Adapting to the Latest Regulations:
A Breakdown of CMS’ 2024 MA and Part D Final Rule Changes for Agents
Stay on top of Medicare compliance changes. Find out more about the 2024 MA and Part D rule changes in our agent-focused breakdown.
The Centers for Medicare & Medicaid Services (CMS) has recently released the final rule for Contract Year 2024, outlining key changes that will impact sales processes. It is important to understand these changes, as failure to comply with the new regulations can lead to significant consequences for your business. Changes will take effect on September 30, 2023.
Here is what you need to know,
City of Hope’s CIO Talks About Using Technology in Cancer Care
Jennifer Greenman discusses how to leverage technology already in place for cancer care needs, as well as City of Hope’s acquisition of CTCA.
In February 2022, CTCA was acquired by City of Hope, a National Cancer Institute (NCI)-designated comprehensive cancer research and treatment organization based in California, with the goal to democratize cancer care and research. The combined system is one of the largest cancer research and treatment organizations in the country, reaching cancer patients and their families in California, Arizona, Illinois, and Georgia.
With 385M patient records exposed, cybersecurity experts sound alarm on breach surge
Cybersecurity experts say healthcare companies must harden their defenses, but it may require regulators and lawmakers to raise the bar on security standards.
Healthcare companies more than ever are using electronic records and tapping digital services. That’s also creating more opportunities for cybercriminals — who already have exposed the private medical information of millions of patients — and bolsters the case for the industry to make security priority No. 1, experts say.
Sponsored by AGA
Report: MA Enrollment Increases to Half of All Eligible Medicare Beneficiaries
Out of 59.82 million people with Medicare Part A and Part B in January 2023, 30.19 million people were enrolled in Medicare Advantage plans, the Kaiser Family Foundation found in a recent analysis.
Medicare Advantage enrollees now account for just over half of all Medicare beneficiaries for the first time in history, a recent analysis found. The Kaiser Family Foundation (KFF) report, published Monday, relied on data from the CMS Medicare Advantage Enrollment files and the CMS Medicare Enrollment Dashboard.
KFF found that out of 59.82 million people with Medicare Part A and Part B in January 2023, 30.19 million people were enrolled in Medicare Advantage plans, which are offered by private insurance companies.
SAVE THE DATE:
2023 Senior Summit: #Exploring the Medicare Jungle
August 22 – August 24, 2023
Pechanga Resort & Casino, CA
For more information click here
Sponsored by Word&Brown
Federal Judge Strikes Down ACA Requirement for $0 in-network preventive care for certain services
The Affordable Care Act (ACA) requires ACA-compliant plans to cover preventive care services at 100%, with zero out-of-pocket costs for the insured, when benefits are rendered in-network. This encourages ongoing engagement with one’s primary care physician, with a goal of identifying health concerns early – ultimately contributing to reduced costs, lower premiums, and better care.
The listing of preventive services to be covered at 100% is comprised and defined by four expert medical and scientific bodies. One of those is the U.S. Preventive Services Task Force (USPSTF). The other three are The Advisory Committee on Immunization Practices (ACIP), the Health Resources and Service Administration’s Bright Futures Project, and the Institute of Medicine’s Committee on Women’s Clinical Preventive Services.
Employers aren’t satisfied with payers’ mental health coverage
A survey finds health plans have room for improvement in areas such as having accurate behavioral health directories.
Nearly all employers agree that mental health coverage is a vital component of benefits offered to employees, but few are satisfied with their health plan’s services, according to a survey by the National Alliance of Healthcare Purchaser Coalitions.
The organization polled 221 employers that provide health coverage to over 10 million employees and dependents from February to March 2023 to gauge experiences with coverage networks.
Understanding Mental health and Wellness Is Important for Brokers
All ACA Medical Plans have Mental Health benefits. Most members of health plans are waiting on average 1 to 2 months for an appointment. We brokers need to know the laws and be advocates to our clients.
California law requires health plans to provide timely access to care. This means that there are limits on how long you have to wait to get health care appointments and telephone advice.
