NEWS & UPDATES

2001, 2017

January 20th, 2017|

CMS ANOC/EOC REQUIREMENTS
Avoid Fines & Penalties

YES, WE WANT TO AVOID
FINES & SANCTIONS

As detailed in section 60.7 of the Medicare Marketing Guidelines manual, all Plans/Part D Sponsors must send the ANOC/EOC (also referred to sometimes as “ANOC Mailings” or ANOC EOC Mailings, or ANOC and EOC Mailings) to Plan Members for receipt by September 30 of each year. New Enrollees with an effective date of October 1, November 1, or December 1, should receive both an EOC for the current contract year and an ANOC/EOC for the upcoming contract year. New enrollees with an effective date of January 1 or later must receive an EOC for the contract year of coverage. Additional materials may not be included in the ANOC/EOC mailing unless otherwise specified. Standalone EOCs do not need to be resubmitted in HPMS.

There are some exception as to the specific timing and the mailing sequence of components for the DSNP, COST, and Employer/Union Group Plans ANOC and EOC Mailings; but, the mandates from CMS regarding ANOC/EOC mailings are strictly enforced, and failure to comply can result in fines and enrollment sanctions for Plans. To ensure that Plans/Part D Sponsors are mailing their ANOC/EOC timely, Plans/Part D Sponsors must indicate the actual mail date in HPMS within three (3) days of mailing.

 

2807, 2016

July 28th, 2016|

TURNKEY SOLUTIONS – ANOC/EOC
PROGRAMMING PRINTING AND MAILING

YES, WE ARE INTERESTED

Direct Media Communications, Inc. (“DMC”) has been creating, printing, and mailing ANOC/EOC materials for Medicare Health Plans, including MAPD, DSNP, MMP, CSNP and COST Plans now for more than a decade. DMC has established a virtually flawless track record with on-time mailings and 100% accurate assembled/inserted package content.

DMC can assist your Plan with turnkey solutions, including Document Creation, Document Review, and the Variable Data Programming of multiple ANOCs and EOCs across multiple Plans to save both time and money for Plans operating in multiple markets. DMC has completed the ANOC and EOC development of 108 versions of these books for a single Plan using just 3 Basic Programmed Dynamic Variable Templates. DMC uses a Proprietary Program Data Grid solution to rip Plan benefits through the dynamic templates and thereby eliminate the tedious task of populating CMS Model Documents. Once DMC programs your Plan’s ANOC and EOC Templates, we can populate variations across hundreds of Plan versions in a matter of a single day.

Our competition wants to sell you a complex software program that still leaves your Plan responsible for developing its own materials. DMC’s Consultants and VDP Programming Team start with this year’s CMS Model Documents and then assist in the development of a Plan Benefit Crosswalk that is used to provide an automated solution to the development of ANOC and EOC documents. For substantially less than what our competition wants to charge for their software; with just spending a mere fraction of the price tag on their software solution, DMC will provide you with finished 2017 ANOC/EOC documents.

2807, 2016

July 28th, 2016|

CMS CHANGES RULES – READ THE NEW
DIRECTORY AND FORMULARY REQUIREMENTS
AVOID FINES & SANCTIONS

YES, WE WANT TO AVOID
FINES & SANCTIONS

Equally as important as the ANOC/EOC Mailings, CMS is now requiring monthly updates of Plan Provider Directory books, Pharmacy Directory books and Formulary books. The 2017 Final Call letter to Medicare Advantage Organizations continued to emphasize the importance of material accuracy in Formularies and Plan Provider/Pharmacy Directories. The increased monitoring and enforcement actions especially as to Provider Directories and Pharmacy Directories has been launched due to preliminary data collected by the PNA (Pilot Program) that found severe violations with the Part D and Part C requirements. For example, 1/3 of the psychiatrists listed by a New York Health Plan as Plan Providers were in fact not affiliated with that Plan. CMS has made it clear that it will be issuing fines and enrollment sanctions against Plans that do not keep these materials updated on a monthly basis.

CRITICAL CMS UPDATE

Medicare Managed Care Manual

Chapter 4 – Benefits and Beneficiary Protections:

110.2.2 – Provider Directory Updates (Rev. 121, Issued: 04-22-16, Effective: 04-22-16, Implementation: 04-22-16)

Section 110.2.2

“If new information is received – MAO’s are expected to update hardcopy provider directories…. every 30 days.”

2807, 2016

July 28th, 2016|

PROGRAMMED PDs, Pharmacy PDs and
Formularies in Just 24 Hours
Print & Mail Books on a Next Day Basis

TELL ME MORE ABOUT
24 HRS. DIRECTORY UPDATES

DMC has developed Proprietary Provider Directory, Pharmacy Directory and Formulary software update programs through which DMC can provide monthly updates to your Plans books in just 24 hours, with no hourly assembly/document creation fees; DMC bills a flat page rate for its program solutions. Just pick up and the phone and by the next day you could have updated Provider Directories, Pharmacy Directories, and Formularies. Plus, DMC provides Translation Solutions and 508 Remediation Solutions on an as needed basis. First time programming of books does require an initial 6.7 hour programming charge in addition to the flat page rate charge; but, all subsequent updates are billed strictly on a flat page rate basis. DMC also offers a Next Day fulfillment program for the mailing of Provider Directories and Pharmacy Directories. Call us today for the most competitive programming rates in the nation.

2807, 2016

July 28th, 2016|

100% Fully Integrated Perfect Bound
Pre-Enrollment Kits (“Welcome Kits”) Get Rave
Reviews from Your Agents & Increase Membership

PLEASE TELL ME MORE

DMC has developed a unique production methodology for the creation of Perfect Bound Pre-Enrollment Kits (PEKs) containing all CMS mandated and Plan requested PEK components for our Health Plan customers. Prior to DMC’s entrance into the Medicare Health Plan market, we are not aware of any Medicare Health Plan that was using 100% fully integrated perfect bound Pre-Enrollment Kits. Multiple paper types, finishes and paper weights are perfect bound into a single book with perforated, removable copies of all Plan and Agent documents such that the Pre-Enrollment Kit becomes a leave behind book with all Member required documents left bound into the book. These attractive PEKs include components such as:

  • Welcome Letter
  • Benefit Highlights Color Pages
  • Summary of Benefits
    • How to Enroll Instruction Forms
    • Scope of Sales Appointment Confirmation Form
  • Enrollment Application Instructions
  • Individual Enrollment Request Form (multiply carbonless form with (a) Plan Copy, (b) Agent Copy, and (c) Leave Behind Member Copy that Stays in Book
  • Star Ratings Page
  • Utilization Procedure Form
  • Privacy Notice Form
  • Perforated & Removable #9 Reply Envelope

Pre-Enrollment Kits (Welcome Kits) – Available through the Corporate Portal Print-On-Demand Solution in just 3 -4 Business Days (minimum order 250 PEKs) […]