Care Improvement Plus « Neishloss & Fleming Inc.

Care Improvement Plus: Medicare Advantage

New Agent Contracting: 2011 - Care Improvement Plus - New Agent Contract

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Care Improvement Plus News

February 9th, 2012

UnitedHealthcare Acquisition of XLHealth Completed

UnitedHealthcare has announced that they have completed their acquisition of XLHealth, which is the parent company of Care Improvement Plus, in a statement today. The original acquisition agreement was completed in November of 2011. This deal seems to signal that UnitedHealthcare will look to increase its presence in the Chronic Illness SNP market, a segment that they have deemphasized over the past few years. It will also potentially strengthen their Dual Eligible SNP delivery system, one of the strengths that Care Improvement Plus has displayed over last 3 years.

The full details on this can be read on the Market Watch website.

There has still been no firm plan given to distribution about the integration of the XLHealth broker distribution with UnitedHealthcare’s existing field force. If this acquisition is handled as recent others have been — Unison, Americhoice, Physician’s Health Choice — agents will need to be contracted with UnitedHealthcare in order to sell.

As a Field Marketing Office (FMO) for both UnitedHealthcare & Care Improvement Plus, Neishloss & Fleming is positioned to assist our agent regardless of which integration plan is selected. Agents can view contracting or product information for both carriers on their corresponding product pages.

October 20th, 2011

CMS Issues Change in Enrollment Period Guidance

UnitedHealthcare has provided us critical information concerning changes in how they are dealing applications & enrollments moving forward during the AEP. In the recently released Centers for Medicare & Medicaid Services (CMS) 2012 enrollment and disenrollment guidance, CMS issued a change that could result in denied enrollments and affect your commissions when enrollment application forms are not completed accurately and completely.

In order for an MA organization to accept an election, a valid request must be made during an election period. It is the responsibility of the organization to determine the election period of each enrollment or disenrollment request. To make this determination, the organization may need to contact the individual directly. The plan may incorporate specific statements regarding eligibility of an election period with the enrollment or disenrollment request. However, if this information is not provided with the request, the plan must attempt to contact the individual by phone or other communication mechanism, and determine within the ten (10) day requirement if she/he is eligible to make an election at that time.

Though the CMS regulations state that the health plan has 10 days to contact the consumer and determine if they are eligible for the election period, it was later clarified and confirmed by CMS to be 7 calendar days, and the 10 day guidance was in error.

For full details on how this change could affect you, please read 2011 - CMS Change to Enrollment Timeline Guidance (89)

September 16th, 2011

Medicare Advantage Premiums Drop, Enrollment Rises

An article today in the USA Today discusses interesting items about Medicare Advantage plan enrollments and premiums, showing that in spite of the reduced reimbursements in the Health Care Reform package Medicare Advantage seems to be thriving. The article, written by Kelly Kennedy, emphasizes “the private sector’s ability to lower costs on its own.”

You can read the whole article on USA Today’s website.

February 23rd, 2011

CMS Announces Preliminary Information for 2012

CMS has recently released information regarding the 2012 Medicare Part D & Medicare Advantage plans. This information also includes preliminary figures on the benefit amounts and cost sharing for 2012 Part D plans. If you are working with Medicare recipients, you probably want to read the announcement.

There was also a news release in the Courier-Journal that CMS will be preliminarily increasing Medicare Advantage reimbursements by 1.6% for 2012. This is excellent news, as the expectation had been that the reimbursements would either remain flat or decrease for next year. You can read the full article here.

February 18th, 2011

MA Plan makes “HouseCalls” to Members

For many of your Medicare clients, the weeks directly following a hospitalization can be a challenging time. Coping with new medications, follow-up appointments and caring for escalated health issues is often difficult to manage.

In recognition of these issues, Care Improvement Plushas launched a new arm of its HouseCalls program providing hospitalized high risk members with free in-home doctor or nurse practitioner visits following their discharge from the hospital. Once the member returns home, doctors and nurse practitioners complete a thorough assessment pertaining to common post-hospitalization issues. The information is fed back to Care Improvement Plus’ clinical team responsible for ongoing member support and communication with primary care and specialist providers.

Common issues identified among members after leaving the hospital include obtaining and understanding newly prescribed medications, scheduling home health care visits, and ensuring necessary medical equipment is ordered. Care management services such as the HouseCalls program allow for direct assessment and coordination of a member’s health needs. This program is an extension of the existing HouseCalls assessment offered to all Care Improvement Plus members.

Neishloss& Fleming Inc.