Medicare Compliance & Reimbursement

New out-of-pocket savings to benes makes plan popular in 2005.

Medicare Advantage health plans will soon receive new support for attracting and retaining beneficiaries with chronic illnesses.

The Centers for Medicare and Medicaid Services announced June 30 that it has approved 143 new Medicare Advantage plans to provide services in 2005, expanding availability to 49 states.

This likely means more Medicare Advantage enrollees in the future, since the plan's more extensive benefits and lower cost-sharing has made it a popular plan among Medicare beneficiaries and health plans, CMS says.

New Approvals A Boon For HMOs, PPOs

Now 73 percent of Medicare beneficiaries will have access to health maintenance organization plans, 80 percent will have access to private fee-for-service plans and 52 percent will have access to preferred provider organization plans. More than 5 million beneficiaries are enrolled in Medicare Advantage health plans.

CMS approved 48 new special needs plans that exclusively or disproportionately enroll beneficiaries who are dually eligible for Medicare and Medicaid, living in institutions, or have severe, chronic or disabling conditions. CMS is considering more than 100 SNP applications for next year.

Feds In Application Review Stage

At this point, CMS is reviewing applications, formularies and bids from Medicare Advantage organizations for 2006, including the new regional PPOs and prescription drug plans. CMS says it plans to finalize contracts with those organizations later this year.

To read the press release, go to http://www.cms.hhs.gov/media/press/release.asp?Counter=1497.