Thursday, October 8, 2009

Making Sense of 2010 Enrollment and Disenrollment Guidance from CMS

CMS recently released their updated 2010 guidance for Enrollment and Disenrollment.  A surprise awaited with a new model enrollment forms (exhibit 1 and 1a) along with new notices.

There are also NEW MA exhibits 34, 35, 36 and NEW PDP exhibits 33, 34, 35.  

Exhibit 33

NEW! PDP Model Notice to Research Potential Out of Area Status

Exhibit 34

NEW! PDP Model Notice for Disenrollment Due Out of Area Status (No Response to Request for Address Verification)

Exhibit 35

NEW! PDP Notice of Disenrollment Due to Out of Area Status (Upon New Address Verification from Member)

As with any guidance from CMS, the first step is identifying what’s new, then moving forward with an analysis of how it will change your business; what it could add, change or remove for your processes.

We’ll be providing more on these guidelines as enrollment deadlines approach.


Pam Argeris is a thought leader in the Healthcare Industry and possesses extensive, hands-on experience with CMS compliance, and multiple regulatory bodies such as NCQA, JACHO, and DOI. In her role at Merrill Corp., Pam focuses on developing solutions for compliance and quality assurance, delivered in a cost effective manner to improve beneficiary and prospect communications. You can contact Pam at

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