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News about laws, regulations, and guidelines

CMS is planning to allow Medicare beneficiaries to contract directly with physicians

On Monday, CMS announced they are seeking to release a direct provider contract model that would allow providers to take further accountability for the cost and quality of a designated population to drive better beneficiary outcomes. This new model would

Posted in Company Information, Industry News, Legislative News, Medicare Advantage/Part D Prescription, Medicare Information, Medicare Supplements

2019 payments to Medicare Advantage plans increases 3.4 percent

Last week the government stated it would increase 2019 payments to the health insurers that manage Medicare Advantage insurance plans for seniors and the disabled by 3.40 percent. This is due to the higher-than-expected rise of enrollments reflecting a projection

Posted in Helpful Tips, Industry News, Legislative News, Medicare Advantage/Part D Prescription, Medicare Information, Sales Tips

Walmart talks about buying Humana

The Wall Street Journal released yesterday that Walmart, Inc. is in the early stages of discussion to acquire Humana, Inc. The two have been working together since 2010, selling low-cost prescription drug plans to medicare beneficiaries. One report states, “for Walmart,

Posted in Company Information, Industry News, Legislative News, Medicare Advantage/Part D Prescription, Medicare Information

CVS and Aetna merge to surge

Another merge in the making….shareholders for Aetna and CVS recently approved the merge by 97%. If approved, the nation’s largest pharmacy network will acquire the third-largest health insurer and is set to be finalized by the second half of the year.

Posted in Company Information, Helpful Tips, Industry News, Legislative News, Medicare Advantage/Part D Prescription, Medicare Information

Cigna is set to acquire Express Scripts for $67 billion

Yesterday, Cigna and Express Scripts released they are in a definitive agreement whereas Cigna will acquire Express Scripts. This press release stated this merger is expected to “drive greater affordability and connectivity with customers and their health care providers, while

Posted in Company Information, Industry News, Legislative News, Medicare Advantage/Part D Prescription, Medicare Supplements

CMS rejects Arkansas’ request to scale back Medicaid expansion

On Monday, CMS rejected Arkansas’ request to roll back its Medicaid expansion. However, they did  approved the state’s proposal to impose work requirements on current Medicaid beneficiaries. Modern Healthcare reports, “the state sought to scale back eligibility to residents earning

Posted in Affordable Care Act, Company Information, Helpful Tips, Industry News, Legislative News, Medicare Advantage/Part D Prescription, Medicare Information

Mercy Health and Bon Secours to merge

Just yesterday we learned that Mercy Health and Bon Secours Healthy System is planning to merge to form a 43-hospital entity that serves the follow states: Maryland, Virginia, South Carolina, Kentucky, Ohio, Florida and New York. Executives of the Catholic

Posted in Company Information, Industry News, Legislative News, Medicare Advantage/Part D Prescription, Medicare Information

The Donut Hole Will Close in 2019

Yes, you heard me right! Last Friday, President Trump signed a budget deal which will provide relief to Medicare beneficiaries a year earlier than expected. Medicare beneficiaries who are on a Part D Drug Plan and pay excessive amounts for

Posted in Affordable Care Act, Company Information, Helpful Tips, Industry News, Legislative News, Medicare Advantage/Part D Prescription, Medicare Information

CMS NEWS: CMS proposes Medicare Advantage and Part D payment and policy updates to provide new benefits for enrollees

Yesterday, the Centers for Medicare & Medicaid Services (CMS) released proposed changes effecting the 2019 Medicare health and drug programs. These changes hope to increase flexibility in the plans by allowing more options and new benefits that are tailor to the beneficiary to improve

Posted in Helpful Tips, Industry News, Legislative News, Medicare Advantage/Part D Prescription, Medicare Information

CMS Kicks-off campaign to prepare for New Medicare Cards for Seniors.

On Tuesday, May 30, 2017, CMS kicked-off a multi-faceted outreach campaign to help providers get ready for new Medicare cards. The Centers for Medicare & Medicaid Services (CMS) is preparing a fraud prevention initiative that removes Social Security numbers from

Posted in Legislative News