Providers Eying Medicare Advantage
The March 28 edition of Medicare Advantage News cites a possible trend for provider organizations to sponsor their own Medicare Advantage plans. In the waning days of the old Medicare+Choice program, many provider-sponsored plans came on hard times, so this may seem like an unusual reversal. However, Medicare Advantage lives up to its name, and offers advantages to sponsors as well as members. This includes risk adjusted capitation payments, the option to offer drug coverage that is subsidized by Medicare, and bonus payments for achieving quality targets. Even with the payment reforms imposed by the Affordable Care Act, Gorman Health Group is hearing from a number of provider organizations that the predictable capitation revenue under MA is looking preferable to the fee-for-service treadmill. Medicare fee-for-service reimbursement is becoming increasingly complex, and fee-for-service margins are eroding. The prospect of moving up the food chain is especially appealing to organizations whose costs are largely fixed. MA matches predictable fixed revenue to fixed costs, while FFS requires a constant scramble after variable revenues to achieve necessary margins.
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Pioneer ACOs: Who will stay and who will go?
Thirty-two Pioneer ACOs sent a correspondence to CMMI in late February, suggesting that they would exit the Pioneer ACO program if CMS did not accept their recommendations for changes to the quality measures employed to determine pay for performance in the Pioneer program. As a group, the Pioneer ACOs suggested to CMMI that because of their collective experience with performance based contracts and performance reporting on quality measures, they -- not CMMI -- know what works and what doesn't when it comes to benchmarking quality to reimbursment.
The Pioneer ACOs argued in their correspondence that the benchmarks set by CMMI were more rigorous than those typically adhered to in the commercial and Medicaid programs. They also argued that the data CMS was using for benchmarking was the Medicare Advantage data, which was not typical of a non-managed care population such as that attributed to the ACOs.
Bottom line: the Pioneers were asking to work with CMMI to come up with a different approach to benchmarking or they would leave the program.
CMS has responded by giving the Pioneer ACOs until May 1 to decide whether to stay or go. What is not clear: Whether CMMI/CMS is willing to compromise and modify the current approach to benchmarking and whether the Pioneer ACOs will leave the program en masse if their wishes are not met.
Note that the the non-Pioneer ACOs are also subject to the same performance based benchmarking approach. So... will a Pioneer exit from the program result in a similar flight from the MSSP ACO program? If that were to occur CMMI/CMS would be faced with a public relations nightmare, one that I would think could be easily avoided by taking another look at the benchmarking issue.
Just saying!!
Resources
Read more on ACO opportunities in our white paper on the topic.
Read about how three Gorman Health Group clients were approved by CMS to become Operating Accountable Care Organizations.
SGR Cut In MA Rates: To Be or Not To Be
With the MA Final Notice due out on April 1, and the 45-Day Notice suggesting the biggest decrease to MA rates in years, the new Congressional Research Service report, which evaluates the HHS Secretary's authority with regard to including or not including an SGR fix in calculating the trend in FFS costs, is of paramount importance. The report concludes that the HHS Secretary, and therefore CMS, likely have broad authority with regard to whether or not CMS assumes that Congress will eventually create an SGR fix, in calculating CY 2014 MA rates.
As background, CMS for years has indicated that the reason it has not included an SGR fix in the coming year's MA rates, is that it does not have the legal authority to do so, because it is required to go by current law, which would presume the SGR cuts would go into effect. In the 2013 Call Letter, published on April 1, 2012, in direct response to commenters suggesting that an SGR fix should be included in calculating MA rates, CMS stated: "CMS's consistent interpretation and longstanding practice has been to base the projected growth percentage on the law as it exists on the date of the announcement…". CMS goes on to explain that they believe the best reading of the statutory language requires them to use current law, and not assume an SGR fix. Therefore, it is of paramount importance, that since CMS's decision is based on their interpretation of what Congress requires of HHS / CMS, that Congress has now had evaluation done by their own legal advisors. "The Congressional Research Service (CRS) works exclusively for the United States Congress, providing policy and legal analysis to committees and Members of both the House and Senate, regardless of party affiliation." CRS is a Legislative Branch Agency, that is part of the Library of Congress.
