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Medicare Blog | Medicare News | Medicare Information

AHIP Warns of Part D Rebate Rule Impact

Posted by www.psmbrokerage.com Admin on Mon, Aug 03, 2020 @ 03:55 PM


AHIP Warns of Part D Rebate Rule Impact

Prescription Drugs

The average basic premium for Medicare Part D prescription plans will be the second lowest average Part D premium since 2013, CMS announced. But industry leaders are not expressing as much optimism about the lower premiums as CMS.

AHIP acknowledged the current Part D average basic premium is one of the lowest since 2013, but the payer organization pointed out the effects the rebate rule could have in continuing savings on out-of-pocket health care costs.

The week before the Administration announced the average basic premium for 2021, the Trump administration signed three executive orders that placed restrictions on pharmacy benefit managers and sought to heighten drug importations. Through these measures, the executive orders aimed to lower drug prices.

AHIP, using CMS statistics, argued the executive orders would instead cause Medicare premiums to rise by 25%, up drug spending in Medicare programs by over $195 billion, and contribute $100 billion toward bailing out drug makers.

AHIP argues, "the Problem Is Still the Price. But nothing in the proposed rule would require Big Pharma to lower their prices."

"We’re winning great savings for seniors. But with the rebate rule, seniors will lose. Let’s focus on real, bipartisan solutions to out-of-control drug costs. In the midst of the COVID-19 crisis – seniors deserve those savings more than ever."

SOURCE

Tags: Medicare Part D, Part D, AHIP

Part D Premiums to Increase Slightly in 2021

Posted by www.psmbrokerage.com Admin on Mon, Aug 03, 2020 @ 11:29 AM


Part D Premiums to Increase Slightly


Medicare Part D - A First Look at Prescription Drug Plans in 2020 123

Part D premiums are set to take a slight uptick in 2021, according to CMS, which estimates the average premium in Part D will be $30.50 next year, a slight increase from $30 in 2020, but still the second-lowest premium rate ever.

Part D premiums have been on a steady decline over the past several years, decreasing by 12% since 2017. Part D enrollment increased alongside declining premiums, with enrollment increasing by 16.7% since 2017.

Part D enrollment has increased alongside declining premiums, CMS said, with enrollment increasing by 16.7% since 2017.

CMS also touted Trump administration efforts to curb costs for Part D beneficiaries, such as launching the Part D Senior Savings Model earlier this year, in which participating Part D plans will offer insulin with a cap at $35 for a monthly supply.

CMS also eliminated the so-called pharmacy "gag clause," which prevented pharmacists from providing beneficiaries with information on alternative, less expensive ways to purchase drugs than through their Part D plan.

President Donald Trump also signed four executive orders targeting drug pricing late last week, including one that aims to revive the scuttled rule that would nix anti-kickback safe harbors for drug rebates in Part D.

More information on the Part D Senior Savings Model can be viewed at: https://innovation.cms.gov/initiatives/part-d-savings-model.

Tags: Medicare Part D, Part D

Enroll Your Medicare Clients Via Text Message

Posted by www.psmbrokerage.com Admin on Wed, Jul 15, 2020 @ 10:55 AM

Tags: Online Enrollment, Medicare Advantage, Part D, YourMedicare

2021 Medicare Advantage and Part D Commission Rates

Posted by www.psmbrokerage.com Admin on Wed, Jun 03, 2020 @ 09:44 AM

Medicare Advantage and Part D Commission Rates


Medicare Advantage Organizations, Prescription Drug Plan Sponsors, Section 1876 Cost Plans, and Medicare-Medicaid Plans

SUBJECT: Contract Year 2021 Agent and Broker Compensation Rate, Referral/Finder’s Fees, Submissions, and Training and Testing Requirements

This memorandum provides contract year (CY) 2021 compensation and referral/finder’s fee limits for agents and brokers, directions for submitting amounts into the Health Plan Management System (HPMS), as well as training and testing requirements.

Compensation Rates and Referral/Finder’s Fees for CY 2021

As provided the compensation amount an organization pays to an independent agent or broker for an enrollment must be at or below the fair market value (FMV) cut-off amounts published yearly by the Center for Medicare and Medicaid Services (CMS).


The CY 2021 FMV cut-off amounts for all organizations are as follows:

Maximum Broker Compensation for 2021
Medicare Advantage Maximum Broker Compensation for 2021

Agent Fair Market Value Payment History:
Agent Fair Market Value Payment History

NOTE: The FMV amounts for CY 2021 may be rounded to the nearest dollar. The Initial Year amount is the maximum allowable amount that organizations may pay for enrollments during compensation cycle-year 1.

The renewal amount is the maximum allowable amount that organizations may pay for enrollments during compensation cycle-years 2 and beyond.

 

Additional Updates:
 

Tags: Medicare, Part D, medicare advantage enrollment,

AHIP 2021: New Training Layout for the Marketing Medicare Advantage + Fraud, Waste and Abuse Program

Posted by www.psmbrokerage.com Admin on Thu, Apr 30, 2020 @ 10:14 AM

Tags: Medicare Advantage, Part D, AHIP, 2021

SEP Notice for Individuals Affected by Severe Weather

Posted by www.psmbrokerage.com Admin on Tue, Apr 07, 2020 @ 03:28 PM

Tags: Medicare Advantage, CMS, Part D

Medicare Flexes And Changes To Meet The COVID-19 Challenges

Posted by www.psmbrokerage.com Admin on Tue, Apr 07, 2020 @ 02:00 PM

Tags: Medicare Advantage, Medicare, Part D, COVID-19

Medicare Advantage plans will get a 1.66% pay bump for 2021

Posted by www.psmbrokerage.com Admin on Tue, Apr 07, 2020 @ 01:54 PM

Tags: Medicare Advantage, Medicare, Part D

CMS FACT SHEET: 2021 Medicare Advantage and Part D Rate Announcement

Posted by www.psmbrokerage.com Admin on Tue, Apr 07, 2020 @ 01:47 PM

Tags: Medicare Advantage, Medicare, Part D

Grow Your Medicare Sales with PSM

Posted by www.psmbrokerage.com Admin on Tue, Dec 31, 2019 @ 09:42 AM

Additional Updates:
 

Tags: Medicare Advantage, Medicare Supplement, Leads, Medicare Sales, Part D, Enrollment Tools, Medicare FMO, online sales

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