CMS Care Compare Empowers Patients When Making Important Health Care Decisions

On September 3rd, the Centers for Medicare & Medicaid Services (CMS) launched Care Compare, a streamlined redesign of eight existing CMS healthcare compare tools available on Medicare.gov. Care Compare provides a single user-friendly interface that patients and caregivers can use to make informed decisions about healthcare based on cost, quality of care, volume of services, and other data. With just one click, patients can find information that is easy to understand about doctors, hospitals, nursing homes, and other health care services instead of searching through multiple tools. For more than 20 years, Medicare’s online compare tools have served as the cornerstone for publicizing quality care information for patients, caregivers, consumers, and the healthcare community. This announcement builds on the eMedicare initiative that first launched in 2018 to deliver simple tools and information to current and future Medicare beneficiaries.  Some of the new tools launched under the eMedicare initiative include: A completely redesigned Medicare Plan Finder Tool for last Open Enrollment; “What’s Covered” app that tells people what’s covered and what’s not in Original Medicare; A price transparency tool that lets consumers compare Medicare payments and copayments for certain procedures performed in both hospital outpatient departments and ambulatory surgical centers; Interactive online decision support to help people better understand and evaluate their Medicare coverage options and costs between Original Medicare and Medicare Advantage; An online service that lets people quickly see how different coverage choices will affect their estimated out-of-pocket costs Webchat option in Medicare Plan Finder helps people get on-the-spot support; and Easy-to-use surveys across Medicare.gov so patients and consumers can continue to offer feedback about their online experiences.

The RDS Opportunity with Part D Advisors The Retiree Drug Subsidy (RDS) program was created to incentivize employers to continue covering the prescription costs for their Medicare eligible retirees. The RDS program reimburses Plan Sponsors up to 28% of all allowable Retiree Drug expenses to help subsidize their financial obligation. PDA is the established expert in this process and has been assisting plan sponsors with reopenings since they became available. Our one-of-a-kind methodology and custom built software can help improve total subsidy recovery by an average of 8-15%. We have spent over a decade crafting a proprietary suite of custom software tools focused on finding additional subsidy in three primary areas: Enhanced Drug Filtering By developing a filter with the nation's leading pharmacy experts, PDA can accurately categorize Part B and Part D drugs allowing us to maximize subsidy payments. Improved Member Eligibility By identifying and retaining member alias information from all available sources, PDA's proprietary software gives Plan Sponsors a unique advantage. Increased Claims Matching PDAs prescription and medical claims processing systems re-adjudicates claims using only Medicare's eligibility rules to maximize orphan claims to member matching.

Cost Savings Spotlight "PDA has been more than we could have asked for. One of the best decisions we made years ago. You all have been so efficient and par none." - Anita Baker, Senior Benefits Analyst Health & Welfare

Did you Know? The address for sending an overpayment remittance to CMS' RDS Center has changed. Effective immediately, Plan Sponsors are to remit payment by sending a check or money order, made payable to the Centers for Medicare & Medicaid Services, to the following address: Retiree Drug Subsidy Center 6054 P.O. Box 7247 Philadelphia, PA 19170-0000 This address is for overpayment remittance only. No other correspondence received at this address will be considered. Instructions for satisfying an overpayment are also detailed in overpayment communications sent from CMS' RDS Center.

Upcoming RDS Deadlines

Reconciliations (plan year end | recon. due date)  06/2019 | 09/30/2020 07/2019 | 11/02/2020 08/2019 | 11/30/2020  Applications (plan year start | app. due date)  01/01/2020 | 10/02/2020 02/01/2020 | 11/02/2020 03/01/2020 | 11/30/2020 

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