Anthem News – Bon Secours Mercy Health Update

Bon Secours Mercy Health is staying in Anthem’s Medicare Advantage network in Ohio.

Anthem announced that they reached an agreement with Bon Secours Mercy Health to keep them in their Medicare Advantage network. They have secured a a new long-term contract, ensuring members will have in-network access for years to come.

Anthem is sending letters to impacted members to share this good news. If members already moved to a new provider, they can stay with them or switch back to Bon Secours Mercy Health.

Please visit anthem.com/MercyHealthOhio for the latest information.

2024 Wellcare Kits Ordering Delay

CustomPoint – 2024 Sales Materials Ordering to Begin Friday, September 29, 2023

In an effort to fulfill all of the 2024 sales material pre-orders first, the CustomPoint portal will open for general ordering of sales materials on Friday, September 29, 2023, instead of Wednesday, September 27 as previously communicated.

We apologize for any inconvenience this may cause and appreciate your patience and understanding.  Please contact your Cornerstone Senior Marketing Service Team if you have any questions.

Cigna: New Way To Submit Your HRA’s for 2024

The enhancements will make your selling experience easier than ever before.

Cigna’s Value Based Enrollment (VBE) initiative continues to be a successful and well-received program among Cigna Healthcare agents.

As part of this program, agents can earn $75 or $125 (depending on the plan) for facilitating Health Risk Assessments (HRAs) with their eligible customers, which means more money in their pocket!

New Way to Access HRAs

Cigna has heard your feedback and have worked to make HRA facilitation easier and faster than before.

Starting on September 29, 2023, you will be able to access Cigna Healthcare’s HRA in the following locations:

• SunFire or ConnectureDRX: HRA embedded in each program for agents that are fully integrated into the respective vendor platform.
• Cigna for Brokers: For non-SunFire users and/or non-Connecture agency partners – Use single sign-on to access SunFire HRA via the “Health Risk Assessment” link in the Tools section.
• eEnrollment: Embedded at the end of the customer enrollment process (i.e., via SunFire HRA widget – HRA will be embedded directly within eEnrollment).

 

Current HRA Tool – Icario

You can continue to use the Icario tool to facilitate HRAs with your customers until January 1, 2024. After this date, Icario will no longer be available to facilitate HRAs, but you will be able to use the new tools listed above – SunFire and ConnectureDRX.

What is a Health Risk Assessment (HRA)?

 

The Health Risk Assessment (HRA) is a tool that helps the health plan assess a customer’s needs by asking a series of health-related questions. Answers are used to partner with health care providers and to develop a plan of care.

 

Facilitating an HRA for your customers provides you an additional opportunity to engage with them and solidify your relationship. It also helps jump start the customer’s journey, engagement, and utilization of Cigna Healthcare’s services resulting in increased retention and improved outcomes for the customer.

 

If you facilitate an HRA for your customers, you are eligible to receive payment, which varies depending on the plan they enroll in.

 

What Medicare plan types are eligible for the VBE HRA payment?

 

The HRA payment will be made for new Medicare Advantage customers, and voluntary customer plan changes that result in active Cigna Healthcare customers.

 

Agents earn $125 when facilitating an HRA with D-SNP and C-SNP customers, and $75 for all other Cigna Healthcare MAPD customers.

 

Prerequisites and Requirements

To be authorized to facilitate the VBE HRA, you must:

• Complete VBE HRA training via Producers’ University. (VBE HRA training is no longer a separate or standalone course – we have embedded the content as a downloadable PDF in Our Compliance Program.)
• Qualify as ‘Ready to Sell’ to complete the enrollment application with the customer.

After you complete the VBE HRA training, you will receive access to Cigna Healthcare’s electronic HRA within 24-72 hours (if you are ‘Ready to Sell’).

Deadlines to Submit HRAs

You must facilitate the HRA with the customer and submit the completed HRA in the portal, within ten (10) calendar days of the customer’s application sign date, in order to ensure a positive customer experience.

As a best practice, you should obtain the HRA immediately after completing the customer’s application for enrollment. Otherwise, we recommend confirming your next appointment with the customer with the date and time details, prior to making the next outreach.

You’ll have until December 22, 2023 to submit the HRA for any customer applications taken from October 1 – December 7 of 2023.

