How CMS' Notice Affects Medicare Advantage Organizations

Law360, New York (February 27, 2017, 10:19 AM EST) -- Jon Biasetti

Benjamin P. Sykes On Feb. 1, 2017, the Centers for Medicare & Medicaid Services, in connection with its 2018 advance notice, advised that quota share reinsurance arrangements are not a statutorily permitted form of reinsurance for Medicare Advantage organizations (MAOs) with respect to Medicare Part C business (CMS advised that the limitations on reinsurance do not apply to Part D (Medicare prescription drug coverage) plans, including the Part D portion of a MA-PD plan).

CMS stated in the notice that "Section 1855(b) [of the Social Security Act of 1935 as amended (the Act) (42 U.S.C. 139w-25(b))] provides four categories...

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