CMS Announces Medicare $2 Drug List Model RFI

Agent Survival Guide Podcast

The Friday Five for October 11, 2024:

• CMS Final Guidance on Round 2 of Medicare Drug Price Negotiations
• HHS Releases ACA Marketplace 2026 Proposed Rule
• Apple Intelligence Features Coming October 28?
• Setting the Record Straight on Cigna & HCSC
• CMS Announces Medicare $2 Drug List Model Request for Information

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CMS Final Guidance on Round 2 of Medicare Drug Price Negotiations:

“HHS Releases Final Guidance for Second Cycle of Historic Medicare Drug Price Negotiation Program.” CMS.Gov, Centers for Medicare & Medicaid Services, 2 Oct. 2024, www.cms.gov/newsroom/press-releases/hhs-releases-final-guidance-second-cycle-historic-medicare-drug-price-negotiation-program.

“Medicare Drug Price Negotiation Program Final Guidance ...” CMS.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/files/document/fact-sheet-medicare-drug-price-negotiation-program-ipay-2027-final-guidance-and-mfp-effectuation.pdf. Accessed 9 Oct. 2024.

HHS Releases ACA Marketplace 2026 Proposed Rule:

Tong, Noah. “CMS Proposes Risk Adjustment Changes, Broker Fraud Crackdown for 2026 Plan Year.” Fierce Healthcare, Fierce Healthcare, 4 Oct. 2024, www.fiercehealthcare.com/payers/cms-proposes-risk-adjustment-changes-fraud-crackdown-and-more.

“HHS Notice of Benefit and Payment Parameters for 2026 Proposed Rule.” CMS.Gov, Centers for Medicare & Medicaid Services, 4 Oct. 2024, www.cms.gov/newsroom/fact-sheets/hhs-notice-benefit-and-payment-parameters-2026-proposed-rule.

Apple Intelligence Features Coming October 28?

Chen, Brian X. “Apple’s A.I. Is Landing Soon on iPhones. Here’s What It’s Like.” NYTimes.Com, The New York Times, 2 Oct. 2024, www.nytimes.com/2024/10/02/technology/personaltech/apple-intelligence-iphone.html.

Clover, Juli. “Here Are All of the Apple Intelligence Features in IOS 18.1.” MacRumors, MacRumors, 8 Oct. 2024, www.macrumors.com/guide/ios-18-1-apple-intelligence/.

Shakir, Umar. “Here’s What Your iPhone 16 Will Do with Apple Intelligence - Eventually.” The Verge, The Verge, 10 Sept. 2024, www.theverge.com/2024/9/10/24237714/apple-intelligence-generative-ai-features-update-schedule.

Davis, Wes. “Your iPhone 16 May Get Its First Apple Intelligence Features Later This Month.” The Verge, The Verge, 6 Oct. 2024, www.theverge.com/2024/10/6/24263398/ios-18-iphone-16-apple-intelligence-coming-october-update-ai-notification-summaries.

Setting the Record Straight on Cigna & HCSC:

“CIGNA Healthcare Offers Medicare Customers Value, Stability and Choice with 2025 Plans.” Cigna Healthcare Newsroom, Cigna, 1 Oct. 2024, newsroom.cigna.com/cigna-healthcare-medicare-2025-plans.

Minemyer, Paige. “Cigna Inks Deal to Sell Medicare Business to HCSC for $3.7B.” Fierce Healthcare, Fierce Healthcare, 31 Jan. 2024, www.fiercehealthcare.com/payers/cigna-inks-deal-sell-medicare-business-hcsc-37b-deal.

“HCSC Agrees to Acquire Medicare Businesses and CareAllies from Cigna.” HCSC Agrees to Acquire Medicare Businesses and CareAllies from Cigna, Health Care Service Corporations (HCSC), 31 Jan. 2024, www.hcsc.com/newsroom/news-releases/2024/agreement-acquire-cigna-medicare-careallies-businesses.

CMS Announces Medicare $2 Drug List Model Request for Information:

“Biden-Harris Administration Takes Next Step on Proposed Model to Lower Prescription Drug Costs for People with Medicare.” CMS.Gov, Centers for Medicare & Medicaid Services, 8 Oct. 2024, www.cms.gov/newsroom/press-releases/biden-harris-administration-takes-next-step-proposed-model-lower-prescription-drug-costs-people.

Fowler, Liz, and Vino Mitta. “CMS Innovation Center’s One-Year Update on the Executive Order to Lower Prescription Drug Costs for Americans.” CMS.Gov, Centers for Medicare & Medicaid Services, 11 Oct. 2023, www.cms.gov/blog/cms-innovation-centers-one-year-update-executive-order-lower-prescription-drug-costs-americans.

“Executive Order on Lowering Prescription Drug Costs for Americans.” The White House, The United States Government, 14 Oct. 2022, www.whitehouse.gov/briefing-room/presidential-actions/2022/10/14/executive-order-on-lowering-prescription-drug-costs-for-americans/.

“Medicare Two Dollar Drug List Model.” CMS.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/priorities/innovation/innovation-models/medicare-two-dollar-drug-list-model. Accessed 9 Oct. 2024.

“Medicare $2 Drug List Model - Request for Information (RFI) - Responses Due December 9, 2024.” Cms.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/priorities/innovation/files/x/newdirection-rfi.pdf. Accessed 9 Oct. 2024.

Resources:

2025 Medicare Advantage and Medicare Part D Premiums: https://link.chtbl.com/ASGF20241004

Cigna to Sell Medicare Business to HCSC: https://ritterim.com/blog/cigna-to-sell-medicare-business-to-hcsc

Key Changes for ACA Open Enrollment 2025 ft. Ross Baker from HealthSherpa: https://link.chtbl.com/ASG2024RossBaker

Preparing Clients for the New Medicare Prescription Payment Plan Program: https://link.chtbl.com/ASG621

Staying Motivated Amidst Change & Disruption: https://link.chtbl.com/ASGM20240710

Webinars & Events: https://ritterim.com/events/

What to Do if Your Medicare Part D Plans Become Non-Commissionable: https://link.chtbl.com/ASGN20241005

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