Whether or not an SGR fix occurs likely represents the largest wildcard in terms of the potential magnitude of change in MA rates versus the approximately 7.5% cut, should the rates be updated as per the 45-Day Notice. In addition to whether or not the SGR fix is included being the largest wildcard, it is also the component that, in the name of "fairness" and "reasonableness", is the most important to fix. Specifically, CMS should assume that the SGR cuts will not take effect, and therefore CMS should increase the trend factor versus what is included in the 45-Day Notice.
As noted above, for many years, in determining the FFS trend factor, which drives MA rates, CMS has assumed that the SGR cuts will occur, which has artificially depressed MA rates. Of course, the SGR cuts have in fact never happened (at least without being fixed retrospectively for FFS providers), so that physicians have never actually lost a dime due to SGR cuts. On the other hand, MA Plans have lost billions of dollars, compared to the way the rates were intended to be calculated, since the rates are set on April 1st, for a period 9 to 21 months in the future (the following calendar year). Of course, the SGR fix has always has always happened after April 1st, once MA rates are set, so that while the physicians are not subject to the SGR cuts, MA plan rates assume the SGR cuts occurred.
Therefore, given the timeliness of this CRS report, which was likely requested by a Member(s) of Congress in able to determine if CMS has the authority on April 1st to assume that there will not be SGR cuts in 2014, it is hopeful that the Secretary / CMS will in fact do what is "fair" and "reasonable", and assume there will be no SGR cuts in calculating the 2014 MA rates. Looking at the language of the CRS report, CRS for example states: that the Medicare Advantage formula "does not specifically address the inclusion or exclusion of the effects of the Sustainable Growth Rate formula on the Medicare physician fee schedule when congressional action may be anticipated at a later date"; that the Secretary has "considerable discretion to interpret the law"; and, that given 11 years of consistent legislative action to avoid SGR cuts that "the foreseeability of congressional action makes such as assumption both authorized and reasonable".
Finally, key reasons as to why it is so "fair" and "reasonable" for CMS to change their method, and assume that there will be no SGR cuts, in addition to that they now have CRS saying the authority may well exist, are that MA rates are: 1) legislatively tied to FFS; and, 2) much closer to FFS costs (and still falling) than in the recent past. The ACA mandates that MA rates are a specified percentage of FFS costs, and in doing so, it is the only reasonable assumption that Congress meant for CMS to accurately calculate expected FFS costs, which would require that they assume no SGR cuts. In fact, the CRS report suggests that the Secretary has a lot of discretion in making an accurate projection. Additionally, with rates now much closer to FFS costs and still falling, it seems much more fair than in the past to not utilize a "back door" method to "inaccurately" calculate the trend in FFS costs, in order to reduce MA payments. According to MedPAC, MA rates as a percentage of FFS have trended down from 114% in 2009, to 110% in 2011, to 104% in 2013. Between the fact that rates are much closer to and trending towards FFS, and that rates are legislatively tied to FFS, it seems only fair that HHS / CMS assume no SGR cuts in calculating the 2014 rates.
Guess we'll see on Monday, April 1 …
Resources
Gorman Health Group Senior Vice President Bill MacBain explains the logic behind the proposed rate change, and shares a brief analysis of the impact in this regulatory summary.
Click here to review GHG's comments in response to the Advance Rate Notice, submitted to CMS on March 1, 2013
Gorman Health Group Senior Vice President Jean LeMasurier summarizes the 2014 CMS Draft Call Letter.
Listen in to John Gorman's take on the draft call letter and his thoughts on the implications for Medicare Advantage health plans - and their providers.
Strange Bedfellows Come to Medicare Advantage's Rescue
If you can say anything about Medicare Advantage (MA), it definitely makes for strange bedfellows in both the private sector and in the halls of Congress. Last Friday the full lobbying fury of the industry was in evidence as three separate groups of legislators appealed to the Centers for Medicare and Medicaid Services (CMS) on its 2014 rate proposal.
First was a bizarre, bipartisan collection of Representatives: Reps. Bill Cassidy and John Barrow and 93 other lawmakers — mostly GOP, but some Dems — begged CMS to reconsider its approach to the 2014 MA rates, saying CMS shouldn't enact new risk adjustment policies and to assume that the 2014 Sustainable Growth Rate cuts will go into effect. "This reduction in funding will leave many vulnerable seniors with fewer benefits, higher out-of-pocket costs, and in some cases the loss of their current MA coverage," they wrote.
