Presentation is loading. Please wait.

Presentation is loading. Please wait.

Medicare Advantage Special Needs Plans CY 2012 Landscape and CY 2013 Application Review Preparation October 28, 2011 Deanna Greene, Acting Director Division.

Published byWinfred Brooks Modified over 8 years ago

Similar presentations

Presentation on theme: "Medicare Advantage Special Needs Plans CY 2012 Landscape and CY 2013 Application Review Preparation October 28, 2011 Deanna Greene, Acting Director Division."— Presentation transcript:

1 Medicare Advantage Special Needs Plans CY 2012 Landscape and CY 2013 Application Review Preparation October 28, 2011 Deanna Greene, Acting Director Division of Medicare Advantage Operations Susan Radke, SNP Team Lead Division of Medicare Advantage Operations MAY CONTAIN INFORMATION THAT IS NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.

2 Overview MA –PD Landscape in CY 2012 SNP Landscape in CY2012 D-SNP State Medicaid Agency Contract Review for CY2012 CY 2013 Application Preparations MAY CONTAIN INFORMATION THAT IS NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law. 2

3 MA-PD CY 2012 Landscape The Medicare Advantage (MA)program remains strong and, in 2012, Medicare beneficiaries have a broad array of health care choices. Access to MA is defined as the percent of beneficiaries having at least one plan available in their county of residence Access to Medicare Advantage plans remains the same at 99.7% MAY CONTAIN INFORMATION THAT IS NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law. 3

4 MA-PD CY 2012 Landscape Only 1% (321,000) of MA and PDP enrollees will be losing coverage at the end of 2011 because of their plan will not be offered in 2012. More than 99% of affected consumers will have other MA plan choices available in their area. MAY CONTAIN INFORMATION THAT IS NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law. 4

5 Special Needs Plans CY 2012 Application Approvals Similarly, beneficiaries enrolled in MA- PD Special Needs Plans continue to have access to SNPs in their areas. 361 SNP applications for CY 2012 approved 64 Chronic Condition SNPs 51 I-SNPs 246 D-SNPs MAY CONTAIN INFORMATION THAT IS NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law. 5

6 2012 SNP Breakdown Percentage of SNP Types MAY CONTAIN INFORMATION THAT IS NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law. 6

7 D-SNP CY 2012 State Medicaid Agency Contract Review 111 D-SNP PBPs (91 H numbers) with State Medicaid Agency contracts were approved this year for operation in CY 2012. Over the past year, CMS tested operational policy regarding the July 1, 2011 state contract submission deadline. MAY CONTAIN INFORMATION THAT IS NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law. 7

8 D-SNP CY 2012 State Medicaid Agency Contract Review The July 1st deadline allows: CMS to review the contracts; Plans and States to correct deficiencies in advance of when D-SNPs must be approved for plan listing in the Medicare & You Handbook, the Medicare Plan Finder, and on Medicare.gov MAY CONTAIN INFORMATION THAT IS NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law. 8

9 D-SNP CY 2012 State Medicaid Agency Contract Review All D-SNPs’ State Medicaid Agency Contracts were approved by CMS Medicare Advantage September deadline. Joint collaboration with CMS CO and RO to provide a consistent message to SNPs on application and State Medicaid contract issues. MAY CONTAIN INFORMATION THAT IS NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law. 9

10 Special Needs Plans CY 2013 Application Cycle CY 2013: All D-SNPs are required to submit State Medicaid Agency Contracts by July 1, 2012. MAY CONTAIN INFORMATION THAT IS NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law. 10

11 Central and Regional Offices are currently working together to: Refine the SNP Proposal / Application in HPMS (to include deficiency notes) ; Refine renewal submission of the MOC; Refine the State Medicaid Agency Contract Review. MAY CONTAIN INFORMATION THAT IS NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law. 11 CO and RO CY 2013 Application Preparations

12 CY 2013 SNP Application Preparations Notice of Intent to Apply CMS released the Notice of Intent to Apply (NOIA) memo in HPMS on October 21, 2011. MA-PD plans that intend to offer a new SNP needs to submit a NOIA to ensure HPMS access by 11/11/2011. Any SNP that intends to expand its service area also needs to submit a NOIA 11/11/2011 or no later than 2/7/2012. MAY CONTAIN INFORMATION THAT IS NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law. 12

13 Questions State Resource Center https://www.cms.gov/SpecialNeedsPlans/05_StateRe sourceCenter.asp#TopOfPage https://www.cms.gov/SpecialNeedsPlans/05_StateRe sourceCenter.asp#TopOfPage SNP MailBox: CMS SNP_Mail@cms.hhs.gov Contacts: Susan Radke, SNP Team Lead Lavern Baty Eric Nevins Melissa Staud Mervyn John Caroline Farrell (0n detail) MAY CONTAIN INFORMATION THAT IS NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law. 13

Download ppt "Medicare Advantage Special Needs Plans CY 2012 Landscape and CY 2013 Application Review Preparation October 28, 2011 Deanna Greene, Acting Director Division."

