Description: This article discuss the historical regulation and changes to the Medicare Physician Fee Schedule - MPFS.

Description: Conditions and required solvency standards of federal waiver to PSOs to provide Medicare+Choice products. Effect on providers, beneficiaries and employers. Issue No. 36

Description: The presentation discusses the history of the Medicare+Choice [M+C] program and the challenges faced by plans offering the program, as well as the challenges faced by those interested in entering the program. From the Record of the Society of Actuaries, Volume 28, No. 2, Session 60

Description: This article provides an introduction to the Medicare Prescription Drug, Improvement and Modernization Act of 2003 and looks at how the Medicare prescription drug plan will affect the commercial market as well as, what PDPs will offer for benefits and if any will offer supplemental benefits. From Health Section News, March 2005, Issue No. 49.

Description: Panelists explore issues facing carriers of Medicare Supplement products, including high trend, fixed designs, limited underwriting ability, legislation, National Association of Insurance Commissioners [NAIC] pursuits, and the American Academy of Actuaries [AAA] task force. From the Record of the Society of Actuaries, Volume 27, No. 1, Session 66

Description: In session 26PD of the 2004 Valuation Actuary Symposium, discussed is how the new Medicare prescription drug legislation creates a number of issues for employers and managed-care plans. Employers must determine the impact of the legislation on their retiree prescription drug costs, evaluate options for plan design and make decisions about how to reflect the effect of the legislation in their FAS 106 valuations. Managed-care plans need to review the effect of the legislation on plan design, statutory filings and financial reporting for their Medicare products.

Description: Two Medicare risk funding provisions that were radically changed by the BBA of 1997 funding variations by geographic area and risk adjustment. Issue No. 36

Description: Provides background about Prescription Drug Plans, PDPs, and the standard benefit package offered under Medicare Part D. It also provides a basic overview of the bid-development process for a PDP and summarizes some general strategies and observations used in developing the 2006 bids that will likely be used for 2007.

Description: This article discusses Medicare cost, specifically the hospital utilization rate and the average daily cost of hospitalization and the effect of Medicare on the great increases in health care costs since 1965.

Description: Issue No. 36. Issues relating to Provider Sponsored Organizations PSOs contracting with HCFA to sponsor Medicare + Choice. Article discusses revenue and the addition of non-Medicare covered benefits.