Then, Senators Max Baucus (D-MT) and Orrin Hatch (R-UT), leaders of the Senate Finance Committee, fired their own salvo. In a rare joint letter, they poked CMS for not giving MA plans enough notice on changes to the Star Rating calculation, and for assuming the SGR cuts would not be blocked, as they have every year for the last decade. This one change to CMS's proposal would restore about 5% to MA payments in 2014. "The lack of transparency surrounding this proposal is troubling," Baucus and Hatch wrote, asking CMS to delay changes until they can be vetted. Their voices are particularly important on the 2014 rates, as it is their panel that will handle the long-awaited confirmation of Marilyn Tavenner as CMS Administrator in the coming weeks.
Later that day a group of 22 other Senators sent a letter to CMS expressing their concerns about the 45-Day Notice. Another strange bipartisan assortment including several influential Democrats urged CMS to assume that Congress will address the Sustainable Growth Rate.
We don't have any doubt that CMS will walk back some of the draconian measures they included in the 45-Day Notice. The agency has the most discretion around its proposed risk adjustment changes, and I suspect many of them won't make it into the final rates on April 1. And while the most meaningful remedy is for CMS to assume an SGR fix will be passed later this year, the agency has never taken such a step and we don't expect they will here.
We believe an SGR fix will pass the Congress again, but not until later this fall and well after 2014 bids are due to CMS in June. That means we'll see a roughly 5% bump in MA rates in 2015 -- but still very tough times for MA plans and their members next year.
Resources
Click here to read the MA rate letter Max Baucus and Orrin G. Hatch sent to CMS on March 15, 2013.
To read the MA rate letter the US House of Representatives sent to CMS on March 15, 2013, click here.
Click here to review the MA rate letter the US Senate sent to CMS on March, 15 2013.
Gorman Health Group Senior Vice President Bill MacBain explains the logic behind the proposed rate change, and shares a brief analysis of the impact in this regulatory summary.
Click here to review GHG's comments in response to the Advance Rate Notice, submitted to CMS on March 1, 2013
Gorman Health Group Senior Vice President Jean LeMasurier summarizes the 2014 CMS Draft Call Letter.
Impact of the Sequester on CMS Funding
On March 1, 2013, the President issued a sequestration order that cuts $85 billion in federal budgetary resources for FY 2013.
By law, on March 27, 2013 Medicare Trust Fund spending will be cut 2 percent and Medicaid will be exempt.
Other CMS expenditures are subject to the sequester on March 1, 2013. The CMS administrative budget falls into the non-exempt non-defense category. In the report, OMB states that sequestration requires an annual 5.0 percent reduction in discretionary programs and a 5.1 percent reduction in mandatory programs. Because these cuts must be made over a 7 month period, OMB estimates the effective percent reductions will be 9 percent for non-exempt nondefense programs.
Following is the official impact of the cuts on CMS in the OMB sequestration report.
The OMB report states that "There is no requirement that sequestration be applied to equally to each type of budgetary resource within a budget account". A variety of news reports and comments from supporters and critics of health care reform have discussed the discretionary authority of the Secretary to move CMS money around in the various accounts. In particular, these reports emphasize the Administration's interest in assuring that Health Care Reform gets off the ground in 2014 and that funding be found for the Federal exchange which was not previously appropriated. Other ACA related cuts include: $51 million in the Prevention and Public Health Fund and $267 million in IRS enforcement funding.
Click here for the OMB report on the impact of sequestration.
Resources
Listen in as Gorman Health Group Senior Vice President Bill MacBain shares an update on the sequester, what GHG thinks is likely to happen next, and the potential impact on Medicare Advantage.
Gorman Health Group Senior Vice President Bill MacBain explains the logic behind the proposed rate change, and shares a brief analysis of the impact in this regulatory summary.
Little Good News for Medicare Advantage in Senate Finance Hearing
The Senate Finance Committee held a hearing on Medicare yesterday and received testimony by CMS Medicare chief Jon Blum. Almost a week after the shocking 45-day Notice for Medicare Advantage (MA) and Part D was released, Blum offered little in the way of good news on the 2014 rates.
Blum said CMS is committed to ensuring seniors have strong choices and accuracy in payments. He briefly addressed the draconian 45-day Notice and said that one reason 2014 proposed rates to MA plans are lower is because Medicare spending is lower, and that's good news for the program. He also said it's longstanding CMS policy not to assume a Sustainable Growth Rate (SGR or the "doc pay cut") fix until it is current law, and said the best way to stabilize both traditional Medicare and MA is with a long-term fix to the SGR. He's certainly right about that, but with a $130 Billion price tag, may not be feasible while the budget debate rages here in DC.
