Section I Parts C and D Annual Calendar
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1 Section I Parts and Annual alendar Below is a combined calendar listing of key dates and timelines for operational activities that pertain to Medicare Advantage (MA), Medicare Advantage- Prescription rug) (MA-P), Prescription rug Plan (PP), Medicare-Medicaid Plan (), and cost-based plans. The calendar provides important operational dates for all organizations such as the date bids are due to MS, the date that organizations must inform MS of their contract non-renewal, and dates for beneficiary mailings. *Note: The dates listed under Part include MA and MA-P plans. The dates listed under Part also apply to MA and cost-based plans offering a Part benefit. January 1 February 14, January 9, January 10, January Annual 45-ay Medicare Advantage isenrollment Period (MAP). Release of ontract Year Y 2019 Initial and Service Area Applications for MA/MA-P/PP,, SNP, EGWP, and 1876 Plan Expansions. MO Renewal Submission period begins for SNP MOs with approvals ending 12/31/. Industry Training and Technical Assistance for Y 2019 Model of are (MO) Submissions. January Industry training on 2019 Applications. Y 2019 Initial and Service Area Expansion Application Management System (HPMS) by 8pm EST. February 14, for MA/MA-P/PP,, SNP, EGWP, and 1876 Plan Expansion are due in the Health Plan February 14, Late February, February, February, March 16, MO Renewals Submissions for SNP MOs with approvals ending as of 12/31/ are due in HPMS by 8pm EST. Submission of meaningful use HITEH attestation for qualifying MA Employer Plans and MA-affiliated hospitals. MS releases instructional memo concerning updates to Parent Organization designations in Release of draft Y 2019 Formulary Reference File (FRF). Parent Organization Update requests from MAOs and sponsors due to MS (instructional memo released in February ). Mid-Late March, Release of Y 2019 Formulary Reference File (FRF). March 30, Release of the Fiscal Soundness Module in March/April, MS coordinates with MAOs and PP Sponsors to resolve low enrollment issues for Y Page 1 of 7
2 *Note: The dates listed under Part include MA and MA-P plans. The dates listed under Part also apply to MA and cost-based plans offering a Part benefit. Early April, Early April, April 2, April April 6, April 10, Mid-April, April 16, April 18, Late April, April 30, May, Early May 2017 May, May 4, May 14, Y 2019 Out Of Pocket (OOP) model and OOP estimates for each plan made available to MAOs, 1876 cost plans submitting MA conversion bids, and Part sponsors for download from the MS website. Information will assist plans in satisfying MA and Part requirements, such as meeting meaningful difference (if applicable) and Total Beneficiary (TB) requirements prior to bid submission. Information about renewal options for Y 2019 (Including HPMS crosswalk charts) provided to plans. Release of the 2019 Final Announcement of Medicare Advantage apitation Rates and MA and Part Payment Policies released, including the Y all Letter. onference call with industry to discuss the Rate Announcement and Y all Letter. Release of the Y 2019 Plan reation Module, PBP, and Bid Pricing Tool (BPT) software in eadline for MAOs and cost plans to submit requests for full contract consolidations for Y. Release of HPMS Memo: ontract Year 2019 Medicare Advantage Bid Review and Operations Guidance. Release of the Y 2019 Medication Therapy Management (MTM) Program Submission in HPMS (11:59 p.m. PT). Industry training on Y 2019 Part Formulary and Benefit Submission/ompliance Training. Total Beneficiary data for Y 2019 Bid Preparation Release. eadline for submission of Y 2019 MTM Programs from all sponsors offering Part including Medicare- Medicaid Plans (except those participating in the Enhanced MTM Model test) (11:59 p.m. PT). Final ANO/EO, LIS rider, Part EOB, formularies, transition notice, provider directory, pharmacy directory, and models for Y 2019 available for all organizations. MA, MA-P and PP plans to notify MS of intention to non-renew, as applicable, a county (ies) or region(s) for individuals, but continue the county (ies) or region(s) for 800 series EGWP members, convert to offering employer- contracts, or reduce its service area at the contract level. This will allow MS to make the required changes in HPMS to facilitate the correct upload of bids in June. Medicare Advantage & Prescription rug Plan Spring onference & Webcast. Release of the Y 2019 Bid Upload Functionality in eadline for submission of Y 2019 MTM Program attestations in HPMS (11:59pm PT). Page 2 of 7
