tci Medicare Compliance & Reimbursement - 2005 Issue 15

DRUG BENEFIT: PDP Sponsors Face Pricing Challenges

Projected enrollment tied to national average.According to information presented by Medicare Payment Advisory Commission staff analysts at the panel's March 10 meeting, Part D bidding is about to get a lot more interesting. MedPAC's analysts said beneficiaries should expect to see a wider variation in plan premiums. According to MedPAC analyst Rachel Schmidt, enrollee premiums will vary more in percentage terms than the plans' bids to Medicare. CMS will calculate premiums by calculating a national average bid based on the bids submitted by risk-bearing plans. The national average will be weighted by each plan's projected enrollment, Schmidt...

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