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

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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.

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

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

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 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

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

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

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 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

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

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

Special Needs Plans CY 2013 Application Cycle CY 2013: All D-SNPs are required to submit State Medicaid Agency Contracts by July 1, 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

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

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, 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

Questions State Resource Center sourceCenter.asp#TopOfPage sourceCenter.asp#TopOfPage SNP MailBox: CMS 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