Expertise & Administrative Support for Maximum Subsidy Payments

Subsidy Applications – Actuarial Attestations – Reporting Requirements

Subsidy Payment Requests – Final Reconciliation – Individual Communications

NEWS FOR ALL EMPLOYERS:

Early Retiree Reinsurance Program (Updated 5/6/10):  Please view this announcement for important information on this new program.

CMS Announcement: Important Reconciliation Deadline Information (Update 2/5/10)
View Announcement

Medicare Part D 2010 Data Spotlight: A Comparison of PDP's Offering Basic and Enhanced Benefits (Updated: 1/4/10)
Read the Full Article.

Bad Mules: A Primer on the Federal and Michigan False Claims Acts (Updated 12/7/09)
Learn more about what is being done to fight fraud and abuse in Medicare and Medicaid.  Read the Full Article.

CMS Proposes Regulatory Changes to Medicare Part D (Updated 10/30/09)
Group Health Plan Sponsors should be aware of several proposed policy changes to Medicare Part D submitted by CMS.  The primary goal appears to be an improvement to payment rules and the coordination of benefits.  CMS is looking to require Part D Prescription Drug Plans to report credible and changed payor information to the COB contractors and require those Plans to coordinate with providers on adjustments, underpayment reimbursements and overpayment recoveries.  They are also proposing filing deadlines to coordinate these benefits with other entities.  For questions about how this may affect your Group Health Plan and its Medicare participants, please feel free to contact Part D Advisors here.  For the full legislation, please see the link below.
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Part D Plan Availability in 2010 and Key Changes Since 2006 (Updated 10/13/09)
Read Full Article

CMS Announcement: Medicare Prescription Drug Plan Prices to Increase (Updated 8/20/09)
This change may require Medicare beneficiaries to enroll in new plans.  Read the full announcement here.

RDS User Guide (Updated 7/31/09)
The RDS has published a complete user guide, packed with helpful tips and educational resources.  Download it here.

2010 Threshold and Limit Adjustment Values Have Been Announced
The CMS is required to announce the Medicare Part D standard defined benefit amounts each year that reflect the increases in drug costs.  2010 Cost Threshold will be: $310.00, and 2010 Cost Limit will be: $6,300.00.  Read the announcement here.

CMS Requests Comments: Proposed Changes to RDS Subsidy Calculation
(Updated 2/11/09)
Full Article

OIG BEGINS AUDITS FOR RDS PLAN SPONSORS (Updated 2/6/09)
The Office of the Inspector General (OIG) has completed the first complete audit for an RDS Plan Sponsor.  The audit was incredibly thorough and lasted nearly five months. During this time the OIG worked to dissect each aspect of the Plan Sponsor's subsidy recovery process including a review of an outside vendor who reported costs to the RDS on their behalf.  Read the report here.

RDS Announces New Guidance On Rebates and Proposed Revisions to RDS-Related Regulations in the Federal Registrar (Updated 1/15/09)
Updated Guidance

GAO Report Finds: Private Fee-for-Service Plans Experiencing High Disenrollment Rates (Updated 12/17/08)
Full Article

The Medicare Retiree Drug Subsidy Faces Increased Scrutiny:
Read more about upcoming CMS audits and the steps you can take to prepare at the link below.  (Updated 10/8/08)
Full Article

Third Party Administrator Alliance (TPAA) Makes Part D Advisors a Preferred Partner
"We're committed to giving our members access to the best in the business, and Part D Advisors passed the test.  I don't know of anyone else who provides the 'soup to nuts' service they do, and certainly no one who does it as well.  I am pleased to have them on the TPAA team." - TPAA President Mark Oelschalger  (Updated 10/1/08)
Read the Full Article at www.TheTPAA.com