• Hypertrophic Cardiomyopathy (HCM)
  • Eyecare
  • Urothelial Carcinoma
  • Hemophilia
  • Heart Failure
  • Vaccines
  • Neonatal Care
  • Type II Inflammation
  • Substance Use Disorder
  • Gene Therapy
  • Lung Cancer
  • Spinal Muscular Atrophy
  • HIV
  • Post-Acute Care
  • Liver Disease
  • Asthma
  • Atrial Fibrillation
  • COVID-19
  • Cardiovascular Diseases
  • Prescription Digital Therapeutics
  • Reproductive Health
  • The Improving Patient Access Podcast
  • Blood Cancer
  • Ulcerative Colitis
  • Respiratory Conditions
  • Multiple Sclerosis
  • Digital Health
  • Population Health
  • Sleep Disorders
  • Biosimilars
  • Plaque Psoriasis
  • Leukemia and Lymphoma
  • Oncology
  • Pediatrics
  • Urology
  • Obstetrics-Gynecology & Women's Health
  • Opioids
  • Solid Tumors
  • Autoimmune Diseases
  • Dermatology
  • Diabetes
  • Mental Health

MCOs weigh Medicare rules, options


In late July, Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Mark McClellan unveiled a massive proposed regulation for implementing the Medicare Modernization Act. The hundreds of pages of fine print (published in the Aug. 3, 2004, Federal Register) describes requirements for Medicare Advantage (MA) plans, subsidies for employers who continue retiree drug benefits, and rules to ensure that prescription drug plans (PDPs) provide adequate and appropriate medicines for seniors. There is considerable detail on PDP operations and benefit design, including copays and quality improvement programs, which apply to MA plans providing drug coverage to Medicare beneficiaries.

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