Medicare Part D brief

Date: September 28, 2014
Location: College Park, MD

Website Assessment Tool

• Developed organizational website content assessment tool to include all Part D content requirements.

• Identifies areas where plans are compliant or need further clarification of posted information.

• Complete data is collected and provides CMS with a vast amount of data regarding Part D websites and compliance to guidelines.

Website Scanning

• Reviewing many different websites to ensure compliance with CMS guidelines.

• Multiple reviewers for each plan to ensure consistency in reporting.

• Training involving test reviews of actual websites before taking part in live reviews.

Real-Time Framework

• Use QuickBase© to allow task order managers to see status of tasks and identify critical pathways that require monitoring.

• Biweekly calls with CMS to ensure consistent communication in addition to frequent e-mail and/or

• Monthly reporting to ensure efficient progress on project.

About the Website Monitoring of Part D Benefits Contract

 

The Centers for Medicare & Medicaid Services (CMS) has broad oversight of plans that offer prescription drug coverage to Medicare beneficiaries. This oversight includes assessing whether the marketing tools that plans use to attract enrollees and to inform beneficiaries about benefits, coverage limitations, and plan changes comply with the guidelines governing marketing materials. CMS contracted Optimal Solutions Group, LLC (Optimal), to determine whether the content that appears on websites for Medicare prescription drug plans meets the compliance requirements established in the June 7, 2012, Medicare Marketing Guidelines (MMG). The goal of the contract is to monitor the plans’ compliance with the MMG to assist Medicare beneficiaries (i.e., sponsor members, prospective enrollees) and their health-care providers in navigating the plans’ websites.

Optimal performs an annual systematic review of sponsor websites (CMS provides plans to be reviewed) to determine their compliance with the MMG. To perform this review, Optimal has developed the Organizational Website Content Assessment Tool, an online tool that allows reviewers to assess the content on the plans’ websites according to the MMG requirements. Per the contract with CMS, after completing the annual assessment, Optimal provides a report that includes the findings and compliance outcomes of the reviewed websites. CMS uses these findings at its discretion to send e-mail notifications, warnings, or noncompliance letters to plans, notifying them of areas that need to be improved. After CMS sends these notifications, Optimal reassesses a subsample of up to 25 percent of the websites originally examined and prepares a report (in draft and final form) for CMS that contains the reassessment findings.