Blum admitted that CMS does have discretion with respect to the risk adjustment model, and that could be good news for MA plans -- changes to the HCC model drove a significant portion of the cuts in the 45-day Notice. He suggested -- obliquely -- that CMS's proposal to refine the HCCs "to exclude certain conditions that are most commonly coded by Medicare Advantage plans" could be reconsidered.
Finance Committee Chairman Max Baucus (D-MT) said there is a need to address the 45-day Notice cuts, but did not offer any specific proposal, and neither did Blum. CMS has lowered the overpayments to MA plans relative to FFS from 14% in 2009 to just 4% in 2013 (before the proposed 45-day Notice cuts to 2014 rates), with the difference to be "phased down further." Blum stated on several occasions that the Medicare Advantage rates were proposed, not final. He said the payment reductions over the past few years coupled with membership growth in the program is evidence that CMS can reduce payments and yet the program can grow.
Blum later suggested that CMS's goal was to ensure that seniors have opportunities to enroll in 4 and 5 star plans, and pointed out that those plans not achieving 4 stars on the CMS rating system would face significant additional payment challenges.
So the brutal proposed 2014 payment rates for MA have Congress' attention, but a solution is far from clear with the sequester looming on March 1. The probability of a legislative SGR fix by June -- when MA bids for 2014 are due -- is virtually nonexistent, and that's tragic as an SGR fix of two or more years would bump up MA rates by about 5%, offsetting much of the shortfall in payments. Fixing the risk adjustment proposals won't impact benchmarks, so are only of limited value. Relief on other proposed payment changes like the Total Benefit Cost limits would be helpful but wouldn't significantly change the rate cuts.
So we got a few rays of daylight in the gloom of the 45-day Notice, but no clear path to fixing its worst features. AHIP is on the Hill with a massive lobbying campaign, and there's a steady stream of visitors to CMS seeking relief, but no evidence yet that we might duck the 9-10% cuts in the proposal with 30 days before it's final.
Resources
Listen in to John Gorman's take on the draft call letter and his thoughts on the implications for Medicare Advantage health plans — and their providers.
Gorman Health Group Senior Vice President Bill MacBain explains the logic behind the proposed rate change, and shares a brief analysis of the impact in this regulatory summary.
Gorman Health Group Senior Vice President Jean LeMasurier summarizes the 2014 CMS Draft Call Letter.
EXCHANGES: Looking for Help
CMS has posted a Q&A about their willingness to allow states to partner in plan management activities without submitting a blueprint. This makes a new fourth category of exchanges. So, in addition to state exchanges, partnership exchanges, federally facilitated exchanges, the new fourth category is states willing to cooperate in FFE states. Basically, CMS has decided to ignore the February 15th deadline for states to note their willingness to partner with CMS.
CMS is looking for a letter from an interested state's governor or insurance commissioner. The letter must provide attestations that the state has the operational capacity to oversee plan management activities, benefit packages, plan compliance and complaint resolution, conduct de-certifications and appeals as well as provide technical assistance to health insurance issuers. In addition, states need to show that they can participate in a one-day review of its operational plans and that they have the capacity to do that.
Once CMS gets the letter, they will initiate a review of the state's request and sign an agreement with the state to allow the state to have a role in regulating QHPs in the Federal Exchange. CMS also provided an enticement by noting that CMS can provide funds the state can use to support these additional activities.
This is the answer for states that wanted to avoid filling out the blueprint required in the Partnership Exchange. While credibility of CMS is challenged, it may just unearth those last states willing to balance their political resistance with their interest in having a hand in controlling health insurance issuers in their states.
Resources
Hear Gorman Health Group experts discuss the Federal Facilitated Exchange (FFE) and implications for health plans.
Gorman Health Group Senior Vice President of Public Policy Jean LeMasurier offers a summary of the latest guidance on the state partnership exchange, released on January 3, 2013 from HHS.
Download Jean LeMasurier's whitepaper on Insurance Exchanges in the ACA.