3 *Note: The dates listed under Part include MA and MA-P plans. The dates listed under Part also apply to MA and cost-based plans offering a Part benefit. Release of Y 2019 Formulary Submission Module in May 14, Release of Y 2019 Actuarial ertification Module in May 18, Mid-Late May, Plans/Part sponsors begin to upload agent/broker May 25, compensation information in Release of the Y 2019 Marketing Module in June 1, Plans/Part sponsors begin to submit 2019 marketing Release of Y 2019 Formulary Reference File Update. materials. Mid to late Release of the Y 2019 Medicare Marketing Guidelines in June, MS sends qualification determinations to applicants Late May, based on review of the Y 2019 applications for new contracts or service area expansions. June Release of state-specific marketing guidance for s. May 31, Release of the 2017 IR Submission Module in eadline for submission of Y 2019 bids (including Service Area Verification) for all MA plans, MA-P plans, PP, cost-based plans offering a Part benefit, Medicare-Medicaid Plans (s), 800 series EGWP and direct contract EGWP applicants and renewing organizations; deadline for cost-based plans wishing to appear in the 2019 Medicare Plan Finder to submit PBPs (11:59 p.m. PT). eadline for submission of Y 2019 Formularies, Transition Attestations, Prior Authorization/Step Therapy June 4, (PA/ST) Attestations, and P&T Attestations due from all sponsors offering Part including Medicare-Medicaid Non- Plans (11:59 p.m. PT). bid eadline for submission of a Y 2019 contract non- related renewal, service area reduction via HPMS from MA plans, items MA-P plans, s, PPs and Medicare cost- based contractors and cost- based sponsors to eadline also applies to an MAO that intends to terminate a current MA and/or MA-P plan benefit package (i.e., Plan 01, Plan 02) for Y Early June to Late August, MS completes review and approval of Y 2019 bid data, to include pricing, plan benefit packages, and formularies. Plans/Part sponsors submit attestations, contracts, initial actuarial certifications, and final actuarial certifications. June, June 8, Window for submitting first round of crosswalk exception requests through eadline for submission of Y 2019 Supplemental Formulary files, Free First Fill file, Partial Gap file, Excluded rug file, Over the ounter (OT) drug file, and Home Infusion file through HPMS (11:59 a.m. ET). Page 3 of 7
4 *Note: The dates listed under Part include MA and MA-P plans. The dates listed under Part also apply to MA and cost-based plans offering a Part benefit. eadline for submission of Medicare Advantage Value Based Insurance esign (VBI) file (Only applicable to June 8, Medicare Advantage Plans that have been preapproved for Part VBI benefits) (11:59 a.m. ET). eadline for submission of Additional emonstration June 8, rug (A) file (s ) (11:59 a.m. ET). MA and PP Audit and Enforcement onference June, and Webcast. MS sends an acknowledgement letter to all MA, MA- Late June, P,, PP and Medicare cost-based plans that are non-renewing or reducing their service area. Early July, 2019 Plan Finder pricing test submissions begin. Early July, eadline for -SNPs to upload required State Medicaid Agency ontract and ontract Matrix to Early July, eadline for -SNPs requesting to be reviewed as Fully Integrated ual-eligible (FIE) SNPs to submit their FIE SNP Matrix to July 5, 2017 Plans deadline to submit non-model Low Income Subsidy (LIS) riders to the appropriate Regional Office for review. Mid July, Release of Y 2019 FRF Update in advance of the Limited Formulary Update Window. Mid-Late July, Y 2019 Limited Formulary Update Window. Late July, Submission deadline for agent/broker compensation information via July Second window for submitting HPMS crosswalk exceptions. Late July / Early August, MS releases the 2019 Part national average monthly bid amount, the Medicare Part base beneficiary premium, the Part regional low-income premium subsidy amounts, the Medicare Advantage regional PPO benchmarks, and the de minimis amount. Late July / Early August, No Later Than July 29, August 1, August 17, August 16-20, Rebate reallocation period begins after release of the above bid amounts. MS informs currently contracted organizations of its decision to not renew a contract for Plans expected to submit model Low Income Subsidy (LIS) riders in eadline for organizations to complete the plan connectivity data in HPMS to ensure timely approval of contracts. Y 2019 preview of the Medicare & You plan data in HPMS prior to printing of the MS publication (not applicable to EGWPs). August 22-24, First Y 2019 Medicare Plan Finder (MPF) Preview and Out- of-pocket (OOP) Preview in MPF Page 4 of 7
