WHAT'S WAPPENING?

Broker comp rates are in for 2019. CMS recently released a memorandum on contract year 2019 agent and broker compensation rate adjustments, submissions and training and testing requirements. Here’s a breakdown of what you need to know.

Medicaid patients in Arizona have scored a victory against balance billing. The Arizona Court of Appeals has made an import ruling in a case involving the Arizona Health Care Cost Containment system (AHCCCS) and tort liens from Banner Health Network and several other hospitals. Per the ruling, hospitals will not be able to enforce tort liens against patients after AHCCCS payment has already been accepted.

The Bipartisan Budget Act of 2018, signed into law on February 9, did more than end the brief government shutdown. Included in the bill were several key health provisions. Here’s a look at what these changes mean for Medicare.

Do your clients need a little extra help? Medicare provides low-income subsidies, also called Extra Help, to qualifying individuals. This is important information for insurance agents as well as beneficiaries. Keep your clients satisfied by ensuring that they receive all the help they’re entitled to and tap into the low-income audience if you haven’t already. Here’s what you need to know.

Changes could be coming to Medicare. CMS published a proposed rule that would make significant changes to Medicare Advantage. Although the proposed changes are intended to provide more flexibility, some concerns have already been raised.

A recent proposal could provide relief for Medicare Advantage producers. The Centers for Medicare & Medicaid Services (CMS) has proposed a rule that would change training requirements.

Iora Primary Care is now welcoming Original Medicare (OM) clients. That means your OM clients with or without supplemental plans will be able to experience Iora care before deciding to switch to a Humana Medicare Advantage plan.

Think of Iora if you have …

For a long time, there's been talk in the air of major healthcare mergers. The big five - Aetna, Cigna, Humana, Anthem and UnitedHealth - have been boiling down to an even bigger three.

Phoenix Health Plan’s Medicare Advantage Plan Exit effective 1/1/17

• PHP and CMS made a “mutual” decision to terminate the plan
• PHP MAPD members received official plan exit notices on 11/1/2016
• SNP Letter
• Non-SNP Letter 
• PHP MAPD members were encouraged to enroll to new plans by 1/1 during AEP
• The SEP period is in effect until 1/31/17 for a 2/1/17 effective date
• All Broker Service calls are being handled at 1-844-320-5281

IN CURRENT NEWS: WellCare to Acquire Medicaid Assets of Phoenix Health Plan in Arizona

On December 22, WellCare Health Plans announced that it would be acquiring some assets, including Medicaid membership and certain provider contracts, from Phoenix Health Plan (PHP).  PHP provides health benefits to more than 50,000 Medicaid beneficiaries in Maricopa County. WellCare will work with PHP and AHCCCS to ensure a smooth transition for members. The transaction is expected to close by the second quarter of 2017.