Draft Call Letter for 2014
The bad news in the 45 day notice is proposed payment cuts to Medicare Advantage plans for 2014 and big changes to risk adjustment but there is also good news about the reduction in almost all of the Part D benefit parameters. The draft Call Letter, which accompanied the proposed rate announcement, also included some news-worthy developments for MA and Part D plans. The document shows that CMS is actively using its regulatory and purchasing authority. CMS is planning to take action in several areas where oversight and monitoring have identified problems or where beneficiary complaints have been noted. In addition, CMS is signaling its intent to use MA plans as laboratories for achieving the Triple Aim.
CMS is proposing to limit beneficiary costs and to ensure fewer plans with clear choices in plan benefits for 2014. CMS is proposing to lower the threshold for increased Total Beneficiary Costs in the MA bids from $36 to $30 per member per month. In addition, CMS is proposing to reduce the minimum monthly cost-sharing out of pocket cost (OOPC) difference between Part D basic and enhanced plans from $23 in 2013 to $21 in 2014. The difference between enhanced plan offerings will be increased from $12 this year to $18 in 2014. And CMS will review supplemental benefits to assure that they provide reasonable value and not excess profits and retentions for plan sponsors
CMS continues to refine the Star Rating measures and is proposing to modify the methodology to calculate the overall Summary Ratings for MA and Part D for 2014. In addition CMS is proposing to modify the methodology to identify low performing plans by changing from a metric of 3 stars to 2.5 stars for any combination of part C or Part D summary ratings for three consecutive years.
CMS is signaling its interest in changing policies in the future in a number of areas. For example, CMS is planning to issue regulations to revise agent/broker compensation to pay renewal amounts for years seven and beyond. CMS is considering proposing requirements to ensure continuation of essential plan operations and critical IT systems in times of disaster. CMS is seeking comments on ways to reduce overutilization of drugs, for example by expanding the required Utilization Review programs beyond opioids to 4 other drug categories. CMS will also undertake a significant revision to the Summary of Benefits to make it more user-friendly for beneficiaries.
CMS is seeking to improve the health care system through private plans. For example, CMS is encouraging plans to use the Blue Button Initiative to make it easier for enrollees to share personal health information with their health team. CMS is encouraging plans to participate in the Million Hearts Initiative for example by lowering the costs of anti-hypertensive medications and expanding their MTM programs. CMS is asking plans for recommendations on shared decision making programs so that CMS can establish standards for such approaches as a feature in MA plans. CMS is asking for plan comments on reward and incentive programs so these can also be further expanded.
CMS monitoring has identified some unacceptable plan practices that will be corrected. CMS will require beneficiary consent for each new prescription or refill prior to delivery under auto-ship refill programs in Part D to avoid waste and excess costs. The draft Call Letter cites several examples where plans are inappropriately shifting drug coverage from Part B to Part D which is not allowed. CMS will require prior authorization for hospice and ESRD drugs to assure appropriate payment under Parts A, B or D. Plans may not inappropriately steer enrollees to sponsor or PBM mail order pharmacies. Plans will be required to have real-time access to critical systems in delegated entities in the future. CMS is tightening up guidance on post-point-of-sale full claim pharmacy adjustments to address abuse. CMS will also assure that costs are not higher in preferred pharmacy networks than non-preferred networks. CMS will monitor MAO and PDP marketing efforts to assure that there are no misrepesentations in areas where Medicare-Medicaid Capitated Financial Alignment demonstrations are operating.
Resources
Listen in to John Gorman's take on the draft call letter and his thoughts on the implications for Medicare Advantage health plans - and their providers.
Gorman Health Group Senior Vice President Bill MacBain explains the logic behind the proposed rate change, and shares a brief analysis of the impact in this regulatory summary.
Gorman Health Group Senior Vice President Jean LeMasurier summarizes the 2014 CMS Draft Call Letter.
CMS Advance Notice for 2014: This Is What Austerity Looks Like
CMS's Advance Notice for Medicare Advantage and Part D for 2014 was released after the close on Friday and tanked health plan stocks on Tuesday. It is a shocking, stark portrait of what austerity looks like. There's nothing but bad news in it, and it's worse than anyone expected. Start with an average cut in payments of 6% (combined impact of ACA, proposed trend, and increase in coding adjustment); now add the likelihood of sequestration taking effect on March 1 -- another 2% cut; add the impact of draconian changes in risk adjustment and the 2014 industry tax for another point or two. All in, CMS could cut as deep as 9-10% if the proposed rates become final on April Fool's Day. The industry has little more than 5 weeks to howl, lobby, mobilize and cajole CMS to its senses before the meat-axe falls.