5 *Note: The dates listed under Part include MA and MA-P plans. The dates listed under Part also apply to MA and cost-based plans offering a Part benefit. August 31, Late August, End of August/Early September, Early September, Mid- September, September 4-7, September 16-30, Late September, Late September, September 30, October 1, Y 2019 MTM Program Annual Review completed. ontracting Materials submitted to MS. Plan preview periods of Part & Star Ratings in MS begins accepting plan correction requests upon contract approval. All contracts fully executed (signed by both parties: Part /Part Sponsor and MS). Second Y 2019 Medicare Plan Finder (MPF) Preview and Out-of-Pocket (OOP) Preview in MS mails the 2019 Medicare & You handbook to Medicare beneficiaries. -SNPs that requested review for FIE SNP determination notified as to whether they meet required qualifications. eadline for Part sponsors, cost-based, MA and MA- P organizations to request a plan correction to the plan benefit package (PBP) via eadline for plans to provide the following documents to current enrollees: Standardized Annual Notice of hange/evidence of overage (ANO/EO) for all MA, MA-P, PP, and cost-based plans (including those not offering Part and those that do offer Part ). The multi-language insert should be sent with the ANO/EO and the SB. Standardized ANO with the Summary of Benefits for - SNPs and s that choose to separate the ANO from the EO. Abridged or comprehensive formularies LIS rider Pharmacy/Provider directories The documents identified above are the Y 2019 documents permitted to be sent prior to October 1,. Organizations may begin marketing their Y 2019 plan benefits. Note: Once an organization begins marketing Y 2019 plans, the organization must cease marketing Y plans to anyone other than beneficiaries who are eligible for valid enrollment (e.g. age-ins and special enrollment periods (SEP)). Organizations may still provide Y materials upon request, conduct one-on-one sales appointments, and process enrollment applications. MPF Page 5 of 7
6 *Note: The dates listed under Part include MA and MA-P plans. The dates listed under Part also apply to MA and cost-based plans offering a Part benefit. Tentative date for Y 2019 plan and drug benefit data to October 1, be displayed on Medicare Plan Finder on Medicare.gov (not applicable to EGWPs). The final personalized beneficiary non-renewal notification letter must be received by PP, MA plan, MA-P plan, and cost-based plan enrollees. October 2, PPs, MA plans, MA-P plans, s and cost-based organizations may not market to beneficiaries of nonrenewing plans until after October 2,. October 11, Part & Star Ratings go live on medicare.gov on or around October 11,. October 15, Part sponsors must post prior authorization and step therapy criteria on their websites for Y October 15, Mid October, November 12, Early November, Late November, ecember 1, ecember 7, Mid ecember, ecember 31, Annual Election Period begins All organizations/sponsors must hold open enrollment (for EGWPs, see hapter 2 of the Medicare Managed are Manual, Section 30.1). Release of the online Y 2020 Notice of Intent to Apply for a New ontract or a ontract Expansion (MA, MA- P,, PPs, and 800 series EGWPs and irect ontract EGWPs). Notices of Intent to Apply (NOIA) for Y 2020 due for MA and MA-P plans,, PPs, and 800 series EGWPs and irect ontract EGWPs. First display of Plan Finder data for sponsors/ma organizations that submitted a plan correction request after bid approval. Part & display measures data are posted in HPMS for plan preview. -based plans must publish notice of non-renewal, as per of Title 42 of the FR. Page 6 of 7 End of the Annual Election Period. Part & display measures data on cms.gov updated. eadline for s that separated the ANO from the EO to provide the EO to enrollees. January 1, 2019 Plan Benefit Period Begins. January 1 Annual Medicare Advantage Open Enrollment Period March 31, 2019 (MA OEP). January 2019 Release of Y 2020 MAO/MA- P//PP/SAE/EGWP applications. January, 2019 Industry training on Y 2020 applications. February 2019 Applications due for Y June 3, 2019 Y 2020 eadline for bid and formulary submission. Nonbid related items
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