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Select creditable/non-creditable coverage letters discontinued
The Medicare Modernization Act (MMA) requires employers (whose policies include prescription drug coverage) to notify Medicare-eligible policyholders whether their prescription drug coverage is considered creditable coverage. This notice provides important information regarding the prescription benefit currently provided as compared to the benefit available under Medicare Part D. In the past, we’ve notified employers of this information with a letter.
We are no longer issuing creditable/non-creditable coverage letters for ACA small groups and fully-insured large groups. This content will now be available on their renewal letter and/or CSA, and brokers may also reference the broker handbook for creditable/non-creditable coverage related to ACA small groups. However, we will still be issuing a letter to fully-insured KYP groups, Geisinger Funding Alternative (GFA) groups, self-funded groups and individual members.
It is the employer’s responsibility to notify Medicare-eligible employees of the notice and their creditable/non-creditable status.
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Reminder: Penn State Health and Hershey Medical Center are in-network
Last week we shared with you that Penn State Health is now part of our provider network. The contract includes St. Joseph Medical Center in Reading, Penn State Children’s Hospital, Hershey Medical Center and more than 2,000 physicians in 127 locations. This agreement applies to all lines of business except for some select self-funded clients. Penn State Health providers are included in the Premier network and Tier 1 in the Choices network.
Providers can be found online at here, or by downloading the participating hospital lists below.
Participating hospitals in the All Access network
Participating hospitals in the Premier network
Participating hospitals in the Choices network
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Geisinger opens new Childbirth Center in Scranton
Bouncing babies are back at Geisinger Community Medical Center with the opening of its new labor and delivery unit!
The Childbirth Center opened Oct. 10, 2019 and returns to the medical center a service it has not offered since 2007: maternity care for expectant mothers and babies. The $15 million center features eight spacious delivery and postpartum suites on the city hospital’s third floor designed to convey an open, home-like feel.
At the Childbirth Center, obstetrician/gynecologists and certified nurse midwives will work together to comfort and care for mothers-to-be and their babies, and expectant moms will be able to tailor their birth plans according to their preferences. Midwives will facilitate natural birth plans, and OB/GYNs will be on duty at all hours to intervene when needed.
A variety of pain management options will be available and if the unexpected occurs during a midwife-assisted birth, physicians will be ready to step in. Should the need arise, the Childbirth Center will work directly with the neonatal intensive care unit (NICU) at Geisinger Wyoming Valley Medical Center in Wilkes-Barre.
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How you can help reduce breast cancer risk
Even though breast cancer isn’t 100% preventable, there are steps you can take to reduce your risk of developing the disease, including adjusting certain lifestyle factors. How many have you accomplished?
- Reduce alcohol use
- Quit smoking
- Eat a healthy diet
- Maintain a healthy weight
- Engage in regular physical activity
- Be aware of your family breast cancer history
- Avoid hormone replacement therapy, if possible
- Perform a self-examination on a regular basis
- Have an annual mammogram, which is free to GHP members
- Consider breastfeeding
Source: American Cancer Society: Breast Cancer Fact Sheet
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News at-a-glance
- CMS announced an initial set of improvements to the new Medicare Plan Finder that will be rolled out ahead of the annual enrollment period on October 15, along with an overview video and pointer videos on plan results, pharmacy selection and adding prescription drugs.
- The Administration released two proposed rules to promote coordinated care and value-based arrangements by modernizing Medicare's Physician Self-Referral Law and the Federal Anti-Kickback Statute.
- The House and Senate will return from their two-week recess on Tuesday and are expected to focus the remainder of the fall on prescription drugs and surprise medical billing, with the House Ways and Means committee holding a hearing on prescription drug issues on Thursday.
This week's news courtesy of the National Association of Health Underwriters
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