If the proposed rates become effective, it will lead to meaningful, painful benefit cuts. Plans will try to shift some of the pain to providers, and doctors, hospitals and pharmacists will see another year of payment cuts. It will stunt the stunning 10%+ growth in Medicare Advantage the last several years. Industry consolidation will intensify as local and regional MA plans struggle to make ends meet.
We knew the ACA cuts to Medicare Advantage were significant and were softened by the Star Ratings Demonstration. We expected that CMS would take a harder line with health plans in a second Obama term, especially with the deficit fight raging in Washington. The draft notice also shows that the Medicare fee-for-service physician pay cut could come home to roost as well on April Fool's Day. A permanent fix to the Medicare physician pay cut would help MA rates by 4.5-5.5%, offsetting some of the shortfall in payments. But it would cost upwards of $130 billion and we can't take that to the bank in the current political environment.
There's a difference between Chicken Little and Paul Revere...and there was an epic meteor shower on our planet this week. The clock is ticking for stakeholders in Medicare Advantage and Part D to engage with their legislators and CMS to prevent these proposed rates from becoming a cruel hazing on April Fool's Day.
Exchanges: Sales Agent Certification
CMS has released a notice seeking comments on their plans for training and certifying sales agents who could enroll persons into the federally facilitated exchanges. To be exact, the notice is about collection of data about the sales agents who are trained and certified for selling coverage offered by qualified health plans on the exchange. It just so happens that the vehicle for doing the collection is the training and certification program that is mandated by the law and the final regulations published last March. So, CMS does not want comments about the requirement to be trained and certified but they do want comments about what information is collected and maintained about individual sales agents.
In the process of telling us what they want to collect, CMS is also letting us know something about the training and certification program. First, they expect that approximately 250,000 agents will take the FFE training and certification program. They note that this excludes all states where a state operated exchange will function. If agents (approx. 240,500) are allowed to sell QHP coverage in state operated exchanges, the states need to develop and offer their own certification program. CMS also notes that captive agents (approx. 110,500) are expected to enroll persons through their QHP. This means any training for these sales agents must be conducted by the health plan and must follow required enrollment processes through the exchange.
CMS will collect basic identifying information such as name, location, and state license as the agent accesses the system. There is no paper process so agents without electronic access need not apply. After providing basic information, the agent will take the training course and complete the exam to be certified. CMS expects the agent to spend 4.75 hours to complete training and testing in the first year allowing for re-taking and re-testing for those who fail to complete it in the first try. For succeeding years, the expected time requirement falls to 3.25 hours. During this process, CMS can identify particular issues about the test such as time required or troublesome questions and concepts. In addition, CMS will know the individual test taker's training history and their relative success. There is no prohibition on retakes or how often an agent can re-take the training and test. Agents who are certified though the process will be listed on the FFE website so that interested persons can contact them for information and assistance.
CMS notes that they will use collected data for oversight and monitoring. CMS will take follow-up actions whenever they identify questionable activity. Also, from time to time, CMS will ask agents to make their records available for oversight and compliance purposes but does not make clear what records are involved in these requests or actions will occur. Finally, agents will be required to sign an agreement that allows all of this to occur plus documents their commitment to periodically updating information.
Access to the portal will begin around July 1. There is no indication of a fee for taking the training and CMS does provide an outline of the training program that covers the basic components of exchange operations and eligibility determinations.
No doubt there will be questions since any data collection efforts with federal implications for the agent call big brother into question. Clearly, sales agents will have concerns about another body getting complaints about their sales activity and CMS will counter that it has over 25 years of experience with sales agent mischief dealing with vulnerable populations in the Medicare Advantage program.
Click here for information on how to submit comments on this notice.
Click here for a description of the data collection program and some of the processes that will be used to train, certify and collect information.
Resources
Senior Vice President for Public Policy, Jean LeMasurier, summarizes the February 7, 2013 notice from CMS regarding Agency Information Collection Activity.
Download a podcast on the key components of OEV calls and get advice on how to handle rapid disenrollment — and other common challenges.
Learn how Gorman Health Group certifies, trains and manages sales agents with our Sales Sentinel software.