , Health Plan Sponsors , Medicare Advantage , Medicare Part D

Preview of Medicare Advantage and Part D Advance Notice and Call Letter: CMS Likely to Address Risk Adjustment, Provider Network,...

The federal government will soon kick off the all-important annual sub-regulatory cycle for the Medicare Advantage (MA) and Part D programs, issuing proposed policy changes and payment rates for calendar year (CY) 2017. The...more

2/10/2016 / Centers for Medicare & Medicaid Services (CMS) , Comment Period , Fee-for-Service , Health Care Providers , Medicare Advantage , Medicare Part D , MedPAC , Recovery Audit Contractors (RACs) , Star Ratings

Mary Moll Alexandre

McDermott Will & Schulte

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