Consolidated Appropriations Act Gag Clause Attestation

2023-12-14T16:29:42+00:00

The Consolidated Appropriations Act requires self-insured plan sponsors to file a gag clause attestation with CMS using the HIOS system no later than December 31st, 2023. A gag clause is any contractual term that prohibit health plan sponsors and plan issuers from having any agreements with a healthcare provider, a network, an association of providers, [...]

Consolidated Appropriations Act Gag Clause Attestation2023-12-14T16:29:42+00:00

Gag Clause Attestations – Diversified Group Course of Action

2023-09-20T16:30:24+00:00

Before December 31, 2023, self-insured plan sponsors are required to file a gag clause attestation with CMS using the HIOS system. For self-insured clients, uploading the attestation is a plan sponsor responsibility under the Consolidated Appropriations Act. However, Diversified Group will submit the attestations to CMS on behalf of our clients in time to meet the [...]

Gag Clause Attestations – Diversified Group Course of Action2023-09-20T16:30:24+00:00

Flexibility in Treatment of Drug Manufacturer Coupons

2020-08-03T16:14:50+00:00

On Thursday, May 7, 2020, the United States Centers for Medicare and Medicaid Services (CMS) released the 2021 Notice of Benefit and Payment Parameters final rule. This rule finalizes the CMS’ proposed modification of existing policy relating to how pharmaceutical manufacturer direct assistance (i.e., coupons) accrues with respect to health plan enrollees’ annual limit on [...]

Flexibility in Treatment of Drug Manufacturer Coupons2020-08-03T16:14:50+00:00

Medicare D Credible Coverage Notices Due by October 15th

2018-09-12T14:26:45+00:00

The Medicare Prescription Drug Improvement and Modernization Act of 2003 implemented prescription drug coverage under Medicare (Medicare D), requiring all employers that offer prescription drug benefits to provide an annual notice of Medicare open enrollment. The notice must go to all Medicare eligible plan participants and qualified beneficiaries before October 15th each year. The notice [...]

Medicare D Credible Coverage Notices Due by October 15th2018-09-12T14:26:45+00:00

CMS Modifies Bundled Pay Requirements

2018-02-15T09:00:36+00:00

While hospitals in 34 geographic areas will still be required to participate in the Comprehensive Care for Joint Replacement Model, hundreds of acute care hospitals in other areas have received a reprieve. In addition to modifying CJR model compliance, CMS recently finalized plans to cancel the Episode Payment and Cardiac Rehabilitation Incentive Payment Models, both [...]

CMS Modifies Bundled Pay Requirements2018-02-15T09:00:36+00:00

Will Bundled Payments Lower Costs?

2017-02-16T08:00:39+00:00

The Centers for Medicare and Medicaid Services (CMS) began their initiative to tie payments to quality or value earlier this year by implementing their Comprehensive Care Joint Replacement Model (CJR). The mandatory program holds hospitals accountable for all costs, processes and outcomes associated with hip and knee replacements performed on Medicare patients. Since hip and [...]

Will Bundled Payments Lower Costs?2017-02-16T08:00:39+00:00

Medicare Part D Notice Deadline: October 14th

2016-10-26T14:18:42+00:00

As you may recall, with the introduction of Medicare Part D prescription drug benefits, the Centers for Medicare and Medicaid Services (CMS) imposed specific notice requirements on employers. Each year, employers whose healthcare plans include prescription drug benefits are required to notify all Medicare beneficiaries and the CMS of the “creditable” or “non-creditable” coverage status [...]

Medicare Part D Notice Deadline: October 14th2016-10-26T14:18:42+00:00
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