CMS Advance Notice of Methodological Changes for Calendar Year (CY) 2013 for Medicare Advantage (MA) Capitation Rates, Part C and Part DPayment Policies and 2013 Call Letter

February 17, 2012
The Centers for Medicare and Medicaid Services (CMS) call letter for Medicare Advantage contractors specifies the terms of participation. A key change for 2013 will require all Medicare Advantage organizations offering existing, new, or expanding dual eligible Special Needs Plans (SNPs) to hold a contract with the state Medicaid plan as a condition of approval or renewal. Without a state contract, existing dual eligible SNPs will not be permitted to operate and the beneficiaries will be disenrolled to original Medicare with the option to enroll in another Medicare Advantage plan. Additionally in the call letter, CMS clarified . . .