Here is the latest edition of Model Consulting's Week in Review Newsletter. We
hope you find the Newsletter informative and helpful.
Your feedback is
extremely important to us. Please contact Tracy Duffield at 215.947.7167 or
tduffield@modelconsultinginc.com to share your ideas, comments
and/or suggestions. We look forward to hearing from you! |
 New
Employer CHIP Notice & Annual Medicare Part D Employer Disclosure to CMS
Important information concerning the CHIP notice
requirement for New Jersey, New
York and Pennsylvania. In addition, a reminder to complete the
annual disclosure requirement to CMS as it relates to Medicare Part D.
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AmeriHealth NJ: Network update
AmeriHealth
New Jersey has signed agreements with Haddon Emergency Physicians, Lourdes
Imaging Associates, Margate Diagnostic Center,
and Palisades Medical Center.
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AmeriHealth NJ: Select
Drug Formulary Update
Beginning
April 1, 2010, AmeriHealth will make some updates to the Select Drug Program®.
We would like to provide you with a list of our most recent changes to the drug
formulary, including a change in our preferred insulin.
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Horizon: Follow-up Q&As about Advantage Formulary
and DAW programs
Following the implementation of the Advantage
Formulary and Dispense As Written (DAW) programs, as communicated in December
2009, Horizon Blue Cross Blue Shield of New Jersey
would like to address several questions that are being frequently asked by the
broker community.
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Horizon:
Information about NJ Continuation and COBRA
On
December 19, 2009, Congress amended the original American Recovery and
Reinvestment Act (ARRA) by extending the eligible time period to be considered
involuntarily terminated from employment until February 28, 2010. Additionally,
the Act now provides a subsidy of 65 percent of the COBRA premiums for up to 15
months for eligible individuals.
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Horizon: Medicare Reporting Mandate
This
is a reminder that as of January 1, 2009, all group health plans must comply
with the reporting requirements found in Section
111 of the Medicare, Medicaid SCHIP Extension Act of 2007. The Centers for Medicare & Medicaid Services (CMS) use
this information to recover payments it made as primary when the Group Health
Plan (GHP) should have been primary and to prevent out-of-turn payments from
being made in the future.
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Horizon:
Multi-payer portal initiative
Horizon Blue Cross Blue Shield of New Jersey, along with other
health insurance carriers in New Jersey, has launched a landmark initiative to make
delivering and receiving health care easier for physicians and patients by
reducing administrative costs and time needed for claims processing.
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