CMS Releases 2011 Draft Call Letter

The CMS 2011 Call Letter has a completely different look and feel this year. It is much shorter in both length and scope in how to direct plans and organizations to details with the Medicare Manuals for regulatory guidance and compliance factors.

Highlights of provisions in the Call Letter include:

• Announcements of a combined calendar listing with side-by-side key dates and timelines applicable to MA, MA-PD, Part D and cost-based plans. The calendar contains important operational dates for plans, such as the date that CMS will begin accepting bids, dates for non-renewing plans, and dates for beneficiary mailings.

• A provision encouraging sponsor practices to curb waste of unused drugs dispensed in the retail setting, information about reassignment, information about the release of data, information on the Medicare Enrollment Assistance Demonstration, and information on potential new B versus D coverage determination for beneficiaries with ESRD.

Jonathan Blum, Acting Director, Center for Drug and Health Plan Choice, writes this as a synopsis of the draft:

Attachment VI provides the draft CY 2011 Call Letter for Medicare Advantage (MA) organizations (MAOs); section 1876 cost-based contractors; prescription drug plan (PDP) sponsors; demonstrations; Programs of All-Inclusive Care for the Elderly (PACE) organizations; and employer and union-sponsored group plans, including employer/union-only group waiver plans (EGWPs). The Call Letter contains information these plan sponsor organizations will find useful as they prepare their bids for the new contract year.

The Advance Notice/Call Letter has been drafted assuming current law. If new legislation is enacted after this Notice is released and before the April Rate Announcement is published, CMS will incorporate changes in the Rate Announcement.

This is not the only CMS draft that has changes. Next week, we will review the 2011 Medicare Marketing Guidelines.

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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 Pamela.Argeris@merrillcorp.com.