New Rule Targets Poor Performers In Medicare Advantage, Part D Program
The Centers for Medicare and Medicaid Services unveiled a rule Monday that would allow the agency to drop plans that fail for three years to earn at least three stars under a five-star rating system.
Modern Healthcare: Rule Would Let CMS Terminate Poor-Performing Advantage, Part D Sponsors
CMS on Monday proposed changes to the Medicare Advantage and prescription drug programs that would implement provisions outlined in last year's Patient Protection and Affordable Care Act. Open to a 60-day comment period, the proposed rule would provide the CMS with the authority to terminate poor-performing Medicare Advantage and Part D sponsors that fail to achieve at least a 3-star rating under the agency's 5-star plan rating system for a period of three years (Zigmond, 10/3).
CQ HealthBeat: Proposed Rule Would Give CMS Power To Drop Poor-Quality Plans
The Centers for Medicare and Medicaid Services announced a proposed rule Monday that would give the agency the power to drop Medicare Advantage plans and Medicare prescription drug coverage plans that get low marks for quality. CMS could terminate plans that fail for three years to earn at least a three-star rating under the agency’s five-star rating system. The provision is part of a regulatory proposal for 2013 that also would put in place certain elements of the health care law. For example, the proposal codifies the 50 percent discount on brand-name drugs prescribed for beneficiaries in the "doughnut hole" — the part of the Part D drug benefit in which beneficiaries are 100 percent responsible for their drug costs (Reichard, 10/3).
California Healthline: Quality Ratings Offered In Medicare Enrollment Window
Open enrollment for Medicare starts at the end of next week. This week, the federal government launched its online service to help people make Medicare decisions. This year, their service offers a little something extra, according to David Sayen, the regional administrator for CMS. Medicare Advantage plans now will be rated for quality of care. Part D prescription drug plans will continue to be rated for quality (Gorn, 10/4).