Do you have to have Medicare Part B?
You have to have Part B to even sign up for a Medicare Advantage plan and must pay those premiums. If your employer offers retiree drug coverage, and you pay for it separately and apart from any Medicare coverage or charges, you would not pay IRMAA surcharges on that drug plan.
Does Medicare Part A cover hospital expenses?
According to the Social Security Administration, which handles a lot of Medicare administrative work, your Part A will cover you for hospital expenses received in the United States. The last time I looked, however, it was impossible to be hospitalized without being treated by health care providers!
What is provider directories?
Provider directories are commonly posted online as PDFs or other “flat file” formats. But most Affordable Care Act (ACA) marketplaces (both state and federally managed) require that they be available in machine-readable formats, which can be easily downloaded and read by computers to identify information that is likely incorrect. ...
Is the provider directory inaccurate?
The information in health plans’ provider directories is often inaccurate. A 2018 report from the Centers for Medicare and Medicaid Services (CMS) found that 52 percent of physician listings in Medicare Advantage (MA) provider directories contained at least one inaccuracy. Typical errors include wrong phone numbers;
What is Slide 18 in the CY 2017 Directory webinar?
Slide 18 in the CY 2017 Directory webinar presentation offers a few examples of how MMPs can demonstrate compliance with the cultural competence training requirement (see footnote 1). One useful source of information for cultural competence resources and training is the U.S. Department of Health and Human Services’ Think Cultural Health website, which
What is the MMP guidance?
MMPs should refer to the guidance in the January 17, 2017, HPMS memorandum “Provider Directory Policy Updates,” which will be incorporated into Chapter 4 of the Medicare Managed Care Manual at a later date. MMPs must keep both hardcopy and online provider directories up to date. MMPs may determine the best method to ensure up-to-date directories, and regular outreach to individual providers (e.g., quarterly) is one way to assist
What is CMS CY 2017?
As discussed in the “Announcement of Calendar Year (CY) 2017 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter,” CMS is aware of pilot programs being tested by some Medicare health plans to use new technology to simplify the process of updating provider directories for physicians and other network participants.8 We are supportive of industry efforts to improve provider directories and encourage health plans and providers to continue to work collaboratively to develop more effective and efficient methods of maintaining accurate provider directories.
Do all disclaimers have to be in all directories?
All required disclaimers must be present in all published Directories. MMPs typically satisfy this requirement in the online format by posting on the Directory webpage either a simple listing of disclaimers or a supplemental PDF with disclaimers and any introductory language. An example of the latter is found on slide 14 of the CY 2017 Directory webinar presentation (see footnote 1).