Annual Medicare Advantage (MA) Open Enrollment Period, during which an individual can enroll in, dis-enroll from, or change Medicare Advantage plans, including Dual Eligible Special Needs Plans (D-SNPs) and Medicare-Medicaid Plans (MMPs).
Updated CY 2020 Medicare Part C and D star ratings released.[i]
[i] States can use the various Part C and D measures in the MA star ratings to assess the quality and performance of MA plans operating in their state. Note that the star ratings are assigned at the contract level, not at the individual plan level. A single MA contract may include more than one type of SNP as well as non-SNP MA plans. For more information, see the ICRC tip sheet “How States Can Use Medicare Advantage Star Ratings to Assess D-SNP Quality and Performance.” Available at: https://www.integratedcareresourcecenter.com/sites/default/files/2020_Medicare_Advantage_Star_Ratings_Guide.pdf
Plan Creation Module, Plan Benefit Package (PBP) module, and Bid Pricing Tool software released in the Health Plan Management System (HPMS); organizations interested in offering a MA, PDP, or MMP product must submit a PBP that accurately describes the coverage details and cost-sharing for all covered benefits by June 1.[i]
[i] States interested in requiring plans to cover certain benefits, including supplemental benefits, will want to have discussions with plans well in advance of the June 1 deadline.
Release of CY 2021 model templates for Final Annual Notice of Change, Evidence of Coverage, LIS rider, Part D Explanation of Benefits, formularies, transition notice, provider directory, pharmacy directory, member identification card and other MMP-specific models. Plans are able to begin uploading these documents for CMS review in July.[i]
[i] To help ensure that these documents represent state policies regarding Medicare-Medicaid integration and accurately describe Medicaid benefits, states may want to review draft templates before plans submit them to CMS.
Deadline for MA and Part D plans to notify CMS of intention to non-renew counties or reduce service area at the contract level.
2021 D-SNP module released for D-SNPs to upload required State Medicaid Agency Contracts (SMACs) and Contract Matrix.
Deadline for all Medicare plans (MA and Part D) to submit CY 2021 bids; plans (including MMPs) deciding not to renew their contracts must notify CMS in writing.
Organizations interested in offering a MA, Part D, or MMP product must submit a PBP that accurately describes the coverage details and cost-sharing for all covered benefits.