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Medicare Compliance

CMS is the federal agency that regulates the Medicare program, including Medicare Part C and D, markets you may be assisting beneficiaries with coverage recommendations. NAHU will post compliance issues or other information you need to know as a Medicare specialists serving Medicare beneficiaries. If there is an issue or concern, you can contact us here.

NAIC and Medigap C & F

NEW! The Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”) prohibits new sales of Medigap Plans C and F for newly eligible beneficiaries beginning in 2020. NAIC outlines model regulation deadlines and requirements to states effective January 1, 2020.

Medicare Plan Finder Updates from CMS

A first phase of improvements has been announced by CMS for the Medicare Plan Finder!

NAHU has been working continuously to advocate for improvements to the new Medicare Plan Finder, and CMS appreciates the comments they’ve received on the new tool. They are continuing to work on improvements for the upcoming Annual Enrollment Period, and have already announced a few updates to the system. More updates are expected in the coming weeks.

CMS released updated Q&As, now with this list of MPF improvements that are planned to be in place by the start of AEP on October 15, 2019:

  • Display drug tier costs
  • Link directly from to new Plan Finder
  • Integrate partial gap coverage into cost sharing
  • Adding Original Medicare info and card for comparison
  • Add sort option for total cost (plan premium + drug costs)
  • Add footnote for excluded drugs
  • Maintain filters and SNP selections when using back button
  • Add option to add mail order on pharmacy selection page
  • Refine the ZIP code entry process
  • Show distinction between preferred in-network versus in-network pharmacy on the Costs-by-Phase table
  • Add note about over-the-counter drugs to drug lookup page
  • Add option to compare a third retail pharmacy when mail order isn’t selected
  • Improve Print Format
  • Various backend technical updates to prepare for display of 2020 plans

CMS has added several new resources to the Plan Finder page on their National Training website and encourage you to access these for information and training.  A few highlights to note: