GAO Reports: Medicare Part D: CMS Should Monitor Effects of Rebates on Plan Formularies and Beneficiary Spending

GAO-23-105270 Published: Sep 05, 2023. Publicly Released: Sep 05, 2023.

Fast Facts

Medicare beneficiaries can have prescription drugs covered via private insurance plans participating in the Medicare Part D program. Premiums and drug costs vary by plan, as do plans’ lists of covered drugs—known as “formularies.”

Drug makers may give plans rebates in exchange for preferred placement over competitors on formularies. The rebates may lower plan premiums, but they don’t reduce beneficiaries’ payments for the drugs.

We found rebates largely went to a small number of drugs, and plans paid less for highly rebated drugs than beneficiaries did.

We recommended that Medicare monitor how rebates affect formularies, beneficiaries, and more.

 

CLICK TO READ FULL ARTICLE 

AHIP Update – this may affect you if you completed AHIP on/before July 31

If you completed your AHIP certification already on or before 7/31/23, you may receive notification via email from AHIP with the heading: Action Needed – CMS Course Updates

Materials have been recently added around the CMS revised and new rules that apply to 2024 Medicare Advantage and Part D plans that require review.  Follow the instructions provided in the email message from AHIP and/or log in to your AHIP Medicare account to review the updated slides then click to confirm you completed the review.  The image below highlights the updates that need reviewing in each of the three affected modules.

Reach out if you have questions.  Email your Cornerstone Senior Marketing Service Team – service@cornerstoneseniormarketing.com 

Anthem’s NEW RTS Screen on Producer Toolbox – Great Resource!

Sourced from Anthem broker email communication:

On July 15, 2023, the Producer Toolbox will introduce a new Ready to Sell (RTS) page that allows brokers to view their RTS status for each state they intend to sell Medicare products.

Brokers will easily be able to see if they are licensed, certified, and appointed with each state – as well as complete any outstanding components they may have.

If you have any questions, please reach out to service@cornerstoneseniormarketing.com 

Now Available with CSG! Med Supp Household Discount Definitions

CSG Actuarial is making it easier to remember carrier Household Discount rules by including definitions in the quoting tool! Quickly view if the carrier’s household discount is Roommate or Multi-Insured.

Roommate: Applicant qualifies for a Household Discount if they are living with another individual over a certain age. Age varies by carrier.

Multi-Insured: Two individuals living in the same household must have a Med Supp policy with the carrier for the discount to apply.

Agents can view the Household Discount percentage and apply the discount to the monthly premium!

 

Don’t miss an incredible opportunity to learn more about the
top Medicare Supplement insurance companies in the market!

Join us Tuesday, July 18 at 9:30 a.m. Central Time as we spotlight these carriers & create carrier heat maps.

REGISTER HERE

Released: 2024 CMS Broker Compensation Rates

Each year CMS publishes the fair market value amounts for initial and renewal compensation for MA and PDP’s, as well as referral fees.

Review the full amounts below for 2024 provided by CMS.

View Full CMS Release

Humana: Member Care Assessment Transition to Health Risk Assessment

Sourced from Humana Broker Email Communication on 6/19/23: 

As annual CMS requirement of those conducting HRA’s, the Model of Care (MOC) training will be rolled out to agents in the Humana Certification and Recertification training starting in PY24.

Be on the lookout for the tool training (Health Care Assessment Training) on Sunfire after cert/recert opens

*** Please note that August 31, 2023 is simply the deadline for the 9/1 start date for HRA. If an agent completes training past 8/31/23 they will still be able to access the Sunfire portal to complete surveys and qualify for compensation as the current program guidelines indicate, we are just highlighting that date to be in line with the roll-out and ensure agents are aware that the training is required to be compensated.***

Important Updates to LeadCENTER – Please Read!

We are excited to announce some significant updates to the LeadCENTER platform that will enhance your lead management experience and empower you to grow your insurance business even further. Below are some of the updates that we are thrilled to share with you:

Design Changes for Enhanced User Experience: We have revamped the design of LeadCENTER to provide you with a more intuitive and streamlined interface. The improved design aims to make lead purchasing and order management a seamless and efficient process. We understand the importance of time in your profession, and these updates will allow you to navigate the platform with ease and speed. To give you a visual demonstration of the design changes, we have created a comprehensive video that showcases the new features and functionalities. Please take a moment to watch the video by clicking on the following link:

WATCH VIDEO

Introducing T-65 Leads: Additionally, in response to numerous requests from our valued users, we are pleased to inform you that we have expanded our lead types to include Turning 65 (T65) Medicare leads. This addition will provide you with a valuable opportunity to target the growing market of individuals transitioning to Medicare. With LeadCENTER, you’ll be able to purchase T65 Medicare leads now conveniently alongside your existing lead types, enabling you to diversify your portfolio and cater to a wider range of clients.

SHOP FOR LEADS

 

Should you have any questions or require further assistance, please don’t hesitate to reach out to our dedicated support team at support@IntegrityLeadCENTER.com. We are here to ensure a smooth transition and provide ongoing support.

Union Security Insurance Co: Important Med Supp Update

Sourced from USIC email communication on 5/17/23:

Effective June 1, 2023 Union Security will be discounting the USIC Medicare Supplement offering in all states.

The Union Security Insurance Company (USIC) Medicare Supplement product, administered by Aetna, will be discontinued as of June 1, 2023.

 

  • We will not accept applications with a signature date after May 31, 2023
  • We will not offer effective dates later than June 1, 2023
  • Agent appointments under USIC will be terminated as of June 1, 2023
  • Paper sales materials for USIC Medicare Supplement plans in all states will be available through today, May 17th, 2023
  • Existing customers will continue to be serviced and offered renewal options
  • Existing policyholders will continue to have access to their account here
  • Agents will continue to be able to access reports and other information from their agent portal here

 

If you have any questions concerning USIC products or contracting please contact your CSM rep.

Cigna’s Value Based Enrollment Program Changes

Sourced from Cigna broker email communication from 5/16/23:

Changes to VBE payments for digital applications starting with June 1 effectives.

At Cigna Healthcare, we believe that the Primary Care Provider (PCP) and patient relationship is of vital importance to drive better health outcomes and increase customer satisfaction and retention.

 

For this reason, we are making changes in how payments are earned through our Value Based Enrollment (VBE) digital application program to further promote the PCP and patient relationship and continue to encourage the collection of a customer email address. This change applies to June 1 effectives and beyond.

 

New VBE payment amounts

Here’s how you can continue to earn up to $50 per approved digital application for new Cigna Healthcare Medicare Advantage (MA) customers:

• Earn $30 for including a valid in-network PCP on the digital application.
• Earn $20 for including a valid customer email address on the digital application.

 

For more information on this change to our VBE program, please feel free to review our VBE Program Broker FAQ after logging in to Producers’ University.

Benefits of this program change

Capturing a customer’s valid PCP and email address at the time of enrollment gives Cigna Healthcare Medicare important information to provide better care for your customers.

Better care results in higher customer satisfaction and retention rates, as well as higher net promoter scores (NPS). This means you can spend more time selling and growing your business and less time addressing customer concerns.

Effective Immediately: UCT Suspends New Product Sales

Important Message

Effective Immediately, UCT is voluntarily suspending the acceptance of new applications for all products due to last quarters filings that showed UCT has dropped below the minimum statutory surplus limit.

Customer service will continue to service existing policies/policy holders/providers. In addition, the processing of claims will not be affected and will continue as usual. 

 

Questions?

Contact your Cornerstone Senior Marketing Team

614-763-2255

service@cornerstoneseniormarketing.com