Similar presentations

MEDICAID MANAGED CARE: OPPORTUNITIES AND IMPLICATIONS OF STATE EXPANSIONS FOR SPECIAL NEEDS PLANS James M. Verdier Mathematica Policy Research, Inc. National.

MEDICAID MANAGED CARE: OPPORTUNITIES AND IMPLICATIONS OF STATE EXPANSIONS FOR SPECIAL NEEDS PLANS James M. Verdier Mathematica Policy Research, Inc. National.
Www.medicareadvocacy.org Copyright © Center for Medicare Advocacy, Inc. CENTER FOR MEDICARE ADVOCACY, INC. MEDICARE ADVANTAGE: 2010 AND BEYOND _____________.

Copyright © Center for Medicare Advocacy, Inc. CENTER FOR MEDICARE ADVOCACY, INC. MEDICARE ADVANTAGE: 2010 AND BEYOND _____________.
1 Guidance for Organizations Interested in Offering Capitated Financial Alignment Demonstration Plans Medicare-Medicaid Coordination Office Vanessa Duran,

1 Guidance for Organizations Interested in Offering Capitated Financial Alignment Demonstration Plans Medicare-Medicaid Coordination Office Vanessa Duran,
Convenient Access to Retail Pharmacies - Analysis on Preferred Cost-Sharing Pharmacy Networks December 16 & 17, 2014 Division of Benefit Purchasing and.

Convenient Access to Retail Pharmacies - Analysis on Preferred Cost-Sharing Pharmacy Networks December 16 & 17, 2014 Division of Benefit Purchasing and.
The Hilltop Institute was formerly the Center for Health Program Development and Management. Medicaid and Medicare Cross-Payer Effects June 17, 2009 Tony.

The Hilltop Institute was formerly the Center for Health Program Development and Management. Medicaid and Medicare Cross-Payer Effects June 17, 2009 Tony.
Special Needs Plans Medicare and Medicaid Plans CY 2015 Model of Care Submission Training January 21, 2014 Susan Radke.

Special Needs Plans Medicare and Medicaid Plans CY 2015 Model of Care Submission Training January 21, 2014 Susan Radke.
HMO Special Needs Plan (SNP) BlueCare Plus Tennessee, an Independent Licensee of the BlueCross BlueShield Association BlueCare Plus Tennessee is an HMO.

HMO Special Needs Plan (SNP) BlueCare Plus Tennessee, an Independent Licensee of the BlueCross BlueShield Association BlueCare Plus Tennessee is an HMO.
1 CMS 2012 Medicare Advantage & Prescription Drug Plan Spring Conference Special Needs Plans Update April 12, 2012 LaVern W. Baty, M.H.S. Susan Radke,

1 CMS 2012 Medicare Advantage & Prescription Drug Plan Spring Conference Special Needs Plans Update April 12, 2012 LaVern W. Baty, M.H.S. Susan Radke,
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential.

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential.
California Medicare Coalition Medicare and Part D: Who Regulates What? Federal and State Responsibilities The California Medicare Coalition is supported.

California Medicare Coalition Medicare and Part D: Who Regulates What? Federal and State Responsibilities The California Medicare Coalition is supported.
2013 Special Needs Plans Model of Care Audits: Best Practices & Lessons Learned Medicare Advantage Special Needs Plans Educational Session Baltimore, MD.

2013 Special Needs Plans Model of Care Audits: Best Practices & Lessons Learned Medicare Advantage Special Needs Plans Educational Session Baltimore, MD.
Renewal Plans & Strategies National Academy for State Health Policy Enrollment 2014 FFM States Ancillary Meeting October 6, 2014 11:00am-12:00pm ET This.

Renewal Plans & Strategies National Academy for State Health Policy Enrollment 2014 FFM States Ancillary Meeting October 6, :00am-12:00pm ET This.
National Fraud Prevention Program: Analytics in Medicare and Medicaid Center for Program Integrity Centers for Medicare & Medicaid Services Department.

National Fraud Prevention Program: Analytics in Medicare and Medicaid Center for Program Integrity Centers for Medicare & Medicaid Services Department.
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential.

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential.
Medicare Part D: 2007 Presented by MMA Project Team Oregon Dept. of Human Services.

Medicare Part D: 2007 Presented by MMA Project Team Oregon Dept. of Human Services.
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential.

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential.
Mercy Care Advantage HMO SNP

Mercy Care Advantage HMO SNP
© 2005 National Mental Health Association The Medicare Drug Benefit: What Is It and What Does it Mean for Mental Health? Get Educated, Get Enrolled An.

© 2005 National Mental Health Association The Medicare Drug Benefit: What Is It and What Does it Mean for Mental Health? Get Educated, Get Enrolled An.
Enrollment Guidance for Medicare Part D Plans Presented by America’s Health Insurance Plans (AHIP) and The National Association of Health Underwriters.

Enrollment Guidance for Medicare Part D Plans Presented by America’s Health Insurance Plans (AHIP) and The National Association of Health Underwriters.
Cal MediConnect Martha Smith

Cal MediConnect Martha Smith

Similar presentations

Ads by Google