If you have a problem getting timely access to care, you should call your health plan. If your plan does not resolve your problem, contact the Help Center. (https://www.dmhc.ca.gov/healthcareincalifornia/yourhealthcarerights/timelyaccesstocare.aspx).
Also, there is a federal hotline 988 billed as an alternative to 911 for people experiencing mental health emergencies. Here, advocates say the shortcut will make it simpler for people in crisis to tap into the state’s network of 13 National Suicide Prevention Lifeline call centers. https://www.samhsa.gov/find-help/988
CVS closes $10.6B acquisition of Oak Street Health to expand primary care footprint
CVS Health has sealed the deal on its acquisition of Oak Street Health, picking up about 169 medical centers in 21 states.
The acquisition will broaden CVS Health’s value-based primary care platform and significantly benefit patients’ long-term health by improving outcomes and reducing costs – particularly for those in underserved communities, according to the company in a press release Tuesday.
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Earning up to half of your CE Credits for your California residence license renewal is actually very easy.
7 (work) days. 12 courses. 1 unmissable event. How many CE Credits will you earn?
June 15,2023 — June 23,2023
EXIT PLANNING FOR BUSINESS OWNERS
Sponsored by Strazzeri/Mancini
Welcome to the Southern California Institute
Watch our video to learn more about the Southern California Institute
The Southern California Institute provides high-quality, collaborative educational and informational events, relying on experts who are active in their profession. This collaboration enables the Institute to consistently present materials in a team-teaching environment. As a result, participants are able to gather the best facts, opinions, judgments, and perceptions from diverse, reliable sources.
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Sponsored by Commission Solutions
Planning to Exit Your Commission-Based Business?
Sharing success with a colleague can pay off big
By Phil Calhoun
Preparing for a life change that involves transitioning your hard-earned commissions and loyal clients? Sharing your success with a colleague can be a great solution. While each situation is unique, a common exit path begins with conversations with industry colleagues about your intentions to sell your commissions to someone who will continue to take good care of your clients. These exploratory conversations usually lead to connecting with experienced sales solution providers. Many opportunities may present themselves, and I recommend considering all your options.
Special thanks to Russ Williams for his new Professional Development contributions twice a month for California Brokers.
His “Letters on Integrity” will explore the themes of Integrity. Readers may explore these themes directly with Russ as he offers a mentoring opportunity through
The Clarity Conversation
“Letters on Integrity”
I practice mutual respect as I meet with both success and failure “What kind of person, work, citizen do I want to be?”
In his seminal work, Frames of Mind, written in 1983, Howard Gardner presented research into the theory of multiple intelligences. Many years later in 2007 Gardner was the featured interview in Harvard Business Review. He wrote about his continuing work, distinguishing five types of cognitive minds, the most refined of which Gardner described as the Ethical Mind.
- May 23 @ 12:30pm- 4:30 pm, GAAHU CE & Wine Tasting, Livermore. Register
- May 22-25 @9:30 am – May 25 @ 1:30 pm, CAHIP-San Diego Chapter, CE Week, Register
- June 7 @ 10:00 am – 7:00 pm, SDAHU Annual Summer Classic Golf Tournament, Poway. Register
- June 12 @ 9:30 am – 5:00 pm, IEAHU Richard Hawkins Memorial Annual Golf Tournament, Riverside, Register
- June 15 @ 9:00 am- 11:00 pm, GAAHU Annual Member Meeting/Board Election, Walnut Creek. Register
- May 8-10, CAHIP Capitol Summit, Sacramento. Register
- May 16 @ 8:00 am-3:00 pm PST, 32nd Annual IEAHU Sales Symposium E3: EARN; ELEVATE; EVOLVE. Register
- May 16-17 @ 9:00 am-5pm, Digital Health 2023, San Diego, Register
- May 18 @ 7:30 am-2 pm PST, CAHIP Desert Cities Health Care Summit, Palm Valley Country Club Palm Desert, CA. Register