More Stores Are Now Available With Anthem’s Grocery Benefits

Sourced from Anthem broker eblast on 9/11/23:

Anthem Medicare Advantage members now have more choices when using their Grocery benefit allowance.

Your clients can now shop in the following stores for Grocery benefits:

Hy-Vee
Publix
HEB
Central Market
H-Mart
Piggly Wiggly
County Market
Harvest Market
Save A Lot
Woodman’s
Sedano’s
Presidente
Winn-Dixie
Fresco y Más
Harveys Supermarket
Hannaford
Stop & Shop
Food Lion
Giant
Giant Food
Giant Heirloom Market
Giant to Go
Martin’s

These stores are now available for using the Grocery benefit only.

For a complete list of local grocery stores, members can log in to MyBenefits.NationsBenefits.com, select the Flex menu and then select Store Locator. The Store Locator will include the newly added stores starting on 9/14/2023.

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 

NAIFA-FSP-Life Happens Announce Intent to Merge

Organizations Unite to Better Serve the Industry

The three organizations have publicly announced their intent to integrate operations to better serve the industry and the American people. The respective boards of all three organizations voted to move forward with merging together pending an overall vote by the membership.

View 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 

KFF Release – 30% Increase in Bonus Payments to MA Insurers

Medicare Advantage insurers will collect at least $12.8 billion in Federal Bonus Payments in 2023—a nearly 30% increase from 2022

New KFF analyses highlight trends in enrollment, benefits and cost-sharing, and bonus payments for Medicare Advantage Plans

Federal spending on bonus payments to insurance companies that offer Medicare Advantage plans will reach at least $12.8 billion in 2023, according to a new KFF analysis. That is a nearly 30% increase from 2022, and more than quadruple the spending in 2015.


These data come from one of three analyses released today by KFF that examine various facets of the Medicare Advantage program, which provides health insurance coverage to nearly 31 million Americans. KFF examined trends in enrollment, premiums, out-of-pocket limits, cost sharing, supplemental benefits, prior authorization, star ratings and bonus payments.

READ THE FULL ARTICLE

CMS Responding to Data Breach at Contractor

CMS Notifying Potentially Involved Beneficiaries and Providing Information on Free Credit Monitoring

The Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have responded to a May 2023 data breach in Progress Software’s MOVEit Transfer software on the corporate network of Maximus Federal Services, Inc. (Maximus), a contractor to the Medicare program, that involved Medicare beneficiaries’ personally identifiable information (PII) and/or protected health information (PHI). No HHS or CMS systems were impacted. Maximus is among the many organizations in the United States that have been impacted by the MOVEit vulnerability. This week, CMS and Maximus are sending letters to individuals who may have been impacted notifying them of the breach, and explaining actions being taken in response. CMS estimates the MOVEit breach impacted approximately 612,000 current Medicare beneficiaries.

CMS and Maximus are notifying Medicare beneficiaries whose PII and/or PHI may have been exposed that they are being offered free-of-charge credit monitoring services for 24 months. This notification also contains information about how impacted individuals can obtain a free credit report, and, for those beneficiaries whose Medicare Beneficiary Identifier number may have been impacted, information on receiving a new Medicare card with a new number.

Below please find a sample of the letter being sent to those who are potentially affected:

 

Dear <<Name 1>>

The Centers for Medicare & Medicaid Services (CMS), the federal agency that manages the Medicare program, and Maximus Federal Services, Inc. (Maximus), are writing to inform you of an incident involving your personal information related to services provided by Maximus. Maximus is a CMS contractor that provides appeals services in support of the Medicare program.

The incident involved a security vulnerability in the MOVEit software, a third-party application which allows for the transfer of files during the Medicare appeals process. Maximus is among the many organizations in the United States that have been impacted by the MOVEit vulnerability.

We are sending you this letter so that you can understand more about this incident, how we are addressing it, and additional steps you can take to further protect your privacy. We are providing information with this notice on free credit monitoring services and, if your Medicare Beneficiary Identifier (MBI) was impacted, will be giving you a new Medicare card with a new Medicare Number. This does not impact your current Medicare benefits or coverage.

What Happened?

Our understanding is as follows:  On May 30, 2023, Maximus detected unusual activity in its MOVEit application. Maximus began to investigate and stopped all use of the MOVEit application early on May 31, 2023. Later that same day, the third-party application provider, Progress Software Corporation, announced that a vulnerability in its MOVEit software had allowed an unauthorized party to gain access to files across many organizations in both the government and private sectors.

Maximus notified CMS of the incident on June 2, 2023. To date, the ongoing investigation indicates that on approximately May 27 through 31, 2023, the unauthorized party obtained copies of files that were saved in the Maximus MOVEit application, but that no CMS system has been compromised. After notifying CMS, Maximus then began to analyze the files to determine which data had been affected. As part of that analysis, it was determined that those files contained some of your personal information.

What Information Was Involved?

We have determined that your personal and Medicare information was involved in this incident. This information may have included the following:

  • Name
  • Social Security Number or Individual Taxpayer Identification Number
  • Date of Birth
  • Mailing Address
  • Telephone Number, Fax Number, & Email Address
  • Medicare Beneficiary Identifier (MBI) or Health Insurance Claim Number (HICN)
  • Driver’s License Number and State Identification Number
  • Medical History/Notes (including medical record/account numbers, conditions, diagnoses, dates of service, images, treatments, etc.)
  • Healthcare Provider and Prescription Information
  • Health Insurance Claims and Policy/Subscriber Information
  • Health Benefits & Enrollment Information

What Are We Doing?

When the incident was discovered, Maximus began an investigation, took the MOVEit application offline, applied MOVEit software patches, and notified law enforcement. CMS is continuing to investigate this incident in coordination with Maximus and will take all appropriate actions to safeguard the information entrusted to CMS.

What Can You Do?

  1. Enroll in Experian Identity and Credit Monitoring Services

Maximus is offering a complimentary 24 months of credit monitoring and other services from Experian at no cost to you. You do not need to use your credit card or any other form of payment to enroll in the service.

Please see Attachment #1 for information on how to utilize your free Experian Services.

  1. Obtain a Free Credit Report

Under federal law, you are entitled to one free credit report every 12 months from each of the three major nationwide credit reporting companies listed above. Call 1-877-322-8228 or request your free credit reports online at www.annualcreditreport.com. When you receive your credit reports, review them for problems. Identify any accounts you didn’t open or inquiries from creditors that you did not authorize. Verify all information is correct. If you have questions or notice incorrect information, contact the credit reporting company.

Even if you don’t find any suspicious activity on your initial credit reports, the Federal Trade Commission (FTC) recommends that you still check your credit reports periodically. Checking your credit report periodically can help you spot problems and address them quickly.

If you find suspicious activity on your credit reports or have reason to believe your information is being misused, call your local law enforcement agency and file a police report. Be sure to obtain a copy of the police report, as many creditors will want the information it contains to absolve you of the fraudulent debts. You may also file a complaint with the FTC by contacting them on the web at www.ftc.gov/idtheft, by phone at 1-877-IDTHEFT (1-877-438-4338), or by mail at Federal Trade Commission, Consumer Response Center, 600 Pennsylvania Avenue, NW, Washington, DC 20580. Your complaint will be added to the FTC’s Identity Theft Data Clearinghouse, where it will be accessible to law enforcement for their investigations. In addition, you may obtain information from the FTC about fraud alerts and security freezes.

Please see Attachment #2 for additional steps you can take to protect your information.

  1. Continue to Use Your Existing Medicare Card

At this time, we are not aware of any reports of identity fraud or improper use of your information as a direct result of this incident. However, if your MBI was impacted, a new Medicare card with a new number will be issued to you. CMS will mail the new card to your address in the coming weeks. In the meantime, you can continue to use your existing Medicare card. After you get your new card, you should:

  1. Follow the instructions in the letter that comes with your new card.
  2. Destroy your old Medicare card.
  3. Inform your providers that you have a new Medicare Number.

For More Information

We take the privacy and security of your Medicare information very seriously. CMS and Maximus apologize for the inconvenience this privacy incident might have caused you.

If you have any further questions regarding this incident, please call the Experian dedicated and confidential toll-free response line at xxx-xxx-xxxx. This response line is staffed with professionals familiar with this incident who know what you can do to protect against misuse of your information. The response line is available Monday through Friday from 8 am – 10 pm Central, or Saturday and Sunday from 10 am – 7 pm Central (excluding major U.S. holidays).

You can also call 1-800-MEDICARE (1-800-633-4227) with any general questions or concerns about Medicare.

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Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter @CMSgov

 

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