Improving health is our policy
Extends the employer waiver from private fee-for-service plan network requirements,
effective CY11.
In a Mar. 23 letter to CMS, House Ways and Means Committee Chairman Kevin Brady (R-TX) and Energy and Commerce Committee Chairman Fred Upton (R-MI), along with other members of the Republican leadership, requested more transparency in the process for rate setting for MA Employer Group Waiver Plans (EGWPs).
The Final Notice governing CY11 Medicare Advantage payments is available here.
SEC. 3207. TECHNICAL CORRECTION TO MA PRIVATE FEE-FOR-SERVICE PLANS. For plan year 2011 and subsequent plan years, to the extent that the Secretary of Health and Human Services is applying the 2008 service area extension waiver policy (as modified in the April 11, 2008, Centers for Medicare & Medicaid Services’ memorandum with the subject ‘‘2009 Employer Group Waiver-Modification of the 2008 Service Area Extension Waiver Granted to Certain MA Local Coordinated Care Plans’’) to Medicare Advantage coordinated care plans, the Secretary shall extend the application of such waiver policy to employers who contract directly with the Secretary as a Medicare Advantage private fee-for-service plan under section 1857(i)(2) of the Social Security Act (42 U.S.C 1395w–27(i)(2)) and that had enrollment as of October 1, 2009.
(202) 309-